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

This is a timely and necessary motion when we consider the state of our health service and the failure of the current Minister for Health who, unfortunately, is not in the Chamber to make any meaningful steps to address this crisis.

University Hospital Limerick, UHL, has been operating in a crisis, and has been for the entirety of Deputy Donnelly's time as Minister.

Indeed, it has been in crisis since Fine Gael closed down the emergency departments in Ennis, Nenagh and St. John's Hospital without delivering additional and needed capacity in UHL.

In Limerick, we have what is called the full capacity protocol, which was designed as an emergency measure to deal with overcrowding. It results in patients being placed in inappropriate areas of hospitals, overcrowding on wards, the cancellation of elective procedures and aggressive discharging practices. The protocol was never intended to be used every single day or to become the norm. While the protocol was used 30 times in 2011, the year Fine Gael took office, it was, unfortunately, used almost every single day in 2023. As of 30 April, the full capacity protocol has been in operation for 118 of the 120 calendar days of 2023. I accept there is a need to use the protocol sometimes but for it to be used so frequently shows there are major issues in our hospital. The Minister should be aware of those issues, which include capacity and staffing challenges. The frequent use of the protocol impacts patients across the hospital. In the first quarter of this year, 2,520 appointments were cancelled at University Hospital Limerick because available resources have been diverted elsewhere. Many of these people have been waiting for hospital appointments for many years with no date for when they will be rescheduled. People who were ready to go to the hospital, and in some cases people who were prepared to go to the hospital, had appointments cancelled.

This is not a new issue. The challenges facing staff and patients at UHL have been well highlighted by me since my inaugural speech in the Dáil in 2016. Of particular concern to me has been the number of people who are treated on trolleys in hallways in UHL and the challenges that poses to the staff and the patients themselves. In UHL today, 81 people are being treated on trolleys. For the year to date, the figure is 7,747. These are incredible figures and if not tackled, 2023 will pass out the disgraceful number of 18,012 patients who were treated on trolleys in 2022. Fine Gael pledged to end the scandal of patients on trolleys but the crisis is worse than ever before. There is a capacity and staffing challenge in UHL. While a 96-bed unit is currently under construction, it will only provide an additional 48 beds. Plans are afoot for a unit with additional beds but are still at the pre-construction stage. This needs to be expedited.

The health professionals in the hospital work very hard but in many cases, wards are understaffed. This is a risk to both patients and staff. In recent weeks, nurses in the ICU embarked on industrial action to highlight that their section is almost 25% short of the necessary staff. With the challenges facing the hospitals, is it any wonder that people are leaving our hospitals prior to being admitted? In the first three months of this year, 1,527 people presented at the hospital and were registered but never got into the emergency department. That is an absolute disgrace. Those 1,527 people were sick and went to hospital but left because they felt they would be better off at home.

The crisis facing our health service is not intractable. It requires work and planning but things can change. What is needed is a multi-annual plan that is backed by a strategic workforce planning to tackle the trolley crisis across the State. The Minister plans to deliver 1,500 beds over the next few years, yet the ESRI tells us we need 2,500. The Minister is already planning to fail. We need the availability of transitional care and recovery beds outside hospital settings. The numbers of these need to be increased, as does access to home care. We need change and I do not believe that a Fine Gael-led Government has the will or inclination to deliver. A mental health de-escalation unit was supposed to be up and running at the end of 2022 but still has not been delivered.

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