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ICU capacity still far below HSE recommendation ahead of winter

After spending billions of euros on healthcare over the last decade, Ireland’s critical care capacity is still far below HSE recommendations.

At the start of the Covid-19 pandemic in early 2020, Ireland had a total of 255 ICU beds.

By early 2022, that figure had grown to 297, representing an additional 42 permanent beds.

In February of this year, Health Minister Stephen Donnelly told the Dáil that his Department was aiming to open a further 28 beds before December, bringing the national total to 325 by this year’s end.

This represents an additional 70 beds since the start of the Covid-19 pandemic.

However, this 325 bed figure is still far below what the HSE has previously called for.

In the 2009 HSE report “Towards Excellence In Critical Care,” it was recommended that Ireland should increase its number of critical care beds to 579 by 2020.

The report, which is now 13 years old, complained about high occupancy rates at the time – a problem which still exists today.

“Almost all hospitals cited discharging patients early due to pressure on critical
care beds; typically CCU and normal ward beds are being used for these patients,” it read.

It should be noted that Ireland had more critical care beds in 2009 than it did in 2020 at the start of the Covid pandemic – 289 versus 255.

Moreover, in 2017, the Department of Health’s “Health Service Capacity Review Report” recommended that Ireland’s adult critical car beds be increased to 430 by 2031 – a goal likely to be missed.

This is despite the fact that Ireland has significantly increased spending on healthcare over at least the past 8 budgets.

In 2012, Ireland spent €14.2 billion on healthcare, compared to €24.4 billion in the latest budget – an increase of roughly €10 billion.

Overall, the government spent €17.1 billion in 2020, and €12.6 billion in 2021(around €30 billion total) including PUP payments and Department of Health spending on PPE.

Ireland’s limited ICU capacity has always been a problem at winter time, posing a challenge for hospitals for years.

However, during the Covid-19 pandemic the pressure became a critical issue, resulting in a lockdown being triggered in both 2020 and 2021.

Now this year, in 2022, Irish mainstream media appear to be gearing up ahead of winter.This month the state broadcaster RTÉ News claimed that winter ICU admission numbers are on course to create “hell on earth” and “armageddon” in hospitals over the winter, between flu season and Covid-19.

“We simply don’t have the bed capacity to cope as things stand and that has not been addressed after many years of agitation on this issue,” said Dr. Fergal Hickey, President of the Irish Association of Emergency Medicine.

“Our acute beds capacity is 2.8 acute hospital beds per 1,000 of the population, the OECD average is 4.3, so we’re going into this with one hand tied behind our back.”

He described the government’s winter initiative as “completely stupid” and said that it is a year-long issue.

“The only time that there seems to be either political interest in this, or health service management interest is in the winter, and yet, we set records all through the year.”

 

 

 

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