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Groundhog Day again for patients languishing on trolleys

Many will be familiar with the film Groundhog Day which describes an arrogant weatherman assigned to cover the annual Groundhog Day event in rural Pennsylvania who then finds himself in a time loop repeating the same day again and again. This 1993 film surely describes the persistent problem of Emergency Department (ED) crowding caused by inpatient boarders being warehoused in the country’s EDs, in turn caused by an ongoing shortage of acute hospital beds. The first recorded case of a patient waiting on a trolley overnight was in 1997 and the problem has been endemic since the early 2000’s. It is now the daily experience of so many patients attending EDs who require hospital admission.
It is deeply disappointing that in spite of two ‘Emergency Department Task Forces’, multiple reviews and consistent commentary on the situation, nothing has changed. Indeed, the problem has been allowed to worsen. Yearly ‘plans’ and ‘Winter Initiatives / Plans’ have failed to address the issue and the HSE continues to condemn further patients to this very unsafe situation day in, day out.
Based on well-conducted Australian studies of excess mortality as a direct consequence of ED crowding, some 300 to 350 of our citizens die avoidably every year as a direct result of the failure to address this issue. If such a large number of preventable deaths occurred in any other environment, those responsible for or with oversight responsibility for the problem would be held to account and removed from their roles.
On Groundhog Day 2017 there will be no significant improvement from the position that pertained on 2nd February 2016 and the same day for most of the last decade. How long do we have to remain stuck in this loop where there is a clear solution to the problem (the creation of additional bed capacity) and this solution is deliberately ignored? Are we going to find that the position on 2nd February 2018 is no better than on this year’s Groundhog Day? If this is the case another 300 to 350 patients will have died completely needlessly while the dreadful inertia continues.

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