Thursday, 19 January 2017
Topical Issue Debate
Hospital Accommodation Provision
I have proposed this issue for discussion every day this week and I thank the Office of the Ceann Comhairle for selecting it today. We need straight answers on the opening of a new emergency department in Limerick University Hospital. I mean no disrespect to the Minister of State, Deputy McEntee, in saying I had hoped the Minister would come to the House to provide direct answers to our questions. Having visited the hospital, the Minister is aware of the position.
For months, we have been told the emergency department is due to open in May of this year. However, the Government has consistently avoided confirming this date. I am of the view that the reason for this relates more to funding than to a difficulty in recruiting staff. My understanding of the HSE service plan is that it provides sufficient money to open the new emergency department in the autumn and that an additional allocation would be required to open it in May. If that assumption is correct, I call on the Minister to insist that funds are made available to open the emergency department in May 2017, as originally scheduled and restated on many occasions.
Earlier this week, we learned that the Government could find €120 million in unallocated savings to meet the cost of an increase in pay for public sector workers. While I do not begrudge these workers a pay increase, I understand that the shortfall in funding to open the emergency department in University Hospital Limerick is a fraction of €120 million. This is a matter of life and death and I do not say that lightly. Patients and staff in the emergency department at University Hospital Limerick have been squashed into a space that is not fit for purpose. The hospital's trolley figures have been among the highest in the country for months. Only recently, the chief fire officer in Limerick warned that the fire service would "have to take enforcement action if things don't improve." Fire officers do not make idle threats and if the chief fire officer's intervention forces a decision to be taken to open the emergency department in May, I welcome it.
Recently, as many as 16 ambulances were lined up outside University Hospital Limerick because they could not disembark patients due to overcrowding. We have heard many harrowing stories, which I do not propose to rehearse. However, I was struck by one particular case of a man with bowel disease who publicly declared his name and address and provided highly personal information about the difficulties he experienced in the accident and emergency department. This took great courage but the individual in question acted to highlight the intolerable conditions at the hospital. At a protest on this issue last week, which I attended, people explained why the issue was so important that they had come out in protest.
Staff at University Hospital Limerick are struggling to manage and I commend all of them, from the most senior to the most junior member of staff and across medical and non-medical grades. While I am aware that emergency departments are under pressure all over the country, in the case of University Hospital Limerick one element of the solution can be implemented, namely, the opening of the new emergency department. This will not solve all the hospital's problems with capacity and bed numbers, as these problems are shared by all hospitals, but a new department would provide space and dignity for patients and a decent working environment for staff.
The building has been constructed and the fit-out is proceeding according to plan and on schedule and recruitment is under way. I ask the Minister of State to confirm that the emergency department will open in May.
The Deputy will appreciate that I am not able to give the answer she seeks. I apologise again on behalf of the Minister for Health, Deputy Harris, for his absence. I welcome the opportunity to address the House on this issue.
As Deputy Jan O'Sullivan stated, the emergency department in University Hospital Limerick is one of the busiest in the country, with more than 60,000 attendances annually. I commend all of the staff at the hospital and those working in other emergency departments which are currently under severe pressure. The opening of the new emergency department at University Hospital Limerick has been identified as a priority in the HSE national service plan 2017. An additional €1.4 million has been allocated to facilitate the opening of the new emergency department this year. I understand it is expected that the building will be handed over to the hospital group at the end of March. As the Deputy will appreciate, it is difficult, at this stage, to be definitive about the opening date given that a period of deep cleaning, commissioning and training of stall on the new equipment will be required before the new emergency department can open. However, I hope it will be operational as soon as possible.
The new facility will triple the size of the current emergency department and immeasurably improve the experience of patients in terms of their comfort, privacy and dignity. The Deputy will be aware that the new unit is being fitted out and recruitment of the additional staff required for the enlarged facility is ongoing. Pending the opening of the new facility, the hospital group is working to alleviate pressures in the emergency department by maximising the use of the model 2 hospitals in its region, namely, Ennis, Nenagh and St. John's hospitals, to free up beds in University Hospital Limerick.
