The current hospital / A&E crisis

NIMAN

Appreciate that our hospitals are under resourced and under staffed, but why do I never hear any of the presenters, interviewers or columnists address the elephant in the room in this crisis?

The fact that the vast vast majority of people sitting clogging up A&Es around the country don't need to be there.

Heard a consultant on Morning Ireland say that typically 5% of people in A&E actually need to be there. That's a shocking stat and explains why we are in such a mess.

I know people are going to say they can't see a GP, but where we are, getting a GP appt isn't a big issue. Can people genuinely not get GP appts?

How much free time must you have to waste that you'd sit in a hospital for a few days, only to be sent home with some paracetamol.

Gatling

You can't get a gp appointment and when you do they refer you to a&e ,

Parents are dragging their kids to a&e because A - they can't get a gp appointment

B- they are convinced a slight tempature means their child is has Strep A ,

I recently had 19 hour wait in a&e with post surgery complications and the absolute majority of the 100+ other people didn't have an serious injuries,but had everything from headaches to sore throat's, none wholm should have been admitted to a&e to clog up yhe the system.

Start making people actually pay on arrival(unless it's an actual emergency) and the numbers will fall dramatically and push the time wasters back to gp surgeries,

Even better bring the army back like they did during covid testing,for pre assessments before being admitted to a&e ,don't need urgent care sorry we're referring you to your gp ,

This keeping a&e free from time drains

Northernlily

I don't think they should be let off the hook this time round. The health service for all the money pumped into has been an absolute **** show for 20 years plus now.

Its not washing with me at all and I don't know how we are not on the streets over it. Far too apathetic as a nation! People are dying unnecessarily.

recode the site

I remember getting into a Twitter spat about this when I responded to a woman posting how she attended A&E after being advised over the phone by her GP to do so if she “got worse” or “didn’t get better”. She got fed up waiting 4 hours and not being seen beyond triage, and then receiving a bill after walking out and going home. Apparently she got better without any further medical attention. She was outraged at being made wait, and more so at being charged for her attendance. I threw in my opinion that it was normal practice for there to be a charge for attending and the choice to walk out was hers, if she really had been very ill she wouldn’t have been fit enough to walk out.

I got berated by all and sundry, including a man who brought his child to be examined for something minor, being kept waiting over 2 hours when he had to get to work. I suggested that maybe he should had made an appointment with GP & he replied that he couldn’t get one at a convenient time and “that’s what the hospital is there for-to treat people”.

There is an ingrained notion in this country that the first port of call is tertiary care, a belief that to go to a GP is to downgrade your illness to a minor malaise when you feel you deserve the topmost technical care there is to be had. For some reason it’s a culture that has built up in this country, although decades ago they used to admit people overnight for anything involving a general anaesthetic for the reason that old anaesthetics took about 24 hours to wear off enough for you to even visit the bathroom yourself. Maybe folk memory of those times plays a part 😂

Goldengirl

The current crisis has people (over 900 ) waiting on trolleys who need tube admitted ie . to a bed in a ward for inpatient treatment .

It is not about people waiting in A+E to be seen for a simple ailment.

I say this with all due respect to the above posters because in normal times I would agree wholeheartedly with your comments about GP access and people attending A+E for non urgent problems .

However the thread is about " the current " crisis .

recode the site

https://www.boards.ie/discussion/comment/120062949#Comment_120062949

The message sent out by HSE today was to steer away unnecessary visits to A&E so they must be adding to the congestion that’s already there due to lack of bed space.

Many are arguing they can’t get a GP appointment. However I got one on the phone today for myself, also a Boardsie got a private online consult. Might not be this ideal everywhere.

Larbre34

Some GP practices have 10,000 patients on their lists and they are closed.

Some pregnant women are having their entire ante-natal care delivered at the Emergency Department or by CareDocs, because they cannot get onto those lists.

Older people suffering serious illness these last few weeks; dehydration from severe norovirus, temporary unconciousness from suspected heart or neuro problems, suspected pneumonia after weeks of enduring Covid and Flu, and RSV and bacterial infections - they are being triaged for Ambulance service over the phone and being told that they are 40th in line and having to wait 6+ hours.

Its the same with kids suffering dangerously high and persistent fevers from Covid and Flu - from which they aren't vaccinated. Their parents are worried sick about signs of meningitis, so sick are they - and yet they can't get an ambulance or even a housecall either.

