AN ANNOUNCEMENT BY the Health Service Executive that up to 50 beds are to close and the use of agency staff curtailed in three northeast hospitals has been met with outrage.
The Louth Meath Hospital Group said the changes, revealed to frontline workers yesterday, must be implemented to ensure compliance with its budgetary obligations under the HSE. As part of efforts to reduce its budget over-run, senior management has said that the use of agency staff across hospitals must be halved by this Saturday and an outright ban on both overtime and agency staff will come into play on 1 December.
Management outlined plans to close 24 beds at Louth County Hospital in Dundalk, while nine will shut in Our Lady’s Hospital in Navan. A temporary closure of 16 beds has also been announced at Our Lady of Lourdes Hospital in Drogheda.
There will also be a decrease in the amount of hours certain operating theatres and day wards are open.
400 posts lost
Tony Fitzpatrick, an industrial relations officer for the Irish Nurses and Midwives Organisation, believes that the cuts to agency staff and overtime equate to taking 400 full-time workers out of the healthcare system.
Those posts include junior doctors, nurses, healthcare assistants, radiographers, pharmacists, cleaners, clerical staff, physiotherapists, porters, lab staff, social workers and others.
An average week will see agency nursing staff or directly-employed nurses clock over 3,000 hours across the three affected hospitals.
More than 3,300 healthcare assistants’ hours, on average, are covered by agency staff or overtime per week, while 563 hours of physiotherapy and radiography duties are performed outside of regular staff requirements.
With at least half of those hours no longer approved, more than 75 full-time nurses will be taken from the hospitals, according to Fitzpatrick.
“That is a massive loss of staff. Agencies and overtime have been covering the deficit caused by the recruitment moratorium,” he explained. “Based on those numbers, it is my view that there will have to be more bed closures to cope with staff reductions.”
Clinical risk assessment
Although the cuts and bed closures are due to be implemented from this Saturday, 1 September, it is unclear if a full clinical risk assessment has been completed.
At a briefing yesterday, unions were told the assessment was not yet finished but its findings would be distributed by 5pm. That report is yet to be released.
The lack of investigation into what impact the cuts will have on frontline services has led to comparisons with the UK’s Mid Staffordshire NHS trust scandal two years ago.
After an initial investigation and subsequent commissioned inquiry, the Francis Report found “shocking” failures in care as hospitals focused on cutting costs and hitting government targets instead of patient care and safety.
The report was commissioned after a probe found that up to 1,200 more people died in the trust’s hospitals when compared to all other regions between 2005 and 2008.
“We now have the exact same conditions as the Mid Staffordshire NHS trust,” claims Fitzpatrick. “What they are proposing this week is unsafe. Everything is combining into a perfect storm – bed closures, staff cuts and budget targets.”
I have no doubt that if they proceed with these plans, significant harm will be caused to patients.
Staff unions have once more called for a lift on the recruitment moratorium and the HSE’s staff count ceilings.
“We have said it constantly but nobody has acted on it,” concluded Fitzpatrick. “The HSE are working under their staffing ceilings but if they were allowed to lift these, savings would be delivered immediately.”
The figures
The Emergency Department at Our Lady of Lourdes Hospital in Drogheda is the busiest in the country and it uses about 15 full time agency staff per week. At least seven of them will not be available to the hospital from Saturday.
Today, 30 patients are currently on trolleys in the department with another 12 admitted patients waiting in a holding area. There are another six patients scattered on trolleys in different wards.
Yesterday, there were a total of 30 emergency patients waiting on beds across the region. In four days time, there will be 50 less beds at the hospitals.
Sinn Féin spokesperson on health matters Caoimhghín Ó Caoláin condemned the closure of up to 50 beds and the restriction of operating hours in an already “hard-pressed” region, describing the decision as “disgraceful”.
He said the closure of beds will increase the pressures on both staff and patients. The TD also questioned what other cuts could come down the line as a result of budgetary measures.
“The budget over-run was inevitable,” he said, “because the cut to the Health Budget in 2012 is unsustainable. If the same is done in 2013 we face melt-down in our public health services. The Government must change course or else condemn patients to further misery.”
Clinical Director at the Louth Meath Hospital Group Dr Doiminic Ó Brannagáin conceded that the changes will likely lead to “an increase in wait times for patients to access planned service across the hospital group”.
“Management realise the enormity of the task facing us, however in order to build sustainability into our services for the future and to prepare for 2013 it is essential that we implement these instructions, maintain them and work together to ensure minimal impact on our patients and clients,” added Margaret Swords, manager of the Louth Meath Hospital Group.
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