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    Lack of acute bed capacity continues to cause severe pressure on EDs

    Regrettable ‘perennial’ problem of inadequate acute bed capacity not addressed

    The Irish Association for Emergency Medicine Has said that it is regrettable that the perennial problem of inadequate acute bed capacity has not been addressed with the same focus, commitment and determination brought to setting up new services for Covid-19.

    Over the past year it had been clearly demonstrated that the Health Service Executive was capable of enormous effort to set up new services and bring them to a high level of performance, with the Covid-19 Testing Infrastructure and Vaccination Programmes being excellent examples of this.

    The IAEM underlined the very negative impact of inadequate bed capacity and its downstream effects on large numbers of patients lodged in Emergency Departments (EDs) awaiting a bed — so called ‘inpatient boarders’ — with its consequent negative impact on patients, including an increased mortality rate for given conditions and a risk of transmission of infectious disease, which had been known for so long.

    In HIQA’s recent commentary on the Irish healthcare system, the Authority pointed out, yet again, that failure to address both bed capacity and poor infrastructure were reasons why the Health Service did not perform to the necessary level.

    The IAEM said that the very public focus of the HSE of late had been to concentrate almost exclusively on the undoubted successes of the Covid-19 vaccination programme to the exclusion of any commentary on, or attempt to address, the underlying systemic issues that HIQA had again reminded us about.

    EDs, and the doctors, nurses and wider team who staffed the units, could not continue to be under unrelenting pressure because of a persistent failure of the HSE, Department of Health and Ireland’s political leadership to address systemic problems which had been identified for over a decade.

    The concern for all of us should be that the problems in the health service which had long remained unaddressed would still be there after the Covid-19 pandemic faded from memory.

    “While many will ask why there hasn’t been any real attempt to properly address these issues in real time, as opposed to aspirations for the future, their very negative impact on the health of the population and ED staff will continue to be felt,” added the IAEM.

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