Maurice Quinlivan (Limerick City, Sinn Fein) | Oireachtas source

The Minister will be well aware that I have spoken on health issues a number of times, both in this Dáil and many times in the Thirty-second Dáil, so here we go again. I feel I have to do so because of the constituency I represent, which is Limerick city and includes part of Tipperary. We have University Hospital Limerick in that constituency.

I have to speak so often on health because, unfortunately, the issues of overcrowding and low staff levels are ever present in the hospital. The number of patients waiting on trolleys is nearly always the highest in the State. A total of 1,146 patients waited on trolleys in University Hospital Limerick in September this year. The numbers are massive and totally unacceptable. While they are down on last year, the Minister will be aware that the pre-Covid figures for January and February were much higher than those for 2019, which will be a major cause of concern after Covid. In February 2020 there were 1,286 on trolleys, by comparison with 973 in February 2019, and in January 2020 there were 1,215 on trolleys, by comparison with 973 in January 2019. Before Covid, the emergency department was often bursting at the seams and it was clearly unsafe for patients and needed urgent intervention.

University Hospital Limerick is a fine hospital and the staff, from porters to nurses and doctors, do an incredible job, but they often do so in very difficult conditions. I hope the Government's winter plan will provide some remedy for the problems faced by the hospital. These issues will become even more difficult to manage with the onset of the winter flu season, as the Minister is well aware.

I accept that the winter plan was never designed to be, or going to be, a panacea for all these issues. I hoped it would provide some solutions and comfort to the people of Limerick. Unfortunately, it seems my reasonable expectations were overly optimistic. As my colleagues said, we were not presented with a plan but with a fantasy list. The Minister knows, or at least should know, the difficulties faced by University Hospital Limerick. I have spoken about them here often enough and he is well aware of them. We are presented with offers and no remedies. What this plan offers is clearly inadequate. It is inadequate in terms of its ambition to increase the number of beds and, most important, in terms of targets to increase the number of staff needed to deliver appropriate care through the winter.

The plan aims to improve patient experience times in emergency departments and reduce trolley numbers by 30% compared with the winter of 2019. These are good ambitions but, quite frankly, the resources needed are not committed to. The plan proposes to open an additional 251 acute beds and 89 sub-acute beds in quarter 4 of 2020, and a further 232 acute beds in quarter 1 of 2021. I welcome any increase in available beds but I wonder whether the targets can be met. There are hundreds of unfilled vacancies across the health service. I am aware, from speaking to nurses recently, that there are a large number of vacancies in University Hospital Limerick. Without filling these positions, the new beds promised cannot be opened. There is construction in Limerick but there seems to be no real plan to make sure the facility will be equipped properly when the beds are in operation. The plan does not show enough ambition.

Sinn Féin's health plan, Better for Health, is ambitious. It would require significant and sustained public investment but would deliver results, not short-term achievements of metrics. It would result in a long-term commitment to move from a two-tier public-private health system to a universal healthcare system. Our plan targets the delivery of 1,100 additional acute and sub-acute beds and 50 ICU beds.

I have a difficulty with what is in the Government's plan and with the question of whether it can be delivered, but I wish to highlight what is not in it, that is, a commitment on mental health. In fact, not only does the plan not make any commitments on this important issue, it does not even refer to it. Mental health services have been chronically neglected for years. The winter plan is meant to be a short-term tactical plan but it is outrageous that mental health is absent from it. The Minister will be well aware that Deputies of all parties have raised their concerns over the number of mental health issues and suicide levels caused by Covid. Funding and resources for mental health are critical in my city, Limerick. The Covid committee has heard expert opinion and anticipates an increase in the number of mental illness cases due to the stress of Covid but there is no plan for this. Throughout the country, there are some wonderful mental health organisations that for far too long have been carrying a burden that the Minister’s Department should be helping with. I commend them on their often unseen and unreported work. The Minister and his Department have a responsibility in this matter.

There is no reference to disability services and no funding allocated for this year to kick-start cancer services that I can see. The Minister mentioned funding for 2021. I welcome the community specialist teams, however. This is a good idea. If this initiative is used correctly, it could support older people and help manage conditions outside the hospital setting. Visiting a hospital is daunting enough at any age but this is especially true with the added concerns about Covid-19 transmission.

I am deeply concerned about what will happen in University Hospital Limerick, especially the emergency department, over the winter. If I were to grade the Minister's plan, I would give him a low C but I am sure the algorithm of his colleague, the Minister for Education and Skills, Deputy Foley, would reduce this mark further.

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