Nurses chief calls for community care spend to free up beds

Chaos in Galway’s hospitals, manifesting itself in unsafe and chronic overcrowding of Emergency Departments – at UHG and Portiuncula – can be eased with more beds, more staff and increased investment in community care, according to Irish Midwives and Nurses Organisation (INMO).

Mary Leahy, First Vice President and Representative of INMO, warned the health system is “on the edge of a cliff” and needs dramatic action to stave off an even worse crisis in the coming years.

Ms Leahy, a public health nurse and former Galway City councillor, said the problems with the health system are “multifactorial” and there are “so many issues to address”.

“In the short-term, we need to invest in community and public health. The rhetoric of politicians is about care in the community and primary care but there isn’t matching investment in community care.

“We have 40 less public health nurses now than in 2008, and yet we have an increased population. The number of people applying for the HDip in public health nursing, has fallen year-on-year. We need 200 places at least every year,” she said.

“The Emergency Department is a capacity issue. In Ireland, we have only 2.8 beds per 1,000 people but the OECD average is 4.8 beds per 1,000. I’m not saying we necessarily need 4.8 but we definitely need more beds because population has increased, we are living longer, and birth rates are up. So, yes, we need investment in community care but we also need more beds in hospitals to cater for an increasing population.

“There is a certain percentage of admissions to ED that are unnecessary admissions. That is because GPs are under pressure and cannot cope. If you invest in more public health nurses, who are involved in preventative medicine, we can reduce the level of admissions and treat people in the community and in their homes, which is where they want to be. You cannot underestimate the value of home care and home help and yet they are the first packages that suffer when there are cutbacks,” added Ms Leahy.

She said retention and recruitment of nurses must be prioritised, after the moratorium on recruitment, emigration and retirements during the recession has robbed the system of thousands of experienced nurses.

“We lost seven ED nurses over a number of weeks to the private sector, so there is an issue with retention as well as recruitment. And it’s not just an issue with ED, nurses working right through the system are burnt-out. They’ve been asked to put the shoulder to the wheel for the last eight years and they have put two and three shoulders to the wheel but it is not sustainable. Nurses were happy to do that in a crisis but there is no sign of the crisis abating,” she said.

Ms Leahy added there was a need to focus on planning ahead.

“There is no forward planning in the health service. There is a need to sit down and devise a strategy for the next 10, 15, 20 and 30 years rather than focusing on the here and now. We need to get rid of annual budgets because you cannot forward-plan.

“There needs to be multi-annual budgets for ten years to allow planning . . . We are on the edge of a cliff in terms of the number of elderly people who are going to need care over the next 20 years, if we don’t do something dramatic to invest in home care and primary care.”

Galway East Dáil Deputy Anne Rabbitte said the overcrowding crisis has spiralled out of control, with a record 600-plus people waiting on hospital trolleys in Emergency Departments across the country one day last week.

“The situation is completely unacceptable and has been generating justifiable outrage and anger among hospital staff, patients and their families. Unfortunately, the scenes witnessed in hospitals this week are all too familiar to people who have attended the Emergency Department at University Hospital Galway in recent months. This week at UHG there were 40 patients on trolleys on the busiest day of the year so far, and there are regularly more than 30 people on trolleys in the UHG ED,” said the Fianna Fáil TD.

Galway/Roscommon Independent, Michael Fitzmaurice said the entire health system is in “meltdown”.

“It has gone way beyond political one-upmanship and point scoring at this stage. People are suffering and it is so unfair. I have dozens of constituents who are having operations cancelled at extremely short notice due to beds not being available on the day of their surgery.

“This is compounding the Emergency Department and trolley crisis. People who are in desperate need of procedures are being forced, and in some cases, being told off the record, to attend EDs because this is the only way they will get their procedure carried out in any sort of a reasonable time,” he said.