A&E Overcrowding, a different perspective

In Blog, Health by Denis Naughten

It’s time to take a new approach to fixing the overcrowding problem in our emergency departments.

Albert Einstein said the definition of insanity is doing something over and over again and expecting a different result. Is this what we are doing within our health service?

The more beds we provide in our hospitals, the more that will be filled. I am not suggesting that we curtail the number of beds but what I am saying is that we are not doing enough to prevent people from getting sick in the first place.

As many people know the health service is something very close to my heart and that is why since my appointment to Government I have been tackling the health problem from a different perspective.

We have to change how the whole health system works and this can only happen by looking at the problem in far broader terms. This starts by trying to prevent people from getting sick in the first instance.

Two measures which I’m driving as Minister are specifically targeting those with respiratory conditions.


Respiratory disease accounts for 5.7% of in-patient discharges but over twice that (12.4%) in the number of bed days used.

There are two other important statistics that need to be considered: firstly 1 in 5 children in Ireland have asthma and we have a total of 470,000 asthma sufferers; secondly it’s estimated that 440,000 people nationwide have COPD (chronic obstructive pulmonary disease).

So is it any wonder that on average 1 in every 8 beds every year in our hospitals is occupied by a patient with respiratory disease, and this figure is much higher during the winter months?

So what are we doing?

Firstly, a pilot initiative is running in Dublin called the Warmth and Wellbeing Scheme which is managed by my Department and the Department of Health. It aims to measure the health and wellbeing impact of improving the energy efficiency in a home. The scheme is open to children aged 12 and under and adults over 55 who are living with chronic respiratory conditions and in receipt of the Fuel Allowance or the One-Parent Family Payment.

Those who have availed of the Scheme are reporting that they’re using less antibiotics, feeling warmer overall and the air in their homes is fresher. The anecdotal evidence is also showing that those who benefited from the scheme are attending A&E less and are also less likely to be admitted to hospital.

Secondly, from next September we are going to phase out – over a 12 month period – the sale of smoky coal. Some are mischievously suggesting that this is a ban on the burning of turf to suit their own political agenda. This is not the case, nor have I even considered such a ban.

What we are doing is banning the sale of smoky coal throughout the country, becoming one of the first countries in the world to do so. This will improve air quality in many of our smaller towns and villages when, on certain days, the smog can be as bad as that which is experienced in major cities across the world such as Beijing.

In tandem with this I am doubling the number of air monitoring stations throughout the country. These stations will be linked to the internet which will give the public access to real time air quality information. This will also help with our own pollen count projections that will benefit asthmatics at certain times of the year.

It is the health of the most vulnerable groups in society that is jeopardised the most by poor air quality: the sick; toddlers and children; older people and those with disabilities.

The steps we are taking now will help to address the unacceptable reality that four people a day in this country die due to poor air quality, with the knock-on impact on hospital admissions and overcrowding.

These actions will also help us to meet our long term climate targets.

The future health of our children and our grandchildren is in our hands. The damage done from air pollution can be gradual and may not be evident for many years. At the very least we owe our future generation air that is clean.