Over the past year it has been clearly demonstrated that the HSE is capable of enormous effort to set up new services and bring them to a high level of performance, with the COVID19 Testing Infrastructure and Vaccination Programmes being excellent examples of this. It is regrettable therefore that the perennial problem of inadequate acute bed capacity hasn’t been addressed with the same focus, commitment and determination. This is particularly regrettable as the very negative impact of inadequate bed capacity and its downstream effects of 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, has been known for so long. In HIQA’s recent commentary on the Irish Healthcare System, the Authority points out, yet again, that failure to address both bed capacity and poor infrastructure are reasons why the Health Service doesn’t perform to the necessary level.
The very public focus of the HSE of late has been to concentrate almost exclusively on the undoubted successes of the COVID19 vaccination programme to the exclusion of any commentary on or attempt to address the underlying systemic issues that HIQA has again reminded us about. EDs, and the doctors, nurses and wider team who staff these units, cannot 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 have been identified for over a decade. The concern for all of us should be that the problems in the health service which have long remained unaddressed will still be there after the COVID19 pandemic fades 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.