Ms Colette Cowan:

For the information of members, the new emergency department opened on 29 May 2017 and has now been opened for one year. This time last year, approximately 179 patients would go through the emergency department each day. This year we have seen a growth of 5.5% in activity and 210 patients on average per day go through the emergency department. Last Friday, we had a high of 229 patients attend the emergency department for treatment. There is a number of reasons for that. Of interest is that in comparison to last year we have an increase of 2,000 patients aged over 75 attending the emergency department. This is a significant jump of 5.9%. Of the 2,000 patients over 75 years who attended for treatment, the figures indicate that 30% will be admitted and remain in the hospital for a number of days to get the full capacity of care they need. This is a major change. We are aware that with population growth, we will have an increased need to treat older people in services. It is known that the Limerick area has the highest number of people aged over 85 living alone. These older people will acknowledge that they tend to come to the emergency department because it is a safe place for them to get treatment.

We have activity from the GP and Shannondoc referrals, which can be high at times. It is important note in respect of general practitioners, however, that they are working flat out. They are working long hours and they rely on us for the diagnostic access, which means they tend to send patients in for treatment and care. We are in discussion with GPs on the development of an urgent care centre. In recent weeks, a few of them visited an urgent care centre in the United Kingdom with some of my team and some of Mr. Gloster's team as part of the effort to find a diagnostic model that support the GP service. I am aware that general practitioners are currently commencing or in negotiations on their contract, which is pivotal. If one wants to assist the emergency department in the mid-west region we need the GP and the primary care service enhanced and supported in their role. I know the negotiations are under way.

Regarding staffing ratios in the mid-west region, I have a very bright clinical director working for me who analysed a great deal of data from the HSE's national human resources department shared his analysis of them. Out of his analysis came his concern regarding the number of whole-time equivalent staff in the mid-west region. We have discussed the matter and we will do further briefing and analysis with national HR to ensure we have the exact facts around those figures because we will need to examine the issue if it is the case that the number is so high. Given that data can be subject to different interpretations, we need to be factual on that.