Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I welcome this opportunity to address the House on the issues raised by the three Deputies. It is not the first time any of them has raised this. We hear it on a consistent basis. I acknowledge the distress that overcrowded emergency Departments cause to patients, their families and front-line staff working in very challenging conditions in hospitals throughout the country.

The health sector is facing significant challenges in providing emergency care over the winter period while also managing the demands of Covid-19.

The emergency department in Limerick is one of the busiest in the country, with over 76,000 attendances in 2021, which was up 16% compared to 2020 and up 7% compared to 2019. However, the numbers of patients waiting on trolleys for admission in University Hospital Limerick, UHL, in 2021 was 4.7% lower than in 2020 and 35% lower than in 2019. I appreciate that this is cold comfort to anyone who is on a trolley. The University of Limerick Hospitals Group has reported that it is continuing to deal with high volumes of patients attending the emergency department at UHL. This pattern has been sustained over a number of months and is being replicated around the country. UHL is working to ensure care is prioritised for the sickest patients. As part of its escalation plan, additional ward rounds, accelerated discharges and identification of patients for transfer to UL model 2 hospitals are under way. Surge capacity has been opened to manage the extremely high levels of activity.

There has been, and continues to be, substantial investment in UHL and the wider hospital group in recent years to address capacity issues. For example, a new emergency department opened in 2017. Since the start of 2020, 98 new beds have opened at UHL. This included the 60-bed modular ward block, which became operational in November 2020. It was established to provide a rapid-build interim solution to begin to address the bed capacity issues at UHL and improve patient flow. This also included a 24 single-room bed block, which functions as a haematology oncology unit, and a temporary 14-bed single room block, which has been designated for confirmed and suspected Covid-19 patients. These were initiated in May 2020 under the national action plan in response to Covid-19.

The winter plan for 2021-22 was published on 15 November and builds on the significant investment in last year’s winter plan. It aims to address the significant combined challenges faced by the health service over the winter period and recognises that a whole system response is required across primary, community and acute care. The scale of the challenges and demands faced by our health system requires both a plan and an associated system of governance and accountability. This system includes leadership, governance and operations to reflect the scale of the challenges faced and investments provided. The winter plan sets out the national, area and site level leadership and governance arrangements that are in place.

On the question of a review of UHL, the Health Information and Quality Authority, HIQA, is closely monitoring the overcrowding situation in a number of hospitals, including at Limerick over the past number of weeks. It has also had recent correspondence with the hospital group CEO regarding its evaluation of the current factors influencing crowding in the emergency department. HIQA has also written to HSE senior management to highlight its intention to initiate inspections under the national standards for safer and better healthcare.

The matter of performance in hospital emergency departments is under constant review by the Department through ongoing engagement with the HSE. The Department will continue to monitor the situation closely. On the question of a review at UHL, HIQA is closely monitoring the overcrowding situation in a number of hospitals and there are no further details in the response from the Minister for Health.

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