Finian McGrath (Dublin Bay North, Independent) | Oireachtas source

I welcome the opportunity to address the House on the issues raised by Deputy Quinlivan. I want to stress that I never rubbished anyone's arguments about Limerick hospital. I understand the issue and apologise on behalf of the Minister, Deputy Harris, who was unable to attend this debate.

I wish to acknowledge the distress overcrowded emergency departments cause to patients, their families and front-line staff working in very challenging conditions in hospitals throughout the country. The number of patients attending emergency departments continues to increase year-on-year. For the first eight months of 2019, the number of patients attending hospital emergency departments increased by 2.9% and the number of emergency department admissions increased by 1.7% compared to the same period last year. The emergency department at University Hospital Limerick, UHL, is one of the busiest in the country. As such, the hospital and CHO mid west were identified as one of the nine focus sites requiring additional investment, focus and support last winter.

According to provisional HSE TrolleyGAR data, there was a 70% increase in patients waiting on trolleys to date in the UHL emergency department in September 2019 compared to the same period last year. In September 2019, there were 897 patients counted on trolleys in UHL, a 28% increase compared to the previous month. It is acknowledged that this is unacceptably high and the HSE is actively working with the UHL group to ease congestion in the hospital, with a focus on facilitating transfers to level II hospitals, assistance from rehab units and community health organisation services and the prioritisation of diagnostics to aid inpatient discharges.

The health service capacity review published last year highlighted the need for a major investment in additional capacity. Progress has been made on increasing capacity in UHL. The average number of open inpatient beds increased by 4% between 2017 and March 2019. Since 2017, an additional 25 beds have been opened in UHL, including eight as part of last year's winter plan. A capital budget of €19.5 million has been approved for the provision of a modular 60-bed inpatient ward block at UHL, with funding of €10 million allocated in 2019. The new modular ward will include three wards comprising 20 single occupancy rooms with en suite facilities, two of which will be full isolation facilities and will provide care and treatment for patients from admission to discharge. The HSE has advised that the enabling works are complete and the main contractor is commencing work. In addition, the national development plan includes a 96-bed replacement ward block in UHL and capital funding was provided in 2018 to progress the design phase of the project.

Planning for winter 2019-2020 has also commenced. The Department has engaged extensively with the HSE in regard to planning for this. In that respect, the HSE has been asked to consider actions and initiatives over and above non-funded actions and to look at the building capacity and options available to them to alleviate the expected overcrowding. The Department expects to receive a draft winter plan in the coming weeks. In the context of planning and preparing for the challenges of the winter period, the Department and HSE have been considering a comprehensive approach to the current high level of delayed transfers of care. However, recognising the urgency of the situation, approval was provided to the HSE to begin actions immediately to the value of €5 million in 2019. As part of these measures, the HSE released a significant number of funding approvals with the NHSS this month, bringing the waiting time for the release of funding back to four weeks.

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