A&E overcrowding: not just flu

The recent increase in swine flu is not the sole or even the leading cause of the record numbers of people left lying on hospital emergency department trolleys around the country last week, the HSE has conceded.

This comes after a HSE statement released last Wednesday that specifically cited an increase in the number of patients with "swine flu, flu-like illnesses and other seasonal illnesses common at this time of year" as being among the contributing factors for that day's "surge in activity" in casualty departments.

Speaking at a press briefing in Government Buildings last Thursday, the HSE's head of health protection, Dr Kevin Kelleher, appeared to contradict flatly the HSE's statement on the significance of the flu. He agreed with the Irish Association of Emergency Medicine (IAEM) that flu had not made a big impact on emergency admissions.

The association had argued that last Wednesday's record number of 569 people on trolleys was a result of recent HSE cutbacks which left more than 1,500 acute hospital beds closed or otherwise unavailable.

A spokeswoman for the HSE has now claimed that the HSE had "at no time" suggested that "swine flu was the sole or leading cause of the emergency department busy period but that it was one of a range of contributing factors".

"Dr Kelleher would like to make it clear that what he meant was that swine flu was not having a big impact on hospital admissions and was not the sole cause, but that it is one of the many contributing factors leading to pressures in hospitals at the moment," she said. "This is in keeping with what the HSE has been saying all week."

However, this is in contrast to the IAEM's interpretation of the HSE's line on the matter.

In its statement last week, it noted that while the "predictable" seasonal advent of H1N1 influenza had increased the outpatient workload of emergency departments, "relatively few" patients with H1N1 required hospital admission.

"Contrary, therefore, to the line taken by the HSE, patients with seasonal influenza have not contributed significantly to the current excess of inpatients being boarded in emergency departments," it said.

"[The] failure to provide adequate hospital bed capacity to deal with the health service's acute workload is the primary problem to be addressed and cannot and should not be blamed on seasonal flu."