Stephen McMahon, of the Irish Patients’ Association, said the data appears to confirm that harm has been caused to patients during the current hospital overcrowding crisis. “Studies have shown that such events in Irish hospitals are under-reported by as much as a factor of two,” he said.

“While the number of adverse incidents may appear small, these numbers are likely to increase.

“We would encourage all healthcare professions to report adverse events as they are aware of them to the National Incident Management System.”

Stephen McMahon of the Irish Patients' Association said that the HSE and the Government have been led into an emergency response, due to the lack of preparation. He said that the Emergency Department Task Force set up in 2016 by then-minister for health Leo Varadkar provided a whole-of-organisation senior management response, with patient representatives on board too.

"It met as many as nine times in a year during Leo Varadkar’s tenure but has only met twice this year," Mr McMahon said. "Bed capacity is a big factor. Bed numbers are regularly announced and repackaged. There never seems to be a reconciled bed count."

The Irish Patients' Association says better accountability is needed to deal with overcrowding. The association's Co-founder, Stephen McMahon, says the Emergency Department Taskforce should be meeting more regularly after only meeting twice in 2022.

Steven McMahon from the Irish Patients' Association is demanding answers from the HSE.

He told Newstalk: "The narrative from the HSE will be 'all this is a once-in-a-lifetime storm' ... No, we've had €23 billion invested in the system, and hundreds of millions put in to top up the system. And there's been very little accountability."

Stephen McMahon of the Irish Patients Association warned overcrowding “contributes to preventable deaths and injuries in our hospitals and communities”.

Stephen McMahon: I think what you've outlined there [Jonathan] is a very fair assessment of how serious the situation is, as of yesterday. In actual fact it's been going on for many years [overcrowding] but I think the sheer scale of it yesterday, almost like a warzone, for both the staff and patients who have had to endure these situations. We're hearing questions about whether junior doctors are being properly used on the discharge of patients; issues [and] questions about whether some consultants, and whether some patients are even seeing a senior consultant for the last seven or eight days in some hospitals. We've raised that with the HSE, which is the appropriate area, to ask them to investigate these allegations but a strong fact of the matter is that this is been going on for many years, Jonathan. This morning we heard about Beaumont Hospital going to full capacity protocol and I’d just like to explain to your listeners how serious it is that activation of the full capacity protocol is the result of many moving parts that not in alignment such as staffing capacity, infection control, and or the lack of management of those moving parts locally nationally and indeed politically. There were 19,135 occasions of full capacity protocols up to August 2020 which took us nearly eight months to establish from the HSE and it should be a near never event. They were supposed to do a risk assessment to understand what moving parts weren't working that caused this to happen, because exactly as you pointed out, Jonathan, it means people's operations are cancelled, the ED is over-run with patients, and perhaps having to move them up to wards and so on and with all the associated risks. In the NHS yesterday there was a report that their consultants said there was something in the region of about 500 patients a week dying as a result of overcrowding, and I’m not saying that that's happening in Ireland but if we downsize that there could be anything from 35 to 40 patients suffering death as a result of the overcrowding crisis that we have at the moment.

Interviewer: Stephen, on that point, in any other organisation if you ended up with a critical situation in a single department you would have staff urgently redeployed from other departments to try and make a dent in that. Is that happening in hospitals? I mean are we seeing consultants who normally live upstairs, if I could put it that way, being brought down to the ED where they probably don't want to be, but they’re needed right now?

Stephen McMahon: Well, this is a key thing, I mean you even hear about where it could be difficult to contact them [consultants] out of hours. You will hear people that are doing Trojan work or you’ve given examples there from the GP about the amount of work, and you were quite in your assessment that they are entitled to their time off and so on, but if there are contractual arrangements there has to be oversight that these are actually being fulfilled. The simple fact of the matter, Jonathan, is that the winter plan that was prepared this year was not even signed off by the board of the HSE. All they did was note it because they didn't have enough time, I think, to actually review what was actually happening.  They noted that the executive management team that put it together and the Minister had published it. The one thing you will very seldom hear from politicians or from people with other vested interests within the health system is the issue of accountability - you've touched on it - but there is really no accountability for when these situations happen. There’s been report[s] from Professor Keane, HIQA and so on, that talk about government's governance and leadership, and I think that it would be appropriate for the chair of the agency to make a public statement about the crisis that's been declared by his own management team on Christmas Eve. And really we could talk about down the road in five years time and Slainte Care - it is a crisis situation at the moment with Covid and flu and the viral infections. But let's say for instance, how difficult would it be for community pharmacist be able to prescribe first line antibiotics for infections, you know like that would be something, but is that a turf war or is it something that can be actually drafted in, as you quite rightly say: all hands to the deck to try and solve problems today.

