As senior doctors in training and working in emergency departments, we welcome the most recent Health Information and Quality Authority (Hiqa) report that identifies unsafe and overcrowded conditions in a major regional emergency department ('Limerick hospital overcrowding 'putting patients at risk'', Home News, June 6th).Innovative and incentivised solutions are needed, along with serious regulatory consequences when action is not taken.Until Hiqa possesses the power of closure (even temporary) against unsafe units, or meaningful ethical or professional sanctions exist against hospital management, we fear that this report will merely accompany the myriad other reports into this issue - gathering dust on a shelf.We might also take this opportunity to signal a further threat to patient safety that has regrettably emerged. In the last few months we now have a situation where major emergency departments are left without in-house emergency medicine registrar cover at night.We hope that we will not need yet another Hiqa investigation as a result of this significant patient safety issue More...

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