Ireland A&E overcrowding causing ambulance chaos – SIPTU organises industrial action ballot

INMO nurses on a demonstration in Dublin demanding more hospital beds

SIPTU has warned that the overcrowding crisis in hospital emergency departments is causing chaos for ambulance professionals across the Republic of Ireland.

The union has already announced that it is planning to hold a ballot of ambulance professionals for industrial action early in this new year.
SIPTU Health Division Organiser Paul Bell said on Sunday: ‘SIPTU representatives are demanding that the Minister for Health, Simon Harris, the Department of Health and the Health Service Executive (HSE) take immediate and effective action to relieve the immense pressure being experienced by ambulance professionals across the country.
‘At the end of November 2019, SIPTU representatives requested that the HSE and Department of Health agree a protocol for the handover of patients at emergency departments.
‘Unfortunately our calls were ignored, and now we have an unacceptable situation where our members are reporting delays in some cases of between three and a half and seven hours outside emergency departments as our now annual winter overcrowding crisis bites.
‘It is outrageous that in 2020 Ireland patients are being treated in the loading bays of hospitals instead of hospital beds.
‘This is not what quality patient care looks like, and this kind of chaos is starving communities of a safe and functioning ambulance service, particularly in areas of the west of Ireland and in the midlands.
‘While the HSE and Department of Health are responding to some areas of the overcrowding crisis – primarily by attempting to boost the number of beds available in hospitals – there seems to be little consideration or emergency planning to make sure ambulances are kept on the road and readily available for communities.
‘Over the weekend, we had the absurd situation where SIPTU members working a 12 hour shift in an ambulance base in County Clare were dispatched on a 901km roundtrip to Clonmel and back to Youghal due to local resources being held up in Tipperary while ambulances from Kilkenny bases were dispatched to emergencies in Cork.
‘This chaotic system is not only bad for patients and driving up ambulance waiting times it is also having a detrimental effect on the health and wellbeing of our members with many ambulance professionals continuously exposed to long shift over-runs and unsatisfactory rest and break times.’
He added: ‘SIPTU representatives have also written to the Director of Ambulance Services and representatives of the Department of Health to request an urgent meeting to highlight our members’ deep concerns and to seek assurances that all is being done to prevent this crisis from spilling into more communities.’
On Wednesday 1st January, Bell announced that members working in the National Ambulance Service (NAS) were launching a national mobilising campaign to win respect and recognition for all ambulance professionals in 2020.
Bell said: ‘Our members, across all grades in the NAS, are determined to secure greater recognition from the health employers including, if necessary, by taking a ballot for industrial action early in the new year.
‘Our members are no longer “van” drivers. They have over a relatively short period of time developed into a highly skilled workforce with the ability to make key clinical decisions and to administer lifesaving medications to patients suffering trauma, cardiac arrest or stroke. That deserves to be recognised.
‘In 2017, SIPTU representatives engaged in a successful national industrial campaign to secure vital resources for our NAS members to do their jobs effectively and safely, including the purchase of a new ambulance fleet to serve the public.
‘In 2019, SIPTU representatives participated in a review of the skillsets of ambulance professionals with a specific focus on emergency medical technicians and paramedics.
‘The findings of this review, due to be published in early 2020, are likely to confirm what SIPTU members already believe – that the role of all frontline ambulance professionals has evolved through education and training to the standard expected of health and social care professionals.’
He added: ‘It may shock the wider medical community, including the Minister for Health Simon Harris and indeed the general public, that ambulance professionals are not regulated, unlike nurses, midwives, radiographers, radiation therapists and physiotherapists, yet they are responsible for administering up to 45 lifesaving drugs and making clinical decisions and in many cases are the first point of contact for patients.
‘The regulation of ambulance professionals must be treated as a priority.
‘As with other health and social care professions, regulation will protect patients, provide a mandatory framework for practice and make it an offence to impersonate staff members.
‘It is well overdue. It may also shock those same actors that ambulance professionals have no recognised pay scale within the public sector consolidated pay scales.
‘This is absolutely unacceptable and must be addressed once and for all.
‘Our members rightly feel that their time for recognition and respect is now and that the government needs to engage on these issues and give them confidence that the future structure, viability and vision of our National Ambulance Service works for the many, not the few.’

  • Nursing unions have cited 2019 as the worst ever for hospital overcrowding, with crisis levels reached at Cork’s two biggest hospitals.

The Irish Nurses and Midwives Organisation (INMO) said on Monday that conditions at Cork University Hospital (CUH) and the Mercy Hospital (MUH) are ‘appalling’ as they battle flu and staff shortages.
INMO General Secretary Phil Ni Sheaghdha said: ‘We know the situation will get worse but it is our view that we have to put emergency measures into place to ensure everything that can be done will be done.’
INMO says that recruitment issues have left staff dealing with appalling conditions at CUH and the MUH and Ni Sheaghdha said that emergency measures are badly needed to solve the crisis.
A total of 118,367 patients went without hospital beds in 2019, according to the end-of-year analysis released by INMO.
This confirms 2019 as the worst-ever year for hospital overcrowding since records began – 9% higher than 2018.
Over 1,300 of the patients were children younger than 16. The worst months for overcrowding in 2019 were November (12,055), October (11,452), and September (10,641).
The INMO points to understaffing and a lack of capacity as key drivers of overcrowding. There are 411 fewer inpatient beds in Ireland’s hospitals today than a decade ago, despite a larger, older population. Ní Sheaghdha said: ‘Things are getting worse, not better’.
She warned: ‘These figures should be falling, but we’re going in the wrong direction. 2019 saw thousands more patients without proper beds – often at one of the most vulnerable points in their lives.’
According to INMO, the number of patients on trolleys last Monday morning would fill the largest hospital in the state, St. James, which has 707 beds, or take more than twice the equivalent of Letterkenny University Hospital’s 333 beds.
The previous worst-ever day was March 12, 2018, during the freezing weather known as the ‘Beast from the East’, when 714 patients went without beds.
University Hospital Limerick has also broken the daily record for an individual hospital, with 92 patients on trolleys. The previous highest figure was 82, also in UHL.
Visitors have been banned from UHL due to the high number of people it is treating for flu. The only exceptions to the visiting ban are people visiting patients who are at end-of-life, are critically ill or who have dementia. Parents visiting paediatric patients are also exempt.
The INMO is calling for a major incident protocol to be adopted across the country, as was done in March 2018.
This would see all non-emergency admissions stopped, electives cancelled, and extra bed capacity sourced from the private and public sectors.
The union is also calling for an infection control plan, as overcrowding increases infection risks.
‘Ireland’s beleaguered health service continues to break records in the worst possible way. Our members are working in impossible conditions to provide the best care they can,’ said Ní Sheaghdha.
‘The excuse that this is all down to the flu simply doesn’t hold. There are always extra patients in winter, but we simply do not get the extra capacity to cope. This is entirely predictable, yet we seemingly fail to deal with it every year.
‘The government need to immediately initiate a major incident protocol. We need to cancel elective surgeries, stop non-emergency admissions, and source extra capacity wherever we can.
‘We also need to immediately scrap the HSE’s counterproductive recruitment pause, which is leaving these services understaffed and thus overcrowded.
‘Behind these numbers are hundreds of individual vulnerable patients – it is a simply shameful situation. This is entirely preventable if proper planning was in place.’