Ms Marie McMahon:

There are 514 people dead. That is a shocking and unforgivable number. Yet, that is the minimum number of deaths the Mid-West Hospital Campaign estimates has happened in our region at the only ED - that at UHL - since our petition, with over 15,000 signatures, was first submitted to this committee on 21 June 2022. Our conservative estimate is based on extensive research carried out by Dr. Chris Moulton and Dr. Cliff Mann, who both have a litany of titles following their names. Dr. Moulton is a consultant in emergency medicine, is involved with the European Society for Emergency Medicine, and is a senior lecturer in emergency medicine at the University of Manchester. Dr. Cliff Mann was the NHS national clinical adviser for accident and emergency care and has other titles. The research was carried out in England in 2019, a country where the ED set-up is very similar to that in Ireland. Further research by other experts in emergency care has since been carried out which supports the findings of Dr. Moulton and Dr. Mann. Based on the outlined research, 514 is the minimum estimate of those who have died as a direct result of delays in the ED at UHL since this petition was presented to this Department. It is a damning indictment on any Government and any health Department that it could ignore five people dying in such a timeframe but over 500 people dying in one small region of the country is unforgivable. It had and has become far too easy to ignore but no more.

Despite extensive lobbying, our political representatives from the counties of Clare, Limerick and north Tipperary have failed to endorse our simple request, which is the reinstatement of our EDs in Ennis, St. John's Hospital and Nenagh. Almost all political representatives from across the region, both in the Dáil and the Seanad, have remained silent on the reintroduction of our EDs.

There has been much deflection. We need more elective hospitals, which do not have emergency departments, more private hospitals, care in the community and ambulance protocol - we have heard it all. Not one political representative from our region has ever acknowledged that this region has only one hospital for a population of over 400,000. Compare that with the furore over Letterkenny hospital – a model 3 with an emergency department – even though the Saolta University Health Care Group region has an emergency department for every 120,000 people. Some political representatives have told us they have spoken to the Minister for Health, officials or colleagues, but they never give us any detail. Words are cheap. We need action. To date, there has been very little.

This campaign continues to do the research. This campaign has worked out just how deprived and starved our area is in comparison to others when it comes to emergency department provision. We have had to do our own research without the help or support of any regional politicians, who have numerous resources, including fully funded staff, to assist them, yet they reassure the region's population that they are on our side. The Minister and many others have talked repeatedly about the investment in UHL and how facilities there are better there than in Portlaoise, Tullamore and Waterford, all of which have emergency departments. The population of Portlaoise's region have 11 other emergency departments to choose from in the same timeframe it would take me and many others in Clare to reach UHL. In Tullamore's region, there is a choice of ten other emergency departments for the population while those in Waterford have a choice of three others in the same timeframe. I do not have that choice. I have one hospital to go to, and that is Limerick. Why are the people of our region treated as second class citizens?

This campaign wrote to the Minister on 5 July following his visit to Clare and Limerick. The reply we received, dated 19 July, failed to address most of the issues we raised. The campaign responded on 19 August and here we are today, 16 November, still awaiting an answer.

A substantial number of people living in the region live over one hour away from Limerick. This does not account for delays in ambulance availability or the difficulties with Shannondoc. No wonder people have said time and again that they do not want to be taken to Limerick's emergency department if they are ill and that they would rather die in their own homes and in their own beds than on a trolley. I wish I had done that for my husband. I would suggest that there are very few families living in the region who have not had, or know of someone who has had, a traumatising experience in UHL's emergency department.

Between 21 June 2022, which is when the petition was submitted, and 13 November, which was the date of this submission, a total of 38,143 people were on trolleys and chairs in UHL's emergency department. Since January 2023, many days have been recorded as having over 100 people on trolleys and chairs in UHL, with a new record of 130 set on 23 October. These figures are counted and published by the INMO, which has been doing this since 2004. It only counts trolleys Monday to Friday, so Saturdays, Sundays and bank holidays are not counted. This is something we as a campaign stress when weekly, monthly and yearly figures are counted, and it is important that this is recognised. The campaign takes a weekly average of Monday to Friday and averages out a figure for Saturday and Sunday. In recent months, attempts have been made to dispute the TrolleyGar figures by Government politicians and HSE personnel. Why now when those figures have never been disputed in more than 18 years of counting? I think we know what the answer is.

My husband died on a trolley back in April 2018. For the first 14 hours he was on that trolley, he would not have been in the TrolleyGar figures because he had not been seen by any doctor. That puts the TrolleyGar figures into perspective.

We in the mid-west region know the reality of having to attend the emergency department of UHL. Sadly, it is our reality and lived experience.