It says something about our loss of a sense of outrage that 563 sick people languishing on hospital trolleys for want of beds has elicited so little condemnation.
In 2006, when money was plentiful and expectations higher, former minister for health Mary Harney was forced to declare a national emergency when the number of patients on trolleys hit 495, well below Monday's level.
Then, in 2011, after trolley numbers peaked at 569, another former health minister, James Reilly, promised that "never again" would they be allowed to go so high.
Reilly repeated this pledge many times as the numbers dropped in the early years of his tenure.
That achievement was to prove short-lived; once the plug was pulled on the extra money that drove the reductions in waiting lists, the upward trend resumed. And so in 2015, on the first proper working day in hospitals after the Christmas break, the number of patients waiting for admission to a bed was just six short of the Government’s self-imposed upper threshold.
Human suffering
Behind the obsession with figures lies so much unnecessary human suffering; patients, many of them elderly, left waiting on trolleys or chairs for hours or even days before they are admitted to hospital. Few will sleep, some will suffer medically, and all will be exposed unnecessarily to the infection risks inherent to overcrowded, chaotic hospital environments.
On the face of it, the numbers shouldn't come as a surprise; the figures for last month were already 53 per cent up on the previous December. The current Minister, Leo Varadkar, warned of the likelihood of a steep rise in emergency department overcrowding. Extra money had been allocated to deal with the problem and an emergency taskforce was convened before Christmas.
However, the increase is coming worryingly early. While there is always some pent-up demand after Christmas, the holiday season is the time of year when as many patients as possible are sent home, so the present overcrowding is happening from a low base.
The winter weather hasn’t been particularly extreme, so there were no grounds for expecting a big rise in respiratory ailments. The norovirus has played some part in the surge, according to the HSE, but given that this is commonly called the winter vomiting bug, that’s to be expected at this time of the year.
Otherwise, the reasons why so many patients are on trolleys are the same old ones we’ve been hearing about for so long: too many patients, too many older patients, and not enough step-down beds for patients who are clinically fit for discharge. Initiatives are promised, but most of them have had to wait for the new budgetary year before they could start.
Wasted money
Money is wasted in the health service. Some patients are unnecessarily referred to emergency departments when they could be treated closer to home. However, the main reasons for hospital overcrowding are lack of beds and shortage of staff. Until these deficits are tackled, high trolley numbers will be a feature of our health service, especially in winter.