The latest initiative by Ministers Leo Varadkar and Kathleen Lynch to tackle hospital overcrowding is the fourth high-level attempt in a decade to solve this problem.
Previous taskforces and units set up to deal with the trolley crisis foundered through lack of focus, follow- through or sustained funding. Some effected a short-term improvement that ended once funding was removed. So why should this plan succeed where others failed?
In their favour, Varadkar and Lynch have secured a substantial sum of money from Cabinet – €44 million – to fund extra places on the Fair Deal scheme and €30 million for temporary beds.
Respect
Varadkar has won the respect of the taskforce he appointed by attending meetings for their duration. Taskforce co-chairman
Liam Doran
, of the Irish Nurses and
Midwives Organisation
, says this initiative is the most “inclusive and forensic” he has been involved in.
The taskforce report, published yesterday, repeatedly refers to the need for sustainable solutions. Yet how sustainable is the funding being provided for nursing home places and extra hospital measures? The present measures might not have been needed if Government had not cut the budget for Fair Deal by €30 million last year,which led directly to longer waiting lists and times.
Varadkar says the funding for the plan is new money and is hopeful the purse-strings will be loosened again in future years. Fair Deal is now a demand-led scheme, he says, and so not subject to an annual budgetary cap. That could mean a rapid rise in spending as the number of over-80s grows by 4 per cent a year.
Ruled out
The alternative is asking families to stump up a greater proportion of the cost of their nursing home care, a possibility neither Minister explicitly ruled out when asked about it.
The plan aims to fund extra nursing home places. This should free up hospital beds and reduce the queues in emergency departments.
Yet this is only part of the emergency department problem. Improvements need to be made in the flow of patients through hospitals, in alleviating shortage of vital staff and in reducing the length of time patients spend in hospital.
It seems incredible, years after this was first promised, that the report is still talking about the need for services like lab tests and scans being made available from 8am to 8pm, seven days a week.
Last Monday, at the end of a mild winter with no major flu outbreak, 501 patients were on trolleys or waiting for a bed.
Varadkar has set himself a target for determining the success or failure of his plan; he wants to ensure that by the end of the year no more than 70 patients are waiting more than nine hours on a trolley in an emergency department.
It’s a modest ambition, but for the sake of the Government’s electoral prospects, he needs to ensure it is achieved.
