Up to 400 excess deaths in Ireland every year are linked to emergency department over-crowding, the president of the Irish Emergency Medicine Association has warned.

Dr Fergal Hickey called for an urgent investment in hospital beds so admitted patients can be sent to wards instead of spending days waiting for a bed to open up.

“The emergency department can’t function as an emergency department, because it is being used as a warehouse for admitted in-patients,” he said.

“That’s what it effectively is; warehousing admitted in-patients in a department which needs to be freed up to see the next group of patients.” 

Studies carried out by the Irish Association for Emergency Medicine previously indicated the excess deaths could come to 350 but as the population has grown pressures have increased in parallel.

“When you look at the numbers of people that are waiting 12 hours and 24 hours, you can see how big a clinical risk this is,” he said.

“The population is now at 5.1m, so that risk is higher. You are probably talking about 400 excess deaths, these are deaths which would not otherwise occur.” 

Yesterday, there were 354 people on trolleys according to the trolley count by the Irish Nurses and Midwives Organisation.

The units under most pressure were Cork University Hospital with 48 waiting, University Hospital Limerick with 43 and University Hospital Galway with 42.

Government approval has been given for elective hospitals in Cork and Galway but the sites have not yet been announced, and there is growing concern in University Hospital Limerick at the lack of a similar plan for Limerick.

Dr Hickey greatly welcomed recent Government plans to recruit 50 additional emergency medicine consultants, but is concerned this will not fix patients’ problems. 

“The Royal College of Emergency Medicine recommends there should be one whole-time equivalent consultant in emergency medicine for 4,000 patient attendances,” he said. 

“Given that we have 1.3m patient attendances, we are currently working off one in 12,000. We have one third of what Britain would say there should be. ” 

However, he said: “The minister seems to think that by appointing more consultants that will in some way solve the trolley problem. Of course it can’t and it won’t.

“The trolley problem is due to the fact there are too few hospital beds.” 

Ireland has 2.7 hospital beds per 1,000 of population compared to the OECD average of 4.3 per 1,000.

This, he said, leads to hospitals frequently running at well over 90% occupancy or over 100% when the accepted safe level is 85%.

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“So you come to the [emergency department] with a hip fracture, then we will decide that you need to be admitted into hospital. There is no bed for you,” he said.

The only way to address this bottleneck, he said is put “somewhere in the order of 2,000 to 2,500 beds into the system.” 

He echoed a call from University Hospital Limerick CEO Professor Colette Cowan for more beds there as part of the solution. 

He highlighted also a salary disparity issue which affects recruitment for all consultant roles.

“The big problem is they are not going to be able to recruit them,” he said.

“Since 2012 what are called ‘new entrant consultants’ earn approximately 2/3 of what consultants appointed prior to 2012 earn. They are doing exactly the same job.”

Read MoreParts of busy Cork emergency department closed due to air conditioning fault

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