Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

A range of issues is being looked at. I will come to the second emergency department in a moment. The point I am making is that to achieve the change we want in UHL, two things have to happen: capacity has to increase and there have to be substantial changes in how the hospital is run and care is delivered.

University Hospital Waterford before Grace Rothwell went in was the worst performing emergency department in terms of trolleys in the countries. If it was not the worst, it was one of the worst. It is now the best. It achieved that through two things: additional capacity in beds and staff in the hospital and fundamental change in how the hospital was run. Anyone in Waterford will say if you walked in at 7 a.m. she was in there asking: "Why is this patient here? Why has this bed not been turned around? Why have we not got this patient back into the community or a homecare package?" They turned it around. When I met the ED team in Waterford, I asked how it had been able to do what other hospitals have failed to do. The senior consultant said it was because they were there when their patients were sick, in the evening and at weekends and they had support from consultant and nursing colleagues across the hospital.

Do we need more investment? We do. That is why we have invested more in UHL than any other hospital in the country and why there are nearly 200 beds, in addition to that, being built on site. Capacity on its own is not enough. The recent HIQA report noted, very encouragingly, that the reforms we have been looking for are beginning to happen and there is much more that can be done.

On the Chair's question as to whether the region needs a second emergency department, I have asked HIQA, as the independent regulator, to look at that, with the clear caveat that there can only be an emergency department if there is a model 3 hospital. I will ask Dr. Henry to come in but the clear clinical advice I have is an emergency department attached to a model 2 hospital is simply unsafe.