This week brought an admission from a local minister that conditions at the emergency department of University Hospital Limerick have reached crisis point.
Jan O’Sullivan’s description of the overcrowding as “intolerable” may not be a direct criticism of the Minister for Health James Reilly but there is a clear inference.
Once he got the job he said he always wanted, Dr Reilly made robust promises that he would be a man of action. He would “dismantle” the behemoth HSE and make the health service more accountable to those who fund it.
The HSE, however, remains something of a punching bag for a government that has continually cut its funding. It remains a convenient buffer while Dr Reilly has not yet seriously confronted the consultants and other powerful interest groups.
Meanwhile in Limerick, 30 patients were on trolleys in the emergency department awaiting admission this Wednesday morning, the highest number in the land. It is an unhappy distinction patients in Limerick have become used to.
A year ago, senior clinical managers in Limerick announced they would feel they had failed if there were still patients waiting on trolleys by the end of 2013.
In the early weeks of 2014, the level of overcrowding has threatened to break new records and the HSE has had to make embarrassing appeals to sick people not to come to the hospital.
The opening date for the new emergency department at Dooradoyle has been pushed out to 2016.
But capacity in ED is not the main issue. It has to be acknowledged that progress has been made in managing beds better throughout the hospital but funding constraints often mean there are not enough beds to accommodate people in the community after discharge. Cutbacks in homecare packages have only aggravated matters.
Dr Reilly must also listen to nurses who have been appealing to lift the recruitment embargo. Last month we reported how overworked nurses were “checking in” to their own place of work through stress. Such dedicated staff deserve better. And so do the patients of Limerick city and county.