Listen to full podcast here (19 mins): https://www.goloudnow.com/podcasts/the-pat-kenny-show-highlights-47/hospital-overcrowding-is-at-breaking-point-382242

Meanwhile, the Irish Patients Association has said it supports a call from the INMO for the mandatory wearing of face masks by members of the public for the next six weeks to minimise infections in congregated settings like pharmacies, supermarkets and places of worship. Director of the IPA Stephen McMahon said this would be a preventative step to protect people from preventable death and injury, given too many people are at risk in the current crises.

The Irish Patients Association’s Stephen McMahon warned overcrowding contributes to preventable deaths and injuries in our hospitals and communities. He also called for an independent investigation into the mess. He said: “We have unconfirmed reports that some public patients have not seen a consultant in the past seven to eight days. “The HSE needs to confirm all public patients have been seen ­regularly by consultants over the past seven days. “A further concern is that we have been informed that some ­junior doctors are reviewing and are not clinically competent to ­discharge patients. The HSE needs to confirm this is not happening and also publish the current ­readmission rates. The HSE needs to advise that all patients are ­discharged from hospital by ­appropriate competent people.

“Finally we believe it appropriate that the chairperson of the HSE board should make a statement to the patients and staff who have been suffering, especially in the light of the HSE’s own executive management teams declaring the current situation a crisis.”

Stephen McMahon: Ennis performance is a lot better (than UHL), it actually beats the national average of 82% satisfaction levels so obviously what's going on in Ennis, from a point of view from patient experience, is very commendable. The issue really exposed is the fact that in UHL, while 71% say they had a good to very good experience that leaves [sic] 29% or 30% of people that didn't have that experience, and they're (UHL) also saying that overall, the results were similar to 2021. You have to ask the questions like the issues that were arising then; what actions have been taken, and that. They had a score that people would rate their experience: like fair to poor was 0-6; good was a 7-8, and very good 9-10. There was loads of sort of grey areas there that people could [sic] tick to give a nuance on what their experience was. The lowest scoring number was this: 30% of the people of admitted to UHL waited more than 24 hours before admitted to a ward. There’s no new news on that really as we would expect that because in the month of November this year there was nearly 1,600 people on trolleys and wards, that was up 17% on the year before so you would expect that figure to drift out further for people’s experiences. 

A number of issues that are very important is that 14% of the people said that they did not have enough time to discuss their care and treatment with the doctor. Now that's a very important aspect of patients to understand - what is actually happening to them and what options they have, and what risks they have.  I suppose an area that I could zone in on [sic[] is quite simply the whole area of discharge of patients, because there were a number of very low scores that would come into the area of ‘fair to poor’. For example, before they left hospital when you’re given written or printed information about what you should or should not do after the leaving the hospital, that really only scored an average of good to fair. Also, did a member of staff tell you about the medication side effects to watch for when you went home. Again, an average of 5.1 in that score. Did a member of start tell you about in danger signals you should watch out for when you go home? They’re the very common sort of things that people are sometimes anxious about when they're going home. What do I need to look out for if I have to go back into the hospital again? It’s not an investment in beds and staff and all that, it's really a question of people asking these questions when they’re discharged - about their medicines, about what to watch out for when they go home…and to ensure that the hospitals are aware of their home situation and planning their discharge. Again, that got a low score, in other words did people have the facilities at home to be safely discharged so they can recuperate and so on. An important one I think, and I’ve heard a number of commentators in the Limerick and Clare areas say this, is that the doctors and nurses give your family or someone close to you all the information they need to help care for you. Again, that got a low score. These are things that can be dealt with pretty straightforwardly by developing the culture of putting the patient at the centre, and their family, and providing this information: Ask them - do you want to know more information about your medicines, or the side effects, or when to take them.

Ask them about what they need to know about going home when they're being discharged, and so on.

If they can do it in a restaurant - how many times during a nice meal that you have someone coming over to you [asking] “is everything okay?” That should be the same in hospital.

Interviewer:  Stephen you feel that there should have been more progress - obviously there are well known issues in terms of capacity and in terms of the hospitals, but you feel that there could have been progress between 2021 and 2022 in terms of the other aspects of care?

Stephen McMahon: Exactly, and I mean what we don't want to find is in 2023 that's there again there's been very little movement between the two years because it begs the question what is this information being used for?

I mean patients and their families went to a lot of effort and time to fill in those surveys a) to share their experience but also that the system would improve particularly where they’re highlighting things that need to change.

You know we would really advocate that that this survey should almost be done in real time, in other words, that should be going on going all the time every day, so that when people are being discharged, to get their experience at the time they're leaving. You could do it in the local supermarket around the airport where you hit the little green light, or the red light and it gives a very quick snapshot as to how people feel about things.

