Hildegarde Naughton (Galway West, Fine Gael)
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I thank the Minister of State for taking this issue. The Minister for Health will be aware of the serious difficulties that have faced patients and staff at University Hospital Galway, UHG, in recent years. I will not go over all the challenges again, save to say that it is among the worst performing hospitals in terms of accident and emergency waiting times and inpatient and outpatient waiting lists. This week, UHG enters its seventh week of code black due to overcrowding and doctors and nursing staff at the hospital stated today that overcrowding is endangering the lives of people in the region.

In response to a parliamentary question I tabled recently, the Health Service Executive informed me that since 2006, capital expenditure at the Galway University Hospitals Group has exceeded €109 million. I do not expect the Minister of State will know how many additional beds this investment provided but the HSE informs me that the number of beds available in the two hospitals in the group, namely, UHG and Merlin Park Hospital, has decreased by 157 since this investment was made. The capacity of both hospitals declined from 812 beds in January 2006 to 655 beds as of October this year. In the meantime, the population has increased substantially, from 4.2 million in 2006 to 4.7 million this year. The ageing population has also increased significantly. Furthermore, UHG has been designated a centre of excellence for major specialties such as oncology and cardiology in the meantime. This means the hospital is supposed to provide expert care in serious cases for approximately 800,000 people living in an area extending from County Donegal to County Clare and eastwards as far as Athlone.

Additional beds are required. The new 75-bed block nearing completion will provide few new beds as other wards will need to close to facilitate access to the new block. In addition, every time a new extension is built at University Hospital Galway, car parking space is removed. The psychiatric unit under construction is being built on the staff car park. There are unapproved plans for a badly needed accident and emergency unit which will, in all probability, eat further into the space available for car parking. It is a simple fact that UHG is in the wrong place and finds itself unable to cope. It is astonishing that there are only 73 inpatient beds in Merlin Park Hospital. I understand most of these beds are occupied by long-stay geriatric patients. Merlin Park Hospital is located in a vast complex encompassing approximately 150 acres of State owned land. At this critical point, is it not clear that we need a new hospital on this vastly under-utilised site?

Helen McEntee (Meath East, Fine Gael)
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I apologise to Deputy Hildegarde Naughten on behalf of the Minister for Health, Deputy Simon Harris, who is unable to take this matter and thank her for raising the issue and for giving me an opportunity to address the House.

The Department of Health has been overseeing a range of measures to reduce the pressure of overcrowding in our hospitals, including University Hospital Galway. A number of ongoing initiatives are under way aimed at increasing capacity in University Hospital Galway. Under last year’s winter beds initiative, 30 new beds opened at the hospital in early 2016. As Deputy Naughten pointed out, a 75-bed ward block is nearing completion on site and is due to open during 2017. This ward block will provide new inpatient accommodation at the hospital. In addition, I am advised by the HSE that consideration is being given to retaining one of the existing wards as escalation capacity. An acute adult mental health unit under construction at the hospital is expected to be operational by 2017.

The programme for a partnership Government contains a commitment to progress the ongoing design and planning phase for a new emergency department for University Hospital Galway. I confirm that a business case for this project has been submitted to the HSE and is being considered by its estates division. University Hospital Galway is fully engaged with the national patient flow improvement project as one of the pilot sites for this programme of work. The HSE advises that the hospital has been working at all levels to improve patient flow and experience and has recently recruited an emergency department assistant director of nursing for patient flow as part of the emergency department escalation task force actions.

I am also advised staffing has been increased in the emergency department where a total of 54 full-time nursing positions are in place, including newly appointed clinical nurse managers. Several vacancies are still being filled.

Staffing is being increased across the health service as a whole. The number of consultants employed has increased by over 100 while the number of nurses, including student nurses, rose by over 680 from the end of September last year to the end of September 2016.

The winter initiative from 2016 to 2017, published in September, has provided €40 million in additional funding for the winter preparedness initiative. The key deliverables of this initiative are directed towards reducing overcrowding pressures in all hospitals in the winter months. The winter initiative is driving a range of measures to support timely discharge of patients from all hospitals, including the provision of additional aids and appliances, as well as increased access to transitional care beds, home care and home help packages. This facilitates patients who need extra supports in being discharged back to their homes and communities.

The winter initiative includes several measures which specifically benefit the western region. University Hospital Galway is a focus site for the 2016-17 winter initiative and has, therefore, been scheduled to receive six extra home care packages per week for the duration of the initiative. Winter initiative measures also include the imminent expansion of a community intervention team in the Galway and Roscommon areas.

Hildegarde Naughton (Galway West, Fine Gael)
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I thank the Minister of State for her reply. I accept that significant advancements have been made in the quality of care provided at University Hospital Galway since 2006. However, the Minister of State will accept that the crisis facing the hospital is one of capacity, not quality. There can be little criticism of the standard of care provided for patients in Galway once they are admitted. We are extremely fortunate to have an outstanding team of clinicians and nurses at the hospital who are doing an exceptional job in exceptionally difficult circumstances. The greatest challenge facing us, on which the Government will be judged, is one of access to treatment and having sufficient capacity in hospital to meet increasing demand. The figures for bed capacity and capital spending show that we are not meeting that challenge. The University Hospital Galway campus has reached developmental saturation point. The terms of the Galway city development plan and spatial constraints on the site mean no more beds can be delivered. Any further capital spending on the site would be a waste. Up to €18 million was spent on a 75-bed ward block due to open next year. However, two wards will close as part of the development, meaning that it will not provide a single extra bed. The problem is that University Hospital Galway has the longest waiting lists in the State and, typically, the highest number of patients on trolleys, but we cannot increase capacity on its current campus. Will the Minister of State, therefore, agree that the solution to the crisis lies away from the existing site? Will she agree that future capital investment should be so focused, rather than spending millions of euro on new infrastructure which will offer no additional beds and no hope to the tens of thousands on hospital waiting lists?

Helen McEntee (Meath East, Fine Gael)
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I agree with the Deputy that it is vitally important that all hospitals, not just University Hospital Galway, operate at the capacity required in their catchment areas. It is important that we do everything in our power to accommodate and keep people away from hospitals when possible. In the coming months, at this time of the year, there will be an increase in the number of beds needed. Consideration has been given to retaining one of the existing wards at University Hospital Galway to deal with escalating demand. The business case for the design and planning phase of a new emergency department has been submitted to the HSE and is being considered. Several vacancies will be filled, which will obviously ease pressure. The €40 million in additional funding for the winter preparedness initiative will help to ease it, too.

As Minister of State with responsibility for older people, I know that work is under way in my section to develop a more formalised and structured approach to home help services, which, again, will help to relieve some of the pressure exerted by delayed discharges, not just within University Hospital Galway but also across the board.

I thank the Deputy for raising this issue. Every effort will be made to relieve the pressures she has described.