Martin Browne (Tipperary, Sinn Fein) | Oireachtas source

Offhand, I cannot think of the man who was in with Ms McNelis. He has done up his place. Everything has been cleared and there is no fire risk but he has failed to get insurance and so cannot draw down the second part of his mortgage to pay for his house. All the specifications have been met and everything is up to the best standard possible but he is in that situation. We need to come up with a solution so that we do not lose that part of our heritage. We will ask the two Ministers of State in and we will see whether they can fill us in on how they read the documentation we got back from Europe.

Petition No. 36 of 2022 is titled "Reopen Ennis, Nenagh and St. John's Emergency Departments” and is in the name of Ms Noeleen Moran. The petition relates to the 2009 Government decision to downgrade Ennis, Nenagh and St. John's Hospitals and to close their emergency departments. This decision directly contributed to an increase in overcrowding at University Hospital Limerick and poorer access to healthcare for those in the mid-west. Trolley watch data highlight the extent of this overcrowding. It is estimated that there is one extra death for every 82 patients admitted to an emergency department whose transfer to an inpatient bed is delayed beyond six to eight hours from the time of arrival at the emergency department. In June 2022, there were only three days on which the numbers on trolleys were lower than 82.

The up-to-date information we have is that the petitioner has raised concerns over the time taken to progress the petition and the lack of response from the Minister of Health. On foot of these concerns, the secretariat completed a full review of correspondence issued and received in respect of the petition. On completion of the review, it was identified that the Minister’s office had responded on 23 January 2023 and, due to an administrative error, this item was missed from the correspondence list for the committee.

In the Minister's response, it is stated that, in 2013, the smaller hospitals framework defined the role of smaller hospitals and the need for both smaller and larger hospitals to operate within hospital groups. The Minister states that this framework provided a stronger role for smaller hospitals like Ennis, Nenagh and St. John’s hospitals in delivering a higher volume of less complex care, in many cases, closer to patients’ homes.

On the emergency departments in Ennis and Nenagh, the response goes on to state that, in April 2009, a process of reconfiguration commenced with the closure of the 24-7 emergency departments in Ennis and Nenagh. These emergency departments were replaced with medical assessment units for GP referrals and by local injury units and urgent care centres for self-referrals. These operate 12 hours a day, seven days a week. These changes were supported by an emergency care network that had been set up in the region and which is led by consultants in emergency medicine.

This reorganisation coincided with the establishment of the motorway from Ennis and Nenagh, on which, the response states, the travel time by ambulance between hub and spoke was never more than 30 minutes. The objective of the reconfiguration was to provide safer care to patients with acute health problems while striving to make specialised services more accessible to patients in their local hospital. Ennis and Nenagh hospitals have an integral role in the future growth of healthcare in this region in the provision of ambulatory care, chronic disease management, day surgery, five-day surgery, endoscopy, local injury and medical assessment units in Ennis, Nenagh and St. John's hospitals, and much more besides.

On overcrowding in emergency departments, the correspondence states the Minister has expressed his concern about overcrowding in the emergency department in Limerick and acknowledges the distress caused to patients, their families and front-line staff working in very challenging conditions in emergency departments in UHL and throughout the country. The HSE's performance management improvement unit has been directed to lead a process, in partnership with UHL team members, supporting the hospital and community services and driving a programme of work to respond more effectively to the current pressures. This process will ensure all necessary immediate steps will be taken to address the issues identified, and a detailed plan is being developed to ensure they will not recur.

The committee recommends that the response from the Minister be forwarded to the petitioner for comment and that the committee write to the petitioner, apologise for the omission of the Minister's response and assure the petitioner that processes are in place to ensure this issue will not arise in the future. Do members have any views on that?