Malcolm Noonan (Carlow-Kilkenny, Green Party) | Oireachtas source

I welcome the opportunity to address the House on this important issue raised by Deputy O’Donnell.

I wish to acknowledge the distress that overcrowded EDs cause to patients, their families and front-line staff who are working in very challenging conditions in hospitals throughout the country. The Minister has visited UHL and has been concerned for some time about the emergency care performance there. It must be recognised that UHL continues to deal with record volumes of patients attending its ED. To the end of May, attendances at the ED were up 11% compared with the first five months in 2019.

After his visit to UHL, the Minister requested that a HSE expert team review the day-to-day functioning of the ED in a leadership, management, operational and clinical context. Following this intervention and the recent HIQA report, the HSE’s performance management improvement unit has been directed by the chief operations officer to lead a process, in partnership with UHL team members, supporting the hospital and community services in driving a programme of work to respond more effectively to the current pressures. The performance management improvement unit will ensure that all necessary immediate steps are taken to address the safety issues identified. A detailed plan will be developed as a matter of urgency in order to ensure that they do not reoccur. The plan will cover issues including admission avoidance, pre-admissions, community interventions and alternative pathways, as well as issues relating to patient flow through the hospital and its ED. There will be a strong focus on pathways for the over-75s.

The Minister also welcomes the recent publication of HIQA's report and is concerned about the significant risk to service users identified in it. The inspection focused particularly on the important issues of patient flow and inpatient bed capacity in the hospital, staffing levels, respect, and dignity and privacy for people receiving care in the ED. The HSE has been requested to prepare comprehensive short- and longer-term improvement plans for all 29 EDs, including that at UHL, in order to ensure sustainable improvements in emergency care performance. The Minister met with senior HSE management yesterday and received an update on progress in the development of those plans.

There continues to be substantial investment in UHL to address capacity issues, including a 28% increase in UHL’s workforce since the end of 2019 and the opening of an additional 98 non-ICU acute beds. This includes the 60-bed modular ward block that was established to provide a rapid-build interim solution to begin to address the bed capacity issue at UHL and improve patient flow.

In order to deal with the increased level of presentations this year, reform of service delivery as outlined in Sláintecare is vital. This includes the expansion of community care and other measures to provide people with the care they need outside of the ED and improve patient flow and egress from hospital by providing more home care packages and nursing home supports. Investment of €1.1 billion was allocated in budget 2021 to expand capacity, increase services and support reform, and this level of investment has been maintained in budget 2022.

I do not have a date for the publication of the action plan. We will come back to the Deputy with that.

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