Mr. Sean Egan:

We have conducted two inspections in Limerick over the past 18 months. First, we echo completely the concerns that have been raised about the impact of overcrowding in that hospital. It is extreme. It is the worst performer in the country. One of the early inspections we conducted in our new programme of inspection was in Limerick, to shine a light on the conditions and seek improvement as regards the findings we raised. When we conduct inspections we expect that a compliance plan is formulated by the hospital and we follow up with the hospital at regular intervals, not necessarily always through inspection but through the review of documentation and other evidence, to confirm that it is moving in the correct direction in the implementation of the recommendations. There was a comprehensive compliance plan provided when we conducted our inspection in March of last year. The reinspection we conducted in February of this year was able to point to some improvement as regards the way the hospital was managing the situation. One of the key issues we found last year was that it was significantly understaffed in the context of nursing staff in the emergency department. That issue was remedied relatively quickly following our inspection but, as our CEO outlined, at the fundamental root of this is that in Limerick there is a deficit in capacity relative to demand. That capacity will be addressed with the addition of extra bed capacity, but that will take some time to actually implement, so-----