HEALTHCARE services across hospitals and community settings in Cork are bracing for what is expected to be a difficult winter period.
Cork hospitals are dealing with record-level overcrowding amid reports of mass staff departures; hundreds of patients are awaiting home help or nursing home places; and GP practices are overrun and can expect to feel the brunt of a possible flu pandemic which is predicted to strike in the coming weeks and months.
In the past week, The Echo reported that Cork University Hospital (CUH) saw more than 400 patients waiting for a bed in its emergency department (ED) or hallways in just eight days.
The Irish Nurses and Midwives Organisation (INMO) has described conditions at the hospital as “unsafe and intolerable” for both patients and staff.
The union, which has sought meetings with HSE management on the issues faced at CUH, has warned of possible industrial action if these issues are not addressed.
It was also revealed in recent days that the number of Cork people awaiting funding for home support rose by 67% in the past four months.
Meanwhile, The Echo revealed this week claims of mass staff departures at Cork University Maternity Hospital (CUMH).
A source within CUMH said that the hospital is “hemorrhaging” staff and has lost 11 or more experienced staff members in recent weeks.
These issues have all come to light as reports from south-east Asia and Australia suggest that Ireland is in for a difficult flu season in the coming months.
Australia has experienced a record number of influenza cases in summer and autumn this year and the illness is expected to hit Ireland in the coming weeks.
Cork GP Dr Nick Flynn warned this week that the country is set to be hit by a “perfect storm” as already overstretched hospitals and community services prepare for a possible flu pandemic.
“There’s a bad winter coming,” he said.
“The intensive care units and emergency departments across Ireland have been under so much pressure during the summer and spring, and this will only increase in the coming months.
“We used to experience summer troughs and winter peaks in terms of demand and pressure on health services. However, the summer troughs have been ebbing out over the past few years and they’re basically gone.
“What we’re experiencing now is year-round pressure,” he said.
“If we experience the flu pandemic that is predicted to hit this winter, planned activity in hospitals will be seriously disrupted and urgent care will be made even more difficult.
“It will affect capacity everywhere.
“There’s a perfect storm brewing because of a system that’s operating at capacity even during quiet periods — and an expected flu pandemic,” warned Dr Flynn.
Meanwhile, the Lord Mayor of Cork, Dr John Sheehan, has led calls for home support funding to ensure people can access health services at home and, in turn, reduce the need for hospital admissions or GP attendance.
In March this year, 119 Corkonians were awaiting funding for the service which allows people to avail of healthcare services in their home. This had risen by almost 70% to 365 by the end of July, according to figures obtained by Fianna Fáil.
Dr Sheehan warned that a failure to provide adequate home support will impact acute hospitals in the coming months in the form of increased hospital admissions and delayed discharges.
Nationally, the waiting list for home support increased from 6,238 at the end of March to 7,346 in July.
Dr Sheehan said he is concerned that these waiting lists are growing ahead of the winter period.
“Home support is the single most cost-effective intervention that can be put in place in the entire healthcare system,” he said.
“It keeps people at home and reduces the rate of hospital admissions as well as nursing home placements.
“Of all the healthcare interventions, providing home support is the most beneficial by a long way,” he added.
Both Dr Sheehan and Dr Flynn called for increased investment and measures to ensure that patients are not forced to attend EDs.
Dr Flynn said the acute healthcare system is already at capacity and that a flu pandemic would only impact this further.
“The figures from Asia and Australia indicate that this flu will be very virulent, it will spread quickly, and it will also be very aggressive,” he said.
“This will result in more people having flu complications and requiring hospital treatment.
“More people will require GP visits and more will be attending hospitals, which is not in anyway capable of taking on more patients because the hospital system is full to capacity.”
Meanwhile, figures from the INMO show that some EDs are already operating to capacity and are, in fact, overcrowded.
CUH saw a total of 781 patients awaiting beds for the whole month of September last year —the hospital has experienced more than half of that figure in just eight days in September this year.
More than 1,000 patients have been left waiting for a bed in CUH for the past two months in a row.
Dr Flynn said that unless capacity, staff, and resources are increased in the coming months and years, it will have a knock-on effect on the entire health sector.
“It might take a year or two to filter through fully but GP surgeries will basically become chronic disease management workshops, similar to hospital outpatient departments.
“This will make it harder for patients to access GP appointments and that will push them into SouthDoc which will be under even more pressure, or back to the EDs which are already under severe pressure.”
Dr Flynn’s stark warning comes at a time when services in Cork are reportedly losing staff rather than gaining them ahead of the expected winter pressure.
A source within CUMH claimed that many of the staff departures there are down to mismanagement.
“People are looking for slightly reduced hours in the hospital but they’re being refused and they’re leaving.
“So instead of reducing a person’s hours slightly by six or three hours, the hospital refuse and they lose a valuable member of staff and 36 hours of work.
“We’re losing staff for the sake of a few hours here and there and this is happening wholesale.”
Nurses and midwives in Cork recently sought an urgent response from hospital management in the region after raising concerns about what they say are unsafe and intolerable conditions at CUH.
The INMO has threatened possible industrial action in the region unless issues at CUH are addressed.
The union said Cork health services have been plunged into a crisis due to record overcrowding, hundreds of vacant frontline positions, and chronic recruitment and retention issues.
“Health service management must take tangible steps to relieve the misery for staff and patients,” said Liam Conway, INMO industrial relations officer for Cork.
“We cannot head into the autumn and winter period with no clear plan to address all of these problems,” he said.