This is not the ****ing fault of patients. There is *NO* culture of people turning up at hospital demanding tertiary treatment. Anyone that is turning up, is either seriously ill, or CANNOT ACCESS BASIC HEALTHCARE ANY BLOODY PLACE ELSE!!!

Stephen Donnelly is talking diarrheoa as per usual. His lips are moving and his hands are gesticulating, but he's not actually doing anything.

An Emergency response would be setting up Defence Forces assisted triage outside the busiest hospitals, to clear the EDs and give medics space to work, do tests and provide dignity.

An Emergency response would put all Consultants and Clinical Nurse Managers and every other qualified practicioner or tester or therapist on a 12 hr on/off rotation, to join nurses and NCHDs in actually diagnosing, treating, medicating and either admitting or discharging patients on a constant 24/7 basis, not just from 9-5.

An Emergency response would be to commandeer the private hospitals again, to act as sanitoria and isolate the Covid and Flu patients that are high dependent, but not intensive care candidates.

Donnelly is a useless shytebag and so is every Minister and Senior Official, who should be enacting a War plan here, not giving pressers telling people its THEIR fault and warning everyone else that they shouldn't get ****ing sick!!!

Goldengirl

https://www.boards.ie/discussion/comment/120062964#Comment_120062964

As I said above, I don't disagree totally, just the present crisis is a total lack of beds for the amount of people who really do need to be admitted and are currently ill enough to be kept in.

Believe me noone is on a trolley/ kept in hospital unless they are too sick to be sent home .

The" stay away or go to a GP / pharmacist " instruction is so people don't end up just piling up in the waiting areas also when even the triage nurses are needed in Resus it's so crazy .

Gatling

https://www.boards.ie/discussion/comment/120062987#Comment_120062987

Sorry in my experience ,your wrong nobody is in a hospital bed because they are too sick to go home ,

I've had several procedures that meant I was in hospital for just under 20 days this year alone , I've met people who were kept in waiting for over a week to have tests done only to be sent home with a referral kept in for a week waiting on tests ,I also came across elderly persons in hospital beds for week's at a time because there was no other facilities for them outside of the hospital,

Others in A&E going live in social media chats asking followers to contact their local TDs to contact the hospital to get them bed because they have a sore throat,

The system well and truly Faqued both by the management of the overall system to people's unrealistic expectations when they rock uo to A&e with relatively minor issues that should be dealt with at Gp level,

Can't access gp service run to a&e this is the one of the biggest problems ,why are gps over whelmed too many retirements and no replacements and expanding free schemes for some people, leaving those who need to see a gp but get told you have to wait 2-3 week's for a phone consult which will still cost €65 but for that 3/4 minutes on the phone to the gp guess what he's referring you to a&e oh that's another € 100 and whatever days off work while you wait 19+ hours in a&e just to see a Dr .

It's all bloody related to beds and trolleys

NIMAN

https://www.boards.ie/discussion/comment/120062984#Comment_120062984

Going by what that Limerick emergency consultant said on MI yesterday then, if we now have 900 people waiting to be admitted to hospital, that means that those 900 are the 5% who needed serious help and care?

So the 95% who attend A&E, who he basically said shouldn't be there, that's 18,000 other folk who obviously come to A&E and end up going back home.

Strumms

The population has grown and continues to grow exponentially. Between 85,000-95,000 in a matter of months, conservative estimates as the state all of a sudden isn’t updating their CSO site unless I’ve missed it 😏

the state can’t train, qualify and pay for the hiring of additional a&e doctors, nurses, plus…security, admin staff, etc to cope with that sudden extra demand, system was barely coping with the pre Ukranian demand….so that’s what happens. A crisis…

Del2005

https://www.boards.ie/discussion/comment/120062937#Comment_120062937

Too many non health care workers in the organisation to get money to the front line and the unions won't allow them to be made redundant. We merged multiple health boards into the HSE yet not 1 person was made redundant, now they want to go back to multiple health boards again so they will need to hire new staff. A while ago I was picking my Dad up from hospital after a day treatment. Asked at the window of the section he was supposed to be in where he was, 2 staff took 5 minutes to tell me they had no idea. Told me to try another section. I found him down the corridor from the window in the section where I asked the staff.

