Ms Noeleen Moran:

Our campaign has been engaging with the public petitions committee since 21 June 2022. We have made continuous submissions to it, creating a full picture of the situation facing the people of counties Clare, Limerick and Tipperary in the aftermath of our hospitals being downgraded to model 2 and our accident and emergency units closed.

We have qualified every assertion that we have made with submissions of local media reports; national media reports; Health Information and Quality Authority, HIQA, reports; the report commissioned by management at University Hospital Limerick, UHL; the Deloitte report; and our own campaign testimonies from local surveys our campaign has conducted. These reports highlight the serious mismatch between capacity and demand that exists at UHL. Over 400,000 people are currently reliant on just one emergency department at UHL. Our region has only one persistently overcrowded emergency department, ED, and no model 3 hospital, which makes it distinct from every other health region. That is why we say it the most disadvantaged health region in the country, by far.

HIQA identified this point in its unannounced inspection of UHL report where it found the hospital non-compliant with national standards. The management of UHL committed to the exploration of a model 3 hospital for the region in its response but no follow-up on this has occurred as far as we are aware.

When we questioned the abandonment of the proposal for a model 3 hospital in a meeting with the Taoiseach, we were told that a model 3 hospital was not the preferred model. In the Taoiseach's constituency of Dublin West, however, Connolly Hospital in Blanchardstown is a model 3 hospital. In 2014, the Taoiseach committed in a newspaper article published that he would not close this hospital on his watch as he directed more funding towards supporting the emergency department at Connolly Hospital. That shows a clear double standard when one considers that there are ten emergency departments within one hour of Connolly Hospital and none within the mid-west hospital region.

Patient dignity does not exist in the corridors of the emergency department of UHL. Lives are being lost, both by those who attend the ED who are not reached in time to be given the care they need because of the levels of overcrowding, and by those who are afraid to attend despite urgently needing care and die at home as a consequence. As part of our correspondence with this committee, we have received communications from UHL management, the HSE and the Department of Health telling us that a Government policy document, Securing the Future of Smaller Hospitals: A Framework for Development, which was published in February 2013, sets out the roles for smaller hospitals and locks us into this situation. We do not believe there is any politician in this country who is unaware of what is happening in the ED at UHL. Last January, 11,000 people from across the mid-west marched in Limerick after a calamitous winter season. As many as 15,000 people have signed our petition calling for our accident and emergency units to be reopened. Like us, the public recognise this could be any member of their family. A mother, father, sister, brother, son, daughter, grandparent or grandchild who is sick and in need of care at any given point could be put at risk because of the failings of the healthcare strategy in the mid-west. Our communities know that people are dying as a consequence. Sadly, people we know have died because of this failed health strategy and family members of the deceased are present with us today.

When the former Minister for Health, Deputy Harris, left the health brief, he acknowledged in an interview to a local newspaper in County Clare that people in the mid-west had been failed. The current Minister for Health, Deputy Stephen Donnelly, also accepted this before he became Minister. Many politicians attend our public protests but there is no follow-up action from them to address the situation. This time last year, we met health spokespersons from various parties because we were extremely concerned that the Christmas period was going to lead to a very serious situation. Sadly, we were not wrong. The Shannondoc out-of-hours GP service collapsed. There was panic. UHL had to declare a major internal incident and surgeries were again cancelled. This year, we have seen trolley numbers trending higher than ever before, indicating that this situation is not improving. On 23 October, a new record was set with 130 members of the public being left waiting on trolleys in the corridors of UHL. The response has been to argue over the metrics, with the Minister for Health favouring a change from the long-accepted Irish Nurses and Midwives Organisation, INMO, Trolleywatch figures to the lower TrollyGAR numbers. Massaging the figures will not do anything for patient care. The response has been to cut funding in the health budget, to introduce a hiring freeze and to introduce a dispersion policy for the elderly to discharge them to nursing homes, regardless of how far they are from their homes or family networks. Given the levels of overcrowding in UHL, we know this will disproportionately affect our communities. Politicians are the policymakers. Everybody knows what is happening in UHL so why the inaction in addressing this? Without a serious change in policy direction, the situation in the mid-west will continue to get worse. That is why we ask members to heed our petition and recommend the upgrading of our hospitals to model 3 and the reopening of our accident and emergency units.