In addition, the HSE winter initiative plan 2016-2017 has provided €40 million additional funding for winter preparedness. As part of this initiative, University Hospital Limerick was identified as one of the nine focus sites experiencing the greatest challenges in terms of emergency department pressures. As the figures on delayed discharges released today show, much of this funding has been put to good use. In line with this initiative, University Hospital Limerick is receiving an additional six home care packages per week until the end of February 2017. In the first three months of the winter initiative, that is, from October to December 2016, community health care services in the mid-west facilitated 1,672 discharges, most of which were from the University of Limerick hospital group. These discharges ensure patients do not experience delays once they have been medically discharged from hospital and free up capacity in the hospital, which is extremely important.
I also note that in early November, the operational hours of the medical assessment unit in University Hospital Limerick were extended by three hours per day. This unit facilitates the immediate assessment, diagnosis and treatment of patients presenting with chronic medical conditions and represents a significant improvement for such patients.
I was also delighted to learn that a transit lounge to accommodate patients deemed medically fit for discharge or suitable for transfer to Ennis, Nenagh and St. John's hospitals opened at University Hospital Limerick earlier this week. The lounge will accommodate 15 patients and will open from 10 a.m. to 6 p.m. It will be staffed by two staff nurses and one health care assistant. In opening the lounge it is hoped to turn around beds earlier in the day, thus making capacity available for admitted patients waiting in the emergency department or overflow areas.
I am assured that pending the opening of the new emergency department, the University of Limerick hospital group is working to identify ways and means to improve processes and systems in the emergency department and throughout the hospital group, with a view to improving service delivery. I apologise again that I cannot provide a definitive date for the opening of the new unit. I will convey the Deputy's request to the Minister and I am sure he will revert to her in due course.
While I appreciate the various efforts that are being made in the meantime, my main concern is that no date has been provided for the opening of the emergency department. I cannot understand why a date cannot be provided given that the building is complete, the fit-out is ongoing and recruitment is under way. The reason given by the Minister of State is that deep cleaning, commissioning and training of staff in new equipment are required. I do not see how this cannot be completed by May. The timetable for opening the new facility has been public for a long time and thus far the project has proceeded in accordance with that timetable. I again call on the Minister to indicate that the emergency department will open in May, as intended.
The issue appears to be the additional €1.4 million allocated to facilitate the opening of the new emergency department this year. I appreciate the Minister of State may not be in a position to answer my question.
Is €1.4 million sufficient to run the unit from May to the end of the year, including in terms of staff and so on? If not, we need an additional allocation. As I said, because of overcrowding in this unit, there is terrible suffering by patients and staff.
According to the fire chief, he will have to take enforcement action if things do not improve, which is a serious undertaking in terms of his duty as fire chief. I hope that this will concentrate minds on the need to ensure that there is adequate funding to enable this unit to open in May. I do not accept that deep cleaning, commissioning and training of staff will take more time than is available between now and May. I would welcome any assurance the Minister of State, Deputy McEntee, could give me in this regard. I hope that the Minister, Deputy Harris, will give us an answer soon. If additional funding is the issue, the amount required being not that large in the scheme of things it needs to be found.
Again, I apologise but I am unable to answer the Deputy's question directly. As I understand it, the unit will not open in May but is to be handed over to the hospital group at the end of March, with the timeline in terms of deep cleaning, commissioning and training of the staff yet to be identified. I will make the Deputy's views known to the Minister, Deputy Harris. A huge amount of funding has been already put in place to try to alleviate the problems in this area. It would be better for everybody if that funding was invested in the opening of the unit rather than on fighting fires or other measures which are always going to be a temporary fix. I will bring the Deputy's concerns to the Minister and ask that he respond to her as quickly as possible.