The Health Service Executive (HSE) chief executive, Bernard Gloster, has announced that occasionally, the planned medical appointments in the Midwest region will have to be delayed for dealing with the rising demand in the emergency department (ED). According to Gloster, due to increased need for emergency care, University Hospital Limerick (UHL) and the wider UL Hospital Group will require intermittent “resets”. This will involve holding off regular care to ensure the adequate availability of beds for urgent cases. This might last for a couple of weeks.
He further explained that the term “reset” denotes the necessity to pause, downsize, or divert non-emergency tasks and focus the resources of the hospital, and the surrounding community services – such as general practice, ambulance service, elderly care facilities – on providing emergency care. He hinted that this approach was adopted recently. The hospital group announced that planned care across the region would be significantly reduced until an unspecified future date.
Furthermore, Gloster suggested that it may be the latter part of August before regular care services resume, with an aim to stabilise the situation before the onset of autumn and winter seasons, which traditionally place additional strain on health services.
The decision has been met with criticism from hospital doctors who argue that it is an unnecessary and unfair neglect of the regional population’s health needs.
Recently, UHL has been under examination following the mishandling of the case of 16-year-old Aoife Johnston which resulted in her death. After the inquest, Grace Rothwell – HSE’s national director of acute hospitals, lead a support group dealing with the existing overcrowding issue in Midwest hospitals.
An external report into Johnston’s death has also been concluded by ex-chief justice Frank Clarke. However, Gloster did not disclose the findings of the report, stating that he is presently expecting feedback from several individuals and will subsequently decide on the necessary course of action.
Mr Gloster, who oversees the HSE finances, accepted the common portrayal of the executive as a “black hole”. The government recently sanctioned an additional €1.5 billion as recurrent funding for the health service, as well as a forthcoming €1.2 billion next year. This move, according to Mr Gloster, has given the executive a certainty they had previously lacked.
Despite this, after last October’s budget, Mr Gloster expressed his dissatisfaction with the funding, deeming it insufficient to cover health service operational costs. The added €1.5 billion allows for the maintenance of 4,000 roles that lacked funding, which he termed as a serious contribution to the country’s health service and its enduring nature.
That being said, he acknowledged that in exchange, the HSE needs to instigate a degree of control that it has potentially been without for a significant period. He strongly believes that, with the implementation of proper checks, by 2025 the HSE’s financial stability will be far improved compared to its state over the past ten years at least, and will be markedly apparent.
In reflecting on his 17 month tenure as head of the HSE, Mr Gloster argues that prioritising urgency stands out as the most significant challenge. He discussed the vital importance of efficiency in healthcare, urging for a redirection of focus to consider the patient’s time, rather than staff time, and the negative impact inefficient practices can have on it.
That said, he appeared satisfied with the progression made in reducing the number of people left waiting on hospital trolleys for admittance. Despite the fact that the year so far has seen over 928,000 visits to A&E departments, amounting to an 8.9% increase compared to last year’s similar period, he noted that numbers of patients left on trolleys has reduced to 66,738, reflecting a 9.9% decrease.
The functionality of our healthcare system has seen commendable enhancements and substantial growth in efficiency is playing a pivotal role in this. Nevertheless, these leaps and bounds are only commendable if we have the ambition to keep pushing them further. It is imperative that we reliably endeavour to boost this change.
The healthcare sector is in a phase of evolution, with Sláintecare’s long overdue revamp of the system now gaining momentum. With the foundation of six new regional zones due to operationalise by September, the pace of this transformation is accelerating.
A stronger focus on digitisation of healthcare is apparent, evidenced by the introduction of virtual hospital wards and the unveiling of a digital blueprint which introduces a national patient application and an electronic health record system. This pushes Ireland into the forefront of healthcare innovation, a position we have previously struggled to hold.
Drastic changes aren’t achievable overnight and I firmly believe in gradual, consistent improvements. My tenure here may end, but conversations on waiting lists or trolleys may still persist. I just aspire that such discussions will reflect a more sustainable, enhanced scenario than when my stint began.
Indeed, we will face challenges like demographic pressures and changes in workforce. These factors will test us in the future. Our mission continues to respond to these challenges, and acceptance of that is paramount.