HSE launches 2018/19 Winter Plan

Concern it is 'too little, too late'
  • Deborah Condon

The HSE has announced a €30 million Winter Plan, which aims to focus on supporting hospital and community operations over the coming months. However, healthcare professionals have expressed their concern that the plan is ‘too little, too late'.

According to the HSE, its plan ‘seeks primarily to support older persons and their transition from the acute setting, and to support acute and community operations'.

As part of this, it proposes curtailing certain activities within hospitals, such as outpatient appointments and planned day case procedures, in order to free up capacity.

There will also be a ‘four-week period of enhanced measures' at nine hospitals which are of particular concern. This four-week period will run from December 17 to January 13 at the following hospitals:
-The Mater Hospital
-St Vincent's University Hospital
-Tallaght University Hospital
-Naas General Hospital
-Midland Regional Hospital Tullamore
-Galway University Hospital
-University Hospital Limerick
-Cork University Hospital
-University Hospital Waterford

"These sites, together with their community partners, will be the focus of intense monitoring and oversight for the four-week period identified. A Winter Action Team has been established for each of the sites and funding has been provided for enhanced measures to support the sites during the focus period.

"The enhanced measures include extended availability of diagnostics, extended opening hours of acute Medical Assessment Units and additional senior decision makers on site," the HSE said.

However speaking about the plan, the president of the Royal College of Surgeons, Mr Kenneth Mealy, pointed out that thousands of people now face having their scheduled surgeries and diagnostics cancelled over the winter period, ‘highlighting the vulnerability of scheduled health care each winter'.

"I understand why, in the existing system, it is necessary for the HSE to prioritise emergency care over scheduled care. It is, however, a sticking plaster of a solution that will discommode thousands of patients and put pressure on waiting lists in the New Year.

"This plan will have the greatest impact on those who cannot avail of private healthcare and, therefore, already wait the longest for their care. The procedures that will be delayed are life-altering procedures for those with chronic non-urgent conditions like joint replacement, where patients have already endured up to two years with severe pain, limited mobility and impaired quality of life," Mr Mealy said.

Meanwhile, the Irish Medical Organisation (IMO) insisted that the Winter Plan will only provide ‘temporary relief for some patients'.

"This plan is too little, too late. As usual, it ignores key issues and offers little in the way of meaningful solutions," commented IMO president, Dr Peadar Gilligan.

The organisation published a six-point plan, which it insisted would result in patients having to wait no longer than six hours in Emergency Departments (EDs):
-Increase acute bed capacity
-Increase access to long-term and rehab care
-Increase staffing levels
-Improve access to diagnostics
-Redesign EDs in order to maximise patient flow
-Provide appropriate resources for GPs and community care

"Capacity issues and difficulties accessing care right across the system manifest in the ED, which is often seen as the only point of access for patients to hospital care.

"The IMO's six-point plan to achieving the six-hour target in EDs in Ireland is based on the views of consultants in emergency medicine and on international best practice. This plan will deliver significant results, but it needs commitment, hard work and dedication from the Government," Dr Gilligan said.

Meanwhile, the Irish Nurses and Midwives Organisation (INMO) expressed its disappointment that the Winter Plan does not tackle the issues of capacity and understaffing enough.

It noted that over 100,000 patients have already been left waiting on trolleys in hospitals nationwide this year - a record high. It also emphasised that overcrowding is ‘not just a winter problem anymore'.

"Hospitals are over capacity every day of every season, and the problem is getting worse. It's clear from our initial consultation that the Winter Plan will not increase capacity at all this year and only modestly next year.

"The Government accepts that we need to grow the health service's capacity, but extra beds require extra nurses. Without addressing pay, our health service will simply not be able to attract enough nurses and midwives," commented INMO director of industrial relations, Tony Fitzpatrick.


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