Then you have our front line staff working long shifts usually understaffed.

airy fairy

I suspect a good deal of beds in wards are being held by elderly, who are not sick anymore, but too weak to be discharged.

Care/nursing homes have no spaces, or are closed due to using same for refugees as it's more financially beneficial to private owners.

GPs are over run with patients and if you ring, and ask for an appointment you are told to present yourself at an ED pushing on the opposite end of hospitals too. For example, there was a time when a GP could carry out an ECG in their surgery before clogging up ED, now they don't have time and you're told to go to ED.

Triage centres opened here and there over the last number of years, for minor emergencies such as sprains, breaks stitches but operate from 9 to 5. This needs extending.

We also have no phn or carers allocated decent hours to those who could actually make it back to their home if they got a small bit of help.

Strumms

1000% correct ^^^^ Major shortages of carers. Care plans can’t be approved so lots of people end up just taking up beds because it’s unsafe to discharge them without care hours. They don’t need to be in hospital but can’t go home.

I know a carer and the money for what is expected of her, both from her employer but especially from clients and their families is ridiculous… pay in many cases is a shade over minimum wage.

Dav010

https://www.boards.ie/discussion/comment/120062984#Comment_120062984

My wife is a A&E Doctor, your post has the same consistency as Donnelly’s excrement.

A huge number of people attending A&Es daily are there because they think their problem is an emergency and because it is quicker/more convenient to go to the A&E than it is to wait for an appointment with a GP.

Doctors waiting times are certainly a contributing factor, the reasons for the shortage of GPs is well known and for another thread, similarly the reasons why delays occur in discharging patients particularly this time of year have been widely covered in the media. But that does not change the fact that the premise of your post, only those that need to be in the A&E are in the A&E, is wrong.

I wish my wife worked 9-5 like you suggest, God knows she would love that, as would all Hospital staff, but she hadn’t worked 9-5 for nearly 30 yrs, neither have the vast majority of those connected to A&E. The staff are burned out, sick, tired, and leaving, there is no more to give. Army assisted triage outside the hospital, in a tent, staffed by who? and you know well the problem would be exacerbated by people having to wait/queue outside this time of year before they can get inside to be seen. Have you forgotten the headlines when people had to queue outside Dublin airport?

This all seems simple to you to solve, make staff work harder, faster, longer, commandeer private hospitals, put all their patients on hold, and what, take on hundreds of new staff to look after the sick from the general hospital there? Or do you think heart surgeons/orthopaedic surgeons/Dematologists/plastic surgeons and their staff are suddenly going to convert to A&E practitioners?

Nuts102

We had an overcrowded health service last year that couldn't cope.

We have welcomed nearly 100k people and are telling anyone else they are free to come here.

We have not increased the number of gp's or hospital staff to handle the population increase.

I mean I am not sure what the government expected to happen.

It's very hard to get a gp appointment and I can understand why parents will panic and go to A&E with young kids instead of waiting weeks for a gp appointment.

whisky_galore

First world country plunging down to a potential third world healthcare situation. It's bleak as fvck.

I'd hate to be in poor health and/or in need of a roof over my head right now.

We really are all fur coat and no knickers in this kip.

Dav010

https://www.boards.ie/discussion/comment/120063243#Comment_120063243

Have you any idea how many advertised, unfiiled posts there are in the HSE? I read before Christmas that there are just under 800 consultant posts alone in our Hospitals at the moment, and GPs take years to train. Who would want to be a GP at the moment? You can’t just say the Government didn’t take on staff, the offers are there.

https://www.boards.ie/discussion/comment/120063261#Comment_120063261

Have you ever been to a third world country? It looks very different to Ireland, we just have far higher expectations than people who live in undeveloped nations.

whisky_galore

'Have you ever been to a third world country? It looks very different to Ireland, we just have far higher expectations than people who live in undeveloped nations.'

No sh1t sherlock.

Dyr

Hand everyone in the country the four or five thousands that the government spend per person on the HSE and we can all spend it on private health insurance

Dav010

https://www.boards.ie/discussion/comment/120063338#Comment_120063338

And yet you think we are “plunging” towards one? Hyperbole maybe, but perhaps you should look at conditions in actual third world countries, and count yourself lucky.

Nuts102

https://www.boards.ie/discussion/comment/120063348#Comment_120063348

Whether we are plunging towards it or not we are heading the wrong way.

