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

Generally, a Minister or Minister of State is on Front Bench cover on a given day and will take a range of questions, whether Commencement matters or Topical Issues, during that day. I am glad Deputy Quinlivan was contacted and informed the matter would not be taken by the Minister for Health or one of the Ministers of State from that Department. This issue of who responds to questions has been raised before. It is important that there be clarity for Deputies who bring forward issues, all of which are serious and important. I respect that Deputy Quinlivan has been raising this particular issue in the Dáil for some time.

I welcome the opportunity to address the House on this issue. The Minister for Health has been concerned for some time about the congestion experienced in the emergency department, ED, at UHL, leading to long patient experience times and patients waiting on trolleys for admission. There were just under 80,000 attendances at the ED in Limerick in 2022, which is up 12% compared with 2019 and is 13% higher than the average for 2017 to 2021. There continues to be a high level of ED presentations in 2023, with more than 59,000 attendances between January and September of this year. I have supplementary information to hand that the Deputy may not have. I can provide it to him after the debate. The figure of 59,000 represents an 11% increase on the same period in 2019. More important is that the attendance figures for patients aged 75 or over have increased by 30% compared with 2019.

There continues to be substantial investment in capacity in University Hospital Limerick, including a 42% growth in workforce since the end of 2019, the opening of an additional 98 acute inpatient beds and a 19% increase in budget in 2022 compared with 2019.

The medical assessment unit, MAU, pathway for 112-999 patients in Ennis and Nenagh hospitals was extended to St. John’s Hospital on 4 August 2023. This initiative allows for patients meeting the clinical criteria to be treated at the MAUs in St. John's, Ennis and Nenagh hospitals. The extension of the 112-999 MAU pathway to St. John’s Hospital means that all three of the UL Hospitals Group MAUs can now treat patients referred by GPs, ShannonDoc and National Ambulance Service, NAS, paramedics. A key element is the telephone referral from the treating paramedic to the receiving MAU doctor, which ensures that the right patient is brought to the MAU. This pathway facilitates patients receiving medical treatment in a hospital closer to their home, assists in reducing patient presentations to emergency departments, and helps to release ambulances more quickly to respond to other emergency calls.

As part of last year’s national winter plan, there was a bespoke, site-level plan for Limerick. While the winter plan officially ended at the end of last winter, many of the plan initiatives continue to be implemented. The local plan focused on local needs and it builds on integration between the community and acute hospital services. UHL’s plan includes measures such as: the recruitment of extra staff including, but not limited to: two whole-time equivalent emergency medicine consultants, additional emergency department registrars and discharge co-ordinators to target patient flow; improving access to diagnostics for both urgent and emergency attendances in the emergency department, and for GPs, and the enhancement of GP out-of-hours supports; and the recruitment of administration staff and the creation of the performance management office to drive the ongoing service improvements in UL Hospitals Group.

The Minister for Health, Deputy Donnelly, asked the HSE to develop a new approach to urgent and emergency care, UEC, planning to reflect the year round demands on emergency departments, including UHL. The approach to planning urgent and emergency care is twofold, which is the delivery of an operational plan for UEC for 2023, recently approved by the Government, and the delivery of a three-year multi-annual UEC plan, which is expected to be submitted to the Government this autumn. The Department of Health is working with the HSE to ensure that the UEC operational plan initiatives are fully implemented.

See this speech in context