Interviewer: Stephen [sic] there were 628 respondents so at 39% participation rate do you think that accurately reflects the experience that patients in general have at the hospital or do you think that the figures we've seen coming out from there would be altered perhaps if there was a wider range of participation?

Stephen McMahon: Well, that’s really a hypothetical question insofar as it's very difficult to establish that.

Obviously would like to see a far higher rate and let me explain. It's our experience with the Irish Patients’ Association that sometimes people have a bad experience, and when they come out and have had their treatments, they just want to put it behind them. They don't want to talk or reflect on it because they just want to get on with living and recovering and so on. If you don't get people closer to when they've had that bad experience and you can actually lose the benefit of learning from that, and that's why we believe that there should be more real time surveys done in the hospital [and] not waiting a year or nine months for a report to be produced for that but actually giving the management feedback almost on a daily basis."

Listen to full interview here [06.05min]: https://soundcloud.com/clarefm/irish-patients-association-questions-lack-of-progress-at-uhl-as-29-report-poor-experience?utm_source=clipboard&utm_medium=text&utm_campaign=social_sharing

"The Irish Patients Association, which has repeatedly called for hospital patients to be surveyed in real time, described the figures as “shocking". “I’d be very concerned by that waiting figure. Five per cent might look like a small number but it can have serious effects on people’s health. We know that the longer you are left in the emergency department the more at risk you are of a preventable injury or death,” said its spokesperson Steve McMahon."

"Irish Patients Association has called for delays in patient care to be treated with the same urgency by the Emergency Department Taskforce as the Government has treated the extreme weather this week. Stephen McMahon of the Irish Patients Association said waiting lists were linked to overcrowding in emergency departments as operations are cancelled to make room for urgent cases. “There has been very little progress this year on weighted waiting times,” he said. "The national weather emergency team meets daily during bad weather vs very infrequent meetings [of the taskforce] for the winter emergency department overcrowding. Who is responsible for this?”

"Stephen McMahon of the Irish Patients Association has called on Minister for Health Stephen Donnelly to urgently reconvene a special meeting of the Emergency Department Taskforce to specifically review the HIQA report. He said the system must be made safer for patients and trust must be restored in the system's ability to improve the situation."

Watch video here: https://www.rte.ie/news/2022/1214/1341750-hiqa-emergency-departments/

"Stephen McMahon from the Irish Patients Association supports the new agreement but says it could go further."

Analysis from the Irish Patients' Association (IPA) found that the number of people on trolleys last month increased by more than 50% compared to the same time last year, with some hospitals experiencing rises of over 100%.

IPA chief Stephen McMahon, commented: "There has been a significant deterioration across the board among most hospitals…in summary, the winter plan is not working."

"Stephen McMahon of the IPA called for these differences to be investigated urgently, warning of a “significant deterioration” across most hospitals around the country."

Stephen McMahon, from the Irish Patients Association, spoke to Sally-Ann Barrett about the managers’ current level of accountability: "They [management] have to be fully accountable which means that they have to have the authority to be accountable for the spend of money and the resources that are under their control. And that it can’t [sic] start to come from the centre, it has to be locally devolved so that you can hold people to account or when underperformance happens. And you know, again, doctors, nurses, pharmacists, allied professions etc., are all accountable to their regulator if they underperform to the expectations of their professionalism; they can lose their licence and indeed lose their job, and yet management within the healthcare system making serious decisions on resources and how things are organised, to not have any such accountability."

Listen to podcast here [0.47 secs long] https://galwaybayfm.ie/galway-bay-fm-news-desk/health-minister-challenges-uhg-management-on-performance/

"Stephen McMahon from the Irish Patients Association says facilities that are available in the region to ease the burden on UHL should be used to their maximum capability." 

"The Minister [for Health] had set a target during the year in the in June that the 75,000 people who are waiting for inpatient operations, such as hips, would be halved by the year end. Now unfortunately that hasn't happened. The 300 million euro that he was setting aside for 2023 for the private sector [and they are] saying they just haven't got the capacity to use that. The Minister admitted recently that the funds of 350 million euro to tackle [this issue] this will be spent, so we do have a serious problem here."

Listen to Podcast here (starts at 7.43 mins): https://go.ivoox.com/rf/96130500

"Stephen McMahon from the IPA says it's having a frightening impact on staff and the level of care they can give: "So the impact of this is the ED is overcrowded. "Patients can be head-to-toe on trolleys with staff having difficulty moving between them. "I had one phlebotomist - a person who takes bloods - who told me at the weekend she had to help someone up from the floor."