We are constantly encouraging immigrants to come here with no cap.

We are not hiring enough people to cope with the demand.

The result is things will get worse year on year until something is done.

mykrodot

https://www.boards.ie/discussion/comment/120063305#Comment_120063305

But that is the difference, we are not a Third World country........we are paying dearly, each and every one of us, in our taxes, in a First World country like Ireland to have a basic health system that works!! That is the difference. We are not a Third World country where poverty is rife, where nobody is contributing through high taxes, we are all contributing here and yet our Health care system has people waiting 3 weeks for a GP appointment. Of course we should have "higher expectations"!

Cordell

https://www.boards.ie/discussion/comment/120063346#Comment_120063346

When everyone have private insurance no one really have private insurance.

I can bet that both of us know someone who's working for the HSE but not as doctors and nurses. This is the main problem, Ireland spends a lot on healthcare, but employ too many useless paper pushers.

And of course the population increase, mostly through immigration, is a big factor no matter how hard some are trying to deny it.

Dav010

https://www.boards.ie/discussion/comment/120063396#Comment_120063396

The jobs are advertised, personnel do not want them, how does that equate to “not hiring enough”?

I agree with you, more staff are needed, but you can’t stop staff leaving, and you can’t make people take jobs they don’t want.

Dyr

https://www.boards.ie/discussion/comment/120063432#Comment_120063432

We all have private car insurance, we all have private house insurance, theres no reason that public health insurance won't work the same way. And, yes given that this is Ireland, the insurers will try to create a cartel and the government and regulators will be in on it but its still better than a system run by TDs and unions.

healthcare is a mess because its run by the government. Unless you change that you wont fix it.

Dav010

https://www.boards.ie/discussion/comment/120063404#Comment_120063404

Can’t dispute that we pay enough in taxes, and Government spend in healthcare is enormous, perhaps we need the German model, where 7.3% of everyone’s income is deducted for health insurance. That will give a huge boost to the health pot and allow more to be spent.

Nuts102

https://www.boards.ie/discussion/comment/120063440#Comment_120063440

Yes and people don't want the jobs because of the workload, which is only going to get worse.

Why would someone want to take a job here working themselves into an early grave.

When they can move somewhere else and have less of a workload.

We are training up healthcare staff and they are then immigrating once qualified.

We can't get gp's to cope with the demand and the current ones will eventually retire.

All while we keep telling everyone in the world to come on in.

We are heading towards a bigger population and less staff to manage then we currently have.

I would hate to see what things will be like in 10 years.

I would like to see what plan we have for this to work, the only thing I have heard is to advise people to wear masks.

Dyr

https://www.boards.ie/discussion/comment/120063469#Comment_120063469

Allow even more to be pisssed into the black hole that is the HSE you mean.

Gregor Samsa

Over the years, I've been with both VHI and Laya, which both offer a Nurse Line service for medical queries. Any time I've ever phoned them, usually related to the kids when they were much younger, the ultimate advice was to go to A&E. We never actually did, because while the issues were concerning enough to seek advice, they definitely weren't serious enough to go to A&E for (which for us would be a 40 minute drive to Limerick and all it's overcrowding and issues). If they had been serious enough for A&E, we wouldn't have been wasting time phoning a nurse. But those services must be sending a hell of a lot of unnecessary traffic to A&E, because basically there's very little medical analysis you can do over the phone, and they have to cover themselves in case it is something serious, and so err on the side of caution.

Never been to A&E myself, but we've had to bring the kids twice. One fell out of a tree and cut her leg badly and needed stitches. If it had happened 30 minutes earlier, we could have brought her to the local Minor Injures Unit 5 minutes away, and she would have been sorted out within an hour. As it was, the unit was closed, so it necessitated the 40 minute drive and 9 hours in Limerick. The second time was another daughter who had been complaining of an intermittent sore stomach for a number of weeks. Brought her to the GP, who told us that it was probably nothing serious, but she should get a scan to rule anything physical out. He said that we'd be waiting months for a scan appointment, so to bring her to A&E to get it done there and then. Waste of recourses (and the scan was clear), but that's the game you're made play.

Cluedo Monopoly

https://www.boards.ie/discussion/comment/120063497#Comment_120063497

You're right. It will only get worse unless work conditions improve. Nurses and doctors are leaving in droves.