A recent report from the INMO has shown that this year is the worst on record for overcrowding in hospitals. Over 121,526 patients were admitted and left waiting for beds. This number will no doubt jump even more dramatically in 2024 once winter pressures are taken into consideration. 

The HSE continue to have no serious plans to improve conditions for either patients or staff and have imposed a recruitment freeze, meaning that staff who are already experiencing burnout have no hope of support as we reach the peak of the winter pressures period, further exacerbating long delays, lack of bed space and unsafe staffing levels. 

Tackling all of the issues that affect our healthcare system effectively requires a holistic approach. We must look for a sustainable plan to reduce overcrowding rather than a superficial solution which avoids tackling the root causes.

We have to be realistic, making any sustainable improvements into overcrowding or waiting lists will take time. There is no easy or quick fix. One of the major obstacles is capacity and staffing levels. Any strategy to reduce overcrowding or waiting times must look at workforce growth as a priority. Alongside this is the need for adequate facilities and equipment. In reality a strategy to effectively manage and reduce overcrowding or waiting lists is a long term goal which requires analytical support. 

Of course this all takes funding and our health services both north and south have been starved of this for a long time. We can no longer accept the option of private healthcare as a solution to all our problems. 

Our healthcare systems north and south are capable of innovation as we have witnessed with the vaccine rollout during Covid. It is vital that we use an innovative strategy to tackle these issues sustainably, taking a holistic approach rather than just a superficial one which will leave us open to ending up back at square one in no time. 

One of the issues raised around overcrowding was patients staying in emergency departments after their need for emergency care. This is a direct result of a lack of pathways out of ED to hospital wards, but also reviewing the whole discharge process, social care or community care being unavailable, this, coupled with an increased use of ED, will continue to be a problem. Unless major changes are made including a workforce plan, service redesign, an injection of funding into community care including pharmacies under a polyclonal model, as well as a public health campaign signposting patients to the appropriate treatment setting, both staff and patients will continue to be put at very serious risk. 

The strategy must look at pathways, ageing populations, long-term conditions, staffing, resources and community care to allow the system to plan ahead and ensure that patients receive the treatment they need while equally ensuring staff are not over stretched. Integrated care remains one of the top priorities for the healthcare system. Without this we are simply ignoring the fact that the majority of patients require a joined up healthcare approach across departments. We also face the very difficult challenge of caring for our elderly when the majority of services are provided by private companies. Ultimately we require action and vision from our government to make a real difference to the health system, not simply scratch the surface to improve statistics so they look good. 

We need a fully-funded all-Ireland NHS which can strategically reform services and ensure a workforce plan that will provide quality and safety for staff and patients across the country. This is the only way to ensure effective and essential cross border working, sharing information and joined up approaches to ensuring quality and safety in our healthcare system removing any need for private healthcare completely.