The HSE has been accused of engaging in a "culture of secrecy" after it was found that an unpublished report about emergency care in nine HSE hospitals discovered “unsafe” and “unacceptable” treatment caused by overcrowding and staff shortages.
As reported in the Irish Examiner, the review, which was conducted in 2019, was not published by the HSE in the wake of Covid-19.
However, it has since been released to the Irish Patients Association under Freedom of Information.
The groups co-founder Stephen McMahon said: “Surely our patients deserve better than this, and we can and must do better than putting the whole problem down to overwhelming demand.”
He also said there was a “lack of appetite” for meaningful reform within the HSE.
The 'Independent Review of Unscheduled Care Performance', which was carried out under Professor Frank Keane, made 30 recommendations.
According to the report, 50 per cent or more of patients spent at least one night in the ED on a trolley before getting a bed or being discharged.
Meanwhile, in one hospital, patients were found to spend up to 10 nights on trolleys.
“For a start, the dignity, privacy, and safety of patients on trolleys needs attention,” the report said.
The report also raised concerns about “the adequacy of executive leadership and operational grip”, with managers often acting in a reactive rather than a proactive manner.
“Out-of-hours executive leadership commonly relied on tight (on numbers) rotas, often on a goodwill basis, which could promote burnout and become unsustainable,” the report stated.
Hospital staff did not always know who was in charge.
The report also criticised the HSE’s TrolleyGar system for counting patients on trolleys which was used instead of patient experience time, stating: “TrolleyGar is not a helpful measure and can introduce perverse behaviours.”
It also found that: “Access to diagnostics in EDs was good for life-threatening conditions, however for clinical decision-making it was slower, particularly at weekends.”
The report said that, due to overcrowding pressures, wards contained patients with a range of illnesses.
This meant that consultants and nurses were constantly moving around the building to find their patients.
The report reviewed Naas General, Tallaght University Hospital, Midland Regional Tullamore, Mater Misericordiae University Hospital Dublin, Cork University Hospital, University Hospital Limerick, University Hospital Waterford, St Vincent's University Hospital and Galway University Hospital.