Derek Nolan (Galway West, Labour)
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The emergency department in Galway is the second busiest, if not the busiest, in the country, with 65,000 attendances last year. There is a not a week that goes by when I do not receive representations in the form of an email or a call from somebody sitting in the emergency department, or whose partner or child is sitting in it. The conditions in which they have to wait are appalling. The emergency department was built in the 1950s and in the interim period was redesigned in the mid-2000s to get over a particular hump. Clearly it is in need of replacement. Some of the statistics and facts we have seen and the admissions the HSE has made about it are stark. For example, it does not allow effective patient streaming; it does not comply with infection control standards; it does not allow the emergency medical programme or unscheduled care and patient experience targets to be met. It is simply not up to scratch and is failing the people of Galway and counties Roscommon, Mayo and Clare, all of whom feed into this acute hospital.

I have raised this issue with the Minister before and we had very positive and constructive engagement, for which I thank him, as well as for being in the Chamber to debate it. We have the hospital on record as stating its emergency department needs to be replaced. Patients, staff and doctors have told me from their personal experience that we need a new emergency department. Everyone, including the Minister, agrees. He has been very forthright in saying in the House that we need a new emergency department in University Hospital Galway. Everyone agrees that the emergency department is failing its patients and staff, but what are we going to do about it?

There are two options available - a €30 million or a €60 million new build, in which the maternity unit would also be replaced. I understand the HSE has opted for the latter as probably the more preferable option. Given this, the next step is providing the money to design a new emergency department. The hospital should be given the go-ahead to engage architects, engineers and surveyors who should get to know the site, design something and obtain planning permission for it. When we have this done - it will take at least one year to go to tender - we will be able to talk about funding. That work is crucial in accessing funding and having a capital plan. There is no point in allotting money for a building that has not been designed or making capital available for a scheme that is nowhere near starting. Let us give the relatively small amount of money required - less than €1 million, plus VAT - to undertake this initial work. That amount could be found in the budget and would go a long way towards advancing the project which the people of Galway and those living in the hospital's wider catchment area deserve. The unfair, undignified and improper setting in which patients are being treated cannot be allowed to continue in place. Simply saying it is wrong and needs to change is not enough.

Leo Varadkar (Dublin West, Fine Gael)
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I thank the Deputy for again raising this issue and giving me an opportunity to outline to the House the current position. During a previous Topical Issue debate last October we both acknowledged the high level of activity at the emergency department in Galway, with approximately 66,000 annual attendances, making it one of the busiest emergency departments in the State. The HSE is working closely with the special delivery unit, SDU, to better manage patient flow through the hospital. This collaboration has reduced the overall number of patients awaiting admission from the emergency department to the main hospital. In the first two months of 2015, 798 patients were on trolleys in Galway University Hospital. This represents a reduction of 309, or almost 28%, compared to the figure in the baseline year of 2011, when there were 1,107 patients waiting on trolleys at some point during those two months. However, it does represent a deterioration on the figure for last year. The level of overcrowding increased by 8.7% in January and February of 2015 compared to this time last year.

Galway University Hospital has recruited and allocated experienced general and paediatric nurses to the emergency department, as well as a fourth advanced nurse practitioner with a specific function in the management of minor injuries. As well as additional staff, a number of construction and infrastructural projects are under way such as the upgrade of the medical gas network, which is the first step to upgrading the maternity department. The construction of the clinical research facility is now complete and the facility is expected to be operational within the next four to six weeks.

The HSE is also in the process of appointing a contractor for the construction of a new clinical ward block which will provide 75 beds, with construction anticipated to start by the middle of April and due to be completed by the end of next year. Enabling works for the new 50-bed acute mental health department have started and it is projected that this facility will also be completed by the end of next year. The transfer of these services to a new unit will facilitate the construction of a new radiation oncology project, currently in design phase, on the old mental health services site.

When we examine trolley numbers and their pattern each week, it is clear that changes in working practices and the way things were done in the past will help to make better use of facilities and smooth out activity in hospitals. Today I received a briefing on the Irish hospitals redesign project which is being piloted at Tallaght hospital. This approach is invaluable in working out, with fresh and often external eyes, how hospitals can be better run and managed. I have mentioned Galway Univeristy Hospital as a potential candidate in the future should it prove to be a success at Tallaght hospital.

In the past I have acknowledged that the current physical infrastructure of the emergency department is not fit for purpose and requires investment. That investment must be considered within the overall acute hospital sector infrastructure programme and the overall capital envelope available to the health service, which is constrained. The HSE is concentrating on applying the limited funding available to infrastructural development in the most effective way possible to meet current and future needs. However, there will be limited funding available for new projects in the next multi-annual period, from 2015 to 2019. I have, however, asked the HSE to make some funding available to advance the development of the plans to upgrade the emergency department at Galway University Hospital. I will seek to have further funding for this project included in the 2016-22 capital plan, although that is a matter for the Government as a whole.