An independent review of 9 hospitals across the country - including University Hospital Waterford, found 'unsafe' and 'unacceptable' treatment.
The report conducted in 2019, was never released by the HSE but has now been made public following a Freedom of Information request by the Irish Patients Association.
The report states that 50% or more of patients spent at least one night on a trolley before getting a bed or being discharged - while it recommended an end to the practice of placing trolleys on wards once the health system becomes stabilised.
The nine hospitals in question were University Hospital Waterford; Naas General Hospital; Tallaght University Hospital; the Midland Regional Tullamore, the Mater, Cork University Hospital, University Hospital Limerick; St Vincent’s University Hospital and Galway University Hospital.
The 2019 report, which the HSE decided not to publish in the wake of Covid-19, was released to the Irish Patients Association under Freedom of Information.
The Independent Review of Unplanned Care covered the years 2018-2019 before the pandemic.
It examined nine hospitals which were under the greatest pressure during winter 2018/2019.
The hospitals selected were: Naas General, Tallaght University Hospital, Midland Regional Tullamore, Mater University Hospital Dublin, Cork University Hospital, University Hospital Limerick, University Hospital Waterford, St Vincent's University Hospital and Galway University Hospital.
The review found the nine hospitals in questions had the highest number of patients on trolleys during the period of Winter 2018 / early 2019. 8 of the hospitals were found to have deteriorated over the period of the previous five years - St. Vincent's being the only outlier.
The average time patients spent in emergency departments before admission averaged from 10 hours 58 minutes at UHW, to 17 hours and 5 minutes in Galway University Hospital.
The review outlined that the hospitals were challenged in terms of unscheduled care delivery, significantly greater when compared to hospitals in the UK, which "must inevitably put patients at risk and cause significant stress to staff".
While the emergency departments in Tallaght and Limerick were 'new', the EDs in UHW and Galway were found to be 'old and barely fit for purpose.'
Hospital staff did not always know who was in charge or if they were approachable. There were questions about the adequacy of executive leadership and operational grip in many hospitals.
A lack of capacity and a shortage of staff and funding were consistent underlying themes across the country.
It was discovered that critical care areas were not kept clear to deal with emergencies, while on occasion - there were transfers of patients out to a corridor when critically ill patients came on site.
Speaking to WLR in response to the publishing of the report, Sinn Fein Spokesperson for Health and Waterford TD David Cullinane, says the HSE has once again failed to be 'open and transparent'.
"In the first instance, it shows again an inability of the HSE to publish reports - and also to be open and transparent in relation to the findings of the report. This was a report looking at emergency departments in nine different hospitals and it found serious issues. There was overcrowding, no joined-up thinking, and no pathway for patients. It shone a spotlight on what is happening and what has been happening in emergency departments over a long period of time."
In relation to UHW, Deputy Cullinane says issues are not the fault of the hospital management - they are down to capacity problems.
"I think we all know with a long time that we have problems at UHW in relation to capacity. It's one of many hospitals that in my view, needs more beds. It needs more surgical theatre capacity and it needs more physical space. We need to expand the footprint of the hospital. There's no doubt about that. For the past 18 months, what we've seen is a change of focus. We haven't had trolley numbers as such in Waterford over that time period. Just because somebody is not on a hospital trolley, doesn't mean that they're not waiting for access to a bed and access for care. We have seen positive change and a more no tolerance approach to trolleys at University Hospital Waterford. Prior to those changes, we did have a very serious problem. We still have a problem in relation to capacity and what I want to see for University Hospital Waterford are the plans that the management want to deliver. In my view, it's not down to bad management at the hospital. It's down to a lack of capacity and a lack of support for the capital infrastructure and the funding to hire staff that needs to be put in to ensure that the hospital is more fit for purpose."
In a statement issued in response to WLR, UHW say they cannot comment on a draft report which they have not seen. They say the context of the report has also changed.
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