Outspoken patient advocate, Dr. James Gray has warned that Ireland’s trolley crisis has grown more critical although he highlighted the problem over 12 months ago.
He said the country had arrived at this situation despite governmental promises and multiple recommendations from the statutory inquiry.
The Tallaght Hospital-based doctor says the trolley crisis is a direct result of capacity and capability issues: “The big issue is lack of beds – somewhere in the region of 1,600 beds were taken out of the Irish health service in the last decade. That alone is a huge void in trying to solve this crisis,” he stressed.
“We had 92,000 patients on trolleys in 2015, nationally. The Irish Association of Emergency Medicine estimate that somewhere between 300 and 350 patients die from crowding-related scenarios every year so this is a massive issue- it’s one of the biggest killers we have in the state and yet it keeps going on year upon year.”
The situation led to his Emergency Medicine colleague Fergal Hickey claiming again last week that over 300 patients a year who would not have otherwise died, are passing away because of the current trolley crisis.
Dr Gray has put forward a possible solution – providing more long-term care (LTC) beds. He explained that around 550 patients are occupying hospital beds currently across the country’s hospitals that should instead be in LTC step-down beds.
He also outlined staffing difficulties across the board, for instance, one in four consultant posts, according to the IHCA, had no applicants in 2015. In addition, he stated that there were 500 consultant vacancies nationally, some of which will be filled by “expensive locums”.
The 2017 budget does not fill Dr. Gray with much hope: “Some of that money was earmarked already so that the actual overall sum pointed out in the budget is a lot less. When you actually break it down something like 2.7 per cent goes into the private system, we’re spending 6.9 per cent on the public system which is well below the OECD average.
As an advocate, Dr. Gray believes it to be his duty to recognise where there are flaws and failings in the system: “If it needs to be said, it needs to be said. As a patient advocate that’s always been my view and I don’t have much time for people who try to hide the sad realities.”
In a wide-ranging interview, he emphasised that the major flaw with the Health Information and Quality Authority (HIQA) was its limitation in only being able to recommend.
He said: “Unfortunately they don’t have power to sanction when it comes to hospitals. That’s a weakness- there’s no accountability built in, if we were to have an organisation, such as HIQA, that was able to make recommendations but also act on lack of compliance with those recommendations i.e. power of sanctions for failing to comply, then that would have a big impact.”