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

I welcome the Health (Amendment) Bill 2023. The abolition of inpatient charges in all public hospitals is a welcome step that will hopefully alleviate some of the financial concerns facing patients who have had the misfortune of having to attend hospital. The inpatient charge of €80 per day was a burden for many, particularly for those who had the misfortune of having to return and stay in public hospitals on multiple occasions, often multiple times a month.

It follows on from the Health (Miscellaneous Provisions) Bill which removed the same charges for persons under the age of 16. Again, that was a welcome move and one which helped patients but there are additional concerns which patients face and these need to be addressed urgently.

Those on outpatient waiting lists still face the burden of long delays and car parking charges when they have hospital appointments. Perhaps the scrapping of these charges would be a positive step for those who need to attend hospital. Regretfully the outpatient waiting lists are even more stark than those of inpatients.

Again in University Hospital Limerick, UHL, there are 28,505 people on outpatient waiting lists with nearly 18% of those, 5,121 people, waiting 18 months or more for an appointment. These lists show no sign of reducing because the staff at the hospital have been pulled away to deal with the trolley and capacity crisis at the hospital. The trolley crisis, recruitment across the services, and access to waiting lists are crucial issues to be addressed in the health service and yet we hear very little from the Minister on these issues.

Already in UHL there have been 3,931 people on trolleys so far in 2023, with 106 people on trolleys yesterday and 107 languishing on trolleys today. Patients and staff deserve much better than this. The people of Limerick and the mid west deserve much better than this.

At UHL in Christmas week the hospital was overwhelmed with presentations, which I have said in here in the Dáil on a few occasions. An emergency plan was implemented in the hospital and this reduced trolley numbers for that month. As soon as the emergency ended, the trolley numbers shot up again and the February 2023 figures were forced on those in February 2022. Unfortunately, in this March we will see figures higher than in the past year as well, unfortunately.

Unfortunately, if the figures continue like this, we will have more people treated on trolleys than the massive 18,012 who were treated in this manner in UHL in 2022. Let us call this what it is. This is a national disgrace. The metrics keep going the wrong way and they seem to be consistently doing so under this Minister’s watch. The members of the Irish Nurses and Midwives Organisation, INMO, are approaching their limit in terms of working conditions which they advise are neither safe for the nurses, for other staff, or for patients. The INMO is balloting for industrial action in pursuance of safe staffing. Is the Minister not embarrassed by this? They have advised that nurses in each hospital have stated that unsafe staffing is the norm. They want and deserve a fully funded workforce plan for the coming winter. In UHL there is funding for 91 ICU nurses yet there are only 70 available to be rostered. These kinds of staffing deficits have a very significant impact on patients and nurses. Nurses work long and hard and many a day deal with the heartbreak and tragedies which are natural in a hospital setting. They need a work-life balance and need to see this Government step up their efforts to recruit and to train nurses.

In January 2022 doctors in the UK issued a paper in the Emergency Medicine Journal showing that the delays to hospital inpatient admissions of more than five hours were associated with an increase in mortality. They noted that for every 82 admitted patients whose waiting time was delayed more than six to eight hours, there is one extra death. At UHL these types of wait times are quite normal at the accident and emergency unit.

Last March Health Information and Quality Authority, HIQA, inspected the UHL accident and emergency department and in its report the health watchdog noted that the overcrowding and the understaffed department posed a significant risk to patient care.

Little adjustments like removing the €80 inpatient charge, while welcome, but are low-hanging fruit in terms of addressing the crisis in our health service. We need to see the Minister reach higher now and seriously commit to tackling the issues of overcrowding, especially at UHL, together with the unsafe staffing levels there and the ongoing capacity levels as we have consistently called for him to do. The Minister cannot sit back and see figures rise exponentially in UHL, which they are going to do again and, unfortunately, 2023 will see even higher trolley numbers.

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