Dr. Mick Molloy:

The two things go hand in hand. There are four streams of healthcare, as we mentioned earlier: chronic, acute, emergency and elective. The elective patients are the ones who tend to suffer because their care can be postponed. The other elements tend to be a little more immediate and take place in the emergency department or the outpatient department. People in cancer treatment and people needing cancer surgeries have to get that care immediately. It happens straight away. However, when people are put on a waiting list, they remain on a waiting list for a long time, hence the need to separate the two groups of patients. Unless there is a significant build in the inpatient facilities, we do not have the capacity to deal with all those elective patients immediately, so those elective hospitals do have a role. A lot of this can be dealt with as day cases but not all of it. Some of it will still require the benefit of a large inpatient facility with additional critical care capacity. Cardiac bypass or cardiac transplant cannot be done as a day case. All that work will still need to be done.

Critical care capacity needs to be enhanced. There was a report in 2009 suggesting our critical care capacity should be 550 beds. After Covid, I think up to 340 beds is our plan at the moment. We will still be well short of what we need in critical care capacity to deal with the volume of the service required at present, so both those elements are required. In the Senator's region in Galway, UHG needs significant expansion in its emergency department. Having been involved in two emergency departments that were new builds, I suggest that very close attention should be paid to the plans that are developed. In both the facilities in which I was involved the places were cut down in size before they were opened. We have now seen the need for them to be increased in size. We should therefore be very careful when the plans are put down that they are not cut back to save some money here and there. If the plan is for 50 or 60 spaces, it should be 50 or 60 spaces. That is what is required. Any of the hospitals in the United States or the UK that function well have significant numbers of spaces for patients to be managed. We expect many of our people to sit on chairs in corridors, which is inappropriate. We have many people waiting in waiting rooms while other patients get their treatment, but they get their antibiotics and fluids while sitting in a waiting area commingling with the patients who are waiting to be seen, which is not acceptable.