Micheál Martin (Cork South Central, Fianna Fail) | Oireachtas source

I thank the Deputy for raising this very important issue and I appreciate his interest in my longevity in politics. On a serious note, we have to keep working hard to effect change. We all have to keep at it.

It is interesting that in the last 20 to 25 years, health has been transformed. There is no comparison between outcomes and survival rates today when compared with 20 or 25 years ago. I said yesterday in the House that the reason for this was that we took a more strategic approach to the big diseases that were killing people. There are a number of aspects to health. There is access, which the Deputy touched on, and of how people are treated in an emergency. There are also the matters of how we increase life span, how we increase quality of life and how we reduce the burden of disease on people. To me, that is the big story in health that always gets lost in the most immediate headlines and that is frustrating for many people who are working. As I mentioned yesterday, I spoke to a consultant in stroke care who posted a story on Facebook last year about an almost miraculous intervention with a patient through thrombectomy. The patient got to hospital in time.

He got 1 million views. The point he was making to me was that we were not communicating events like that. It just took off. It was a very good story about how a person was saved through modern methods of dealing with stroke, but also a better strategic approach to dealing with stroke in terms of stroke units. The cancer strategies have been immensely successful, with the centralisation of cancer centres and so on. The cardiovascular strategy has been very successful. However, numbers are growing because the population is growing and I feel that services have not grown over the 20-year period to match population growth. That would be a view I would have, and I think that manifests in health.

In terms of the specific issue, my understanding is that the protected disclosure might have been sent in June. I stand to be corrected on that. The Minister has met with the NCHDs concerned. As the Deputy knows, the HSE performance management and improvement unit led an intensive engagement with the hospital group and the mid-west community healthcare organisation, CHO, throughout the summer in response to how the hospital was functioning. To be fair, it was not just NCHDs. I think HIQA also raised issues about the hospital. The unit worked with UHL to support and oversee the implementation of rapid improvements in services in the region. These measures include a renewed focus on hospital avoidance, patient flow discharge planning, and regular and frequent assessments of patients with long stays. The performance management and improvement unit is still supporting UHL. It remains a work-in-progress.

There is a bespoke site-level plan for Limerick as part of the national winter plan. It needs more consultants and the recruitment of extra staff - two emergency medicine consultants and discharge co-ordinators to target patient flow. That is now happening and they have been hired. The plan also includes improving access to diagnostics in the emergency department, the enhancement of GP out-of-hours services, and committing to the presence of senior decision-makers on a 16-hour, seven-day-per-week basis. The workforce in Limerick has grown by 833 whole-time equivalents. That is an increase of about 29%.

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