The current hospital / A&E crisis

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

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 .

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.

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.

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.

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.

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.

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.

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.

Hospitals stretched to their limits, says INMO (rte.ie)

The President of the Irish Association for Emergency Medicine, Dr Fergal Hickey said the current pressure on emergency departments is "the latest in a series of worsening situations".

Speaking on RTÉ's Drivetime programme, Dr Hickey, who is also a former consultant at Sligo University Hospital said Ireland is entered the clinical winter of 2022/2023 with too few hospital beds and "the dogs on the street know that".

"Emergency departments have been under pressure for months on end and this is just the latest in a series of worsening situations," he said.

Dr Hickey added that Ireland has 2.8 acute hospital beds per thousand of the population, while the OECD average is 4.3.

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There was a doctor on the radio this morning saying we have the same number of acute beds as we did in 1981. Crazy stuff.

Before people start blaming Covid, here is a press release from the INMO in November 2019.

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2019 has seen the highest number of patients on trolleys in any year since records began – despite it still being November.

“Winter has only just begun and the record is already broken. These statistics are the hallmark of a wildly bureaucratic health service, which is failing staff and patients alike.

“We take no pleasure in having to record these figures for a decade and a half. We know the problem, but we also know the solutions: extra beds in hospitals, safe staffing levels, and more step-down and community care outside of the hospital.

“No other developed country faces anything close to this trolley problem. It can be solved, but a strong political agenda to drive change is needed.

“The INMO has written to the health and safety authorities this week to try force a change from the employers. Hospitals should be a place of safety and care – not danger.”

I’ve had to bring my children to the GP 3 times since November, I’d no problems getting an appointment for that day or early the next day depending on when I called. 

I had to being my 79 year old mother to the out of hours GP service in Drogheda. I’d no problem getting an appointment for that after noon. And it was a very efficient services when I got there. I've been to A&E with my mother and the staff did their best but but it's a Sh1t show due to under staffing

It is not problems of to many people attending A&E when they don't need to. You have 700+ people waiting on trollies to be admitted. These are people who have been seen and accessed by a DR who has admitted them, clearly they need to be there.  Not moving them up stream into the hospital is clogging up A&E and they still need to be looked after by the staff in A&E as well as them coping with new arrivals.

Given that expenditure per capita is quite high, well above OECD average, but the results aren't, it's not a question of funding, but efficiency.

I don't know how many are too many, but it's not just the numbers and salaries paid, it's the inefficiency and overhead that exacerbate the problem.

The magical Irish medical card.

And so why does a triage function exist and why is it not being used to not only rank the seriousness of presentation, but also to turn away people who have absolutely no medical need to be at an ED, but could could go to a GP or CareDoc or PCC or even a Pharmacy?!