The lives of critically ill patients are being put at risk as hospitals have less than half of the intensive care consultants needed. There are currently only 35 whole-time intensive care consultant roles in Ireland, even though 82 is the figure required to deliver the highest standard of care.
Furthermore, the Irish Hospital Consultants Association (IHCA) claims a recommendation of almost 300 more intensive care unit (ICU) beds has been ignored.
“Not only are we woefully under-resourced with IC (intensive care) consultants, we also lack sufficient ICU beds. A HSE-commissioned expert report published in September 2009, recommended that ICU beds increase from 289 to 579 beds.
“Yet a 2019 HSE report on the number of ICU beds found that there are currently only 249 beds — 40 less than 10 years ago. This places Ireland below most other European countries for the provision of critical care beds,” a IHCA spokesperson said.
The IHCA #CareCantWait campaign focuses on the lack of resources in intensive care units.
“There are so many knock-on effects of under-resourcing of our ICU services,” said Dr Tom Ryan, a consultant in intensive care and anaesthesia. During hospital surge periods, such as winter, there are often no ICU consultants or beds available for patients.
Instead, critically-ill patients are cared for in our emergency departments, or in theatre recovery areas while they await an ICU bed. EDs are not the appropriate care setting for seriously ill patients and this practice increases the risk that these patients will die.
There are other knock-on effects, according to Dr Ryan, including junior doctors emigrating to work in health services which prioritise patient safety.
Other effects include the cancellation of cancer surgeries on the morning of the proposed surgery, “because a patient with a life-threatening illness must be prioritised,” stated Dr Ryan.
Aside from the comments of the consultant and the association, an audit of ICU services, undertaken by the National Office of Clinical Audit concluded that the shortage of beds meant a level of bed occupancy which was “above the recommended levels for safe patient care and is likely to make staff retention more difficult”.
Dr Ryan also said that Simon Harris, the health minister, had indicated his intention to sit down with the IHCA and the Irish Medical Organisation to address this issue from September on.
The Department of Health said ICU vacancies and bed capacity are a matter for the HSE. “In relation to general consultant recruitment, the Government remains committed to recruiting consultants with overall numbers employed by the HSE have increased,” it said.
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