Sinn Féin spokesperson on Health, David Cullinane TD, has said that the latest HIQA reports into emergency department dysfunction across the state show that widespread investment in capacity as well as reform of patient care is urgently needed.
Teachta Cullinane added that he agreed with the Association of Emergency Medicine that more beds were needed at some locations, while significant reform in the management of patient flow was needed in others.
Teachta Cullinane said:
“Emergency department waits have continued in the wrong direction in the last year, and now stand at half a day on average. Some locations, such as Cork, have average waits at, or in excess of, 24 hours.
“The solutions have been in the open for many years – some locations need additional bed capacity, and many need a total change in approach to how and where patients are cared for.
“Some hospitals are performing well, and others are performing well in some areas but falling down in others. All hospitals need to be learning from the successes and failures of each other.
“We need significant investment in primary and community care, especially in training more general practice doctors, primary care nurses, and allied health and social care professionals, to move more care out of hospitals.
“Too many patients are being treated in the wrong place, at the wrong time, leading to costly delays in their care.
“Alternative care pathways and locations as well as additional step-down capacity, planned based on the health needs of communities on a local and regional basis, must be advanced.
“We also need to see much greater investment in public diagnostic capacity, with direct access for GPs as well as a modernisation of acute hospital diagnostic capacity to increase efficiency. We know that many ED delays are due to waits for scans.
“Some hospitals, such as Kilkenny and Waterford, have implemented far more efficient patient management plans which decrease length of stay and deliver care closer to home, as well as rapid access to urgent day case care.
“This all reduces pressure on emergency departments, reducing waits for all patients simply by making better use of existing resources with outside-the-box thinking.
“The Minister for Health is reacting to crisis after crisis by sending in support teams, which shows how bad the situation has gotten, but unless the teams are bringing more beds and staff with them, they will not be able to address the problems.
“We need a serious, multi-annual plan which addresses long emergency department waits through a reorientation of care, investment in capacity, and investment in workforce planning.
“Regionalisation, integration of care, and investment in the National Ambulance Service to provide better services as well as community-based services are all necessary components of such a plan.
“We will never reduce health waiting lists if we cannot get on top of the crisis in emergency departments, but this requires strategic multi-annual planning which has not been forthcoming from the Minister for Health.”