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Small hospitals could help ease ED pressure

21 Nov 2014


Dr Tony O’Connell, National Director of Acute Hospitals

Some small hospitals within hospital Groups could be transformed into elective surgical units, the HSE’s National Director of Acute Services Dr Tony O’Connell has suggested.

Speaking to Irish Medical Times last week, Dr O’Connell said that while this was something that would have to be decided and planned by each individual hospital Group, there was an opportunity to increase the amount of elective surgery work that took place in small institutions.

“There are some great examples of increasing the activity in smaller hospitals in areas like endoscopy, colposcopy, even things like eye surgery, we could do more of that in smaller hospitals that have less pressure from their emergency departments on the bed numbers in the hospital,” Dr O’Connell suggested.

“There is potential. It needs to be planned clearly, needs to be examined, but yes that is a logical consequence of saying that we need to become more efficient,” he added.

Addressing the RCSI Millin meeting, Dr O’ Connell said the health service was a “very challenging environment” with budget cuts taking €4 billion out of the HSE’s budget in the last seven years.

He also said that the service had lost 15,000 in staff numbers and there were challenges attracting and retaining clinical staff.

Added to this, he said there were performance challenges such as trolley wait times and delayed discharges, which he said, currently stood at 824.

Dr O’Connell also said by the end of December this year there would be about 32,000 people overdue on the waiting list for booked procedures, and that the health service would be running at a deficit of €510 million by the end of the year with the acute hospital system accounting for €273 million of this.

According to him, there was a three per cent increase in emergency attendances and a two per cent rise in emergency admissions compared to last year and the HSE has had to reduce elective admissions by five per cent.

Dr O’Connell also told the meeting the health service had survived over the past seven years almost entirely on the goodwill of frontline staff and managers who are “trying hard to work within this complex environment”.

“But we do have to change how we do things…. to achieve the kind of system that we want for our relatives if they were the patients within the system… that is cultural change and that is hard. To get cultural change we need leadership and I think clinicians have a significant role to play in leadership,” he added.

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Click here to view the full article which appeared in Irish Medical Times