"The Irish Patients' Association is warning elective procedures may have be curtailed this winter due to severe overcrowding in Irish hospitals. Spokesperson for the Irish Patients Association, Stephen McMahon is calling for one policy in particular to be introduced. ''So what we would like to see is that if somebody is  given an appointment for surgery and operation in the future, that the surgeon and their staff actually tell the patient, that they do have an entitlement to get their treatment onto the cross border directive, so that they don't have to wait years to get that treatment.''

“What we would like to say is that if somebody is being given an appointment for surgery and operation in the future, that the surgeon and their staff actually tell the patient, that they do have an entitlements to get their treatment onto the cross border directive, so that they don’t have to wait years to get that treatment.”

"The stark figure comes from the Irish Patients’ Association, as October saw a 26 per cent increase in patients attending EDs on the same month last year. Stephen McMahon from the Irish Patients Association says it’s having a frightening impact on staff and the level of care they can give: 

Listen to the podcast here: https://highlandradio.com/2022/11/08/some-eds-dealing-with-three-times-more-patients-than-2021/

"Stephen McMahon, co-founder of the patient rights and safety advocacy group the Irish Patients Association (IPA), said: “We see that some steps are being taken to improve patient flow through EDs but this revelation regarding turnaround times is yet another example of deteriorating conditions.

“The increase in emergency ambulances turnaround times nationally signals a further exposure to risk for patients in the community as ambulance capacity is reduced and its service becomes more challenged.” Mr McMahon stated that the latest figures mean the National Ambulance Service (NAS) would have to double its fleet to achieve an average 30 minute turnaround time.

“We appreciate the great work that our emergency responders do and those who work in overcrowded EDs - this deterioration is not their fault,” he added. “It has happened over a long time due in part to poor governance and accountability at all levels.”

"Speaking to The Echo, Stephen McMahon, co-founder of the Irish Patients Association (IPA), said that, while steps are being taken to improve patient flow through emergency departments (EDs), this revelation regarding turnaround times is yet another example of deteriorating conditions. Mr McMahon added that the increase in emergency ambulance turnaround times nationally signals a further exposure to risk for patients in the community. Mr McMahon stated that the latest figures mean the National Ambulance Service (NAS) would have to more than double its fleet in the SSWHG to meet the 30-minute turnaround target. “We appreciate the great work that our emergency responders do and those who work in overcrowded EDs - this deterioration is not their fault,” he added."

"If we start having a build-up of COVID and influenza, that's a sort of double whammy on the system. We know how the system can be affected by that from our experiences with COVID. The impacts are that it's unsafe for patients and staff when you have emergency departments which are overcrowded. On top of that, you have patients who have been waiting maybe a year for an operation, which has been cancelled as the bed is needed by somebody else."

"Irish Patients’ Association co-founder Stephen McMahon said the medicine shortage is ‘worrying’. He said: ‘It’s particularly so for patients with chronic illness. One thing we’re always told as patients is to take your medicine regularly, don’t skip it – and with good reason. But here are patients who  are having to do that very thing.’ Mr McMahon also pointed to price differences between branded and generic drugs as a possible cause why some facilities, particularly private facilities, might not be accessing certain drugs. ‘You could have a station where the bean counters are saying, “not those brand drugs”, [because they] are too expensive.’

"This is not a case of patients not turning up, this is the system actually saying they're cancelling those appointments"

'If we start having a build-up of COVID and influenza, that's a sort of double whammy on the system. We know how the system can be affected by that from our experiences with COVID. The impacts are that it's unsafe for patients and staff when you have emergency departments which are overcrowded. On top of that, you have patients who have been waiting maybe a year for an operation, which has been cancelled as the bed is needed by somebody else. The lesson we've got to learn is that it's vital that people get their booster shots. It's important that people still have time to take care of themselves. We know that the virus is out there, and for people who may have had boosters five, six or seven months ago, it's time to revisit that.'

The Irish Patients Association (IPA) broadly welcomed the announcement on Wednesday but sought assurances that moves to scrap inpatient fees would not have a knock-on effect for operational funding in hospitals. “It’s especially welcome considering the way inflation has gone now [and affected] families,” said IPA director Stephen McMahon. “In an awful lot of these cases it is people on low, middle incomes that are being [hit] by those charges so that’s welcome. “But in the end nothing is for nothing so it’s important that the hospitals are reimbursed for whatever the amount of money it was that they would have been collecting out of these charges, that they’re not penalised.” Mr McMahon also said similar concessions should be introduced for adults attending hospitals.

Irish Patients' Association, Mr Stephen McMahon said: "It's a major concern in the IPA that with so many GPs due to retire in the coming years, that there are going to be very big [service] holes in certain parts of the country. That has to be urgently addressed now."