Maurice Quinlivan (Limerick City, Sinn Fein)
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It is no offence to the Minister of State, Deputy Finian McGrath, but I wish to express my disappointment that the Minister, Deputy Harris is not here. This is the second time I have raised a matter concerning University Hospital Limerick in the Topical Issue debate.

Eugene Murphy (Roscommon-Galway, Fianna Fail)
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He is on the hustings.

Maurice Quinlivan (Limerick City, Sinn Fein)
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Gabh mo leithscéal.

Eugene Murphy (Roscommon-Galway, Fianna Fail)
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He is on the hustings.

Bernard Durkan (Kildare North, Fine Gael)
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Never mind. Deputy Quinlivan should proceed with the debate.

Maurice Quinlivan (Limerick City, Sinn Fein)
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Yes, I am sure he is on the hustings. This is the second time-----

Finian McGrath (Dublin Bay North, Independent)
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He is at the Mad Cow.

Maurice Quinlivan (Limerick City, Sinn Fein)
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I am sorry but Members are using my time. This is the second time I have had a matter selected for the Topical Issue debate concerning University Hospital Limerick for which the Minister has not turned up. On the previous occasion the Minister of State, Deputy Catherine Byrne, substituted for him and she said she would come back to me with the answer but she did not do that. I ask the Minister of State, Deputy Finian McGrath, if he commits to it that he will ensure I will get a response from the Minister.

The issue I raise concerns the imminent opening of the new emergency department in University Hospital Limerick, which is very welcome. It is hoped to open the department this month. I am delighted to see €24 million is being invested in a critical piece of infrastructure for our city. The amalgamation of Ennis, Nenagh and St John's hospitals was rushed and the promised centre of excellence was not delivered at the time. To date, the amalgamation has been nothing but a disaster which has led to the present emergency department being described by the Health Information and Quality Authority, HIQA, in recent years as unfit for purpose. The situation remains the same today.

While it is great that the new emergency department is opening, I wish to address some concerns surrounding the move to the new facility that the Minister will, I hope, address. People in Limerick and the entire mid-west have waited a long time for the new emergency department which will benefit patient care and staff working conditions significantly. Having waited for years for it, it is essential we get it right.

The Irish Nurses and Midwives Organisation has raised serious concerns about the move to the new emergency department. According to HSE management, a minimum of 24 patients will be placed on trolleys and recliner chairs in the new emergency department. That has come as a severe shock. The use of trolleys in emergency departments is unacceptable. We need to move away from that means of operation and not embed them into new plans. It is unacceptable that HSE management in the hospital intends to transfer the existing trolley problem to the new emergency department rather than use it as an opportunity finally to solve the problem.

In addition, the INMO has suggested to management that space freed up in the old emergency department could be used to accommodate patients. That would lead to less overcrowding and increased patient safety, but the suggestion has been rejected by management. Other concerns raised by nurses working in the hospital include insufficient staff being assigned to the new emergency department and a lack of staff with an emergency department specialist qualification. I have long campaigned for adequate staffing and funding for University Hospital Limerick. I know how important the hospital is to Limerick and the wider mid-west, and I want to ensure the new emergency department is staffed and resourced adequately.

I know the staff will do their best, as they always have done for many years, to ensure patients are properly looked after when they move into the new emergency department, but they need assistance from management and the Government to address issues they can foresee as they are on the ground. Will the Minister of State ensure the Minister commits to addressing the concerns highlighted and that he will come back to me on them?

Finian McGrath (Dublin Bay North, Independent)
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I thank Deputy Maurice Quinlivan for raising this very important issue. I know he cares passionately about the hospital in Limerick. I will convey all his concerns to the Minister, Deputy Simon Harris, who sends his apologies for not being present today.

I welcome this opportunity to address the House on this issue. Delivering the new emergency department at University Hospital Limerick is a key project for both the Department of Health and the HSE and is identified as a priority in the HSE National Service Plan 2017. The building is now complete and should be ready to open shortly. There is a bit of good news. The emergency department in University Hospital Limerick is one of the busiest in the country, with approximately 65,000 attendances annually. I am mindful too that demand for emergency department services at the hospital continues to rise. In 2016, University Hospital Limerick experienced a 4.6% increase in new emergency department presentations and we have seen a further increase, of 1%, so far this year.

The House will be aware that overcrowding at the emergency department in University Hospital Limerick has been a concern for some time. I am well aware of the situation there as I have been in the hospital with family members in the past. It is clear that the accommodation and resources in the existing emergency department are not sufficient to support a modern emergency department. The emergency department in University Hospital Limerick frequently works above capacity and that contributes to inefficient ways of working and poor patient experience. However, the end is in sight and there is no doubt the opening of the new emergency department will represent a significant boost for patients in Limerick, Clare, north Tipperary and surrounding areas. Staff too will benefit from the very much improved working environment. I am delighted, therefore, to confirm that the new emergency department will be three times the size of the current department and will provide modern, safe and fit for purpose facilities that meet the expectations of patients and families.

At the same time the new facility will provide high quality, comfortable accommodation that protects patients’ privacy and dignity. This is a very important issue for patients and their families. I understand that the new accident and emergency department has been designed on a pod-based system. The design will improve efficiency and once patients have been triaged they will be assigned to different areas of the emergency department, depending on the seriousness of their condition. Each of these units or pods will have its own waiting area which will accommodate patients waiting to be seen by a clinician following triage. This is very important and is good news.

Clinical teams will be assigned to these units and will be responsible for the treatment, discharge or admittance of patients, within their particular unit. Because of these separate units, it is expected that the time from triage to treatment will be much improved, resulting in fewer patients waiting extended periods of time in the emergency department, and an improvement in the patient experience time. It is also planned to open an interim short-stay unit for admitted patients in the area of the current emergency department, which was occupied by paediatric patients and the clinical decision unit. This unit will have capacity for 17 patients and will dramatically reduce the number of patients waiting on trolleys in the emergency department. The CEO of the UL hospitals group has confirmed that there is no basis for any suggestion that 24 patients will be accommodated on trolleys in the new emergency department.

Maurice Quinlivan (Limerick City, Sinn Fein)
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I thank the Minister of State for his response. I must take him up on his comment on the 24 patients on trolleys because the INMO is insistent that this is what they have been told by management.

I welcome the positive development for Limerick. This emergency department will be a great benefit to many people. I will be visiting the hospital tomorrow at the invitation of the CEO. Limerick has waited long enough for this investment. Everybody has agreed that the old emergency department was not fit for purpose but the concerns of the nurses working on the ground are worrying. A new building and facilities will be of little use if there are no trained specialists there to staff them. These nurses from the INMO are on the ground and know the issues better than anyone. They know what works and what is needed. I suggest the Minister of State listens carefully to their concerns and addresses the problems they raise.

The nurses have also highlighted the need for more preparation for the move to the new facility. Only one dry run of the new facility has been undertaken to date and problems were highlighted in this. It is my understanding that normally two or three dry runs are done before a move like this. Nurses want more preparation and more run-throughs before patients start coming through the doors. Management is clearly not listening to the INMO, and that is why I must raise it here. I look forward to the Minister of State taking action on these issues. I welcome what is happening and I hope the Minister of State does not turn what is such a good news story for Limerick into a bad news story by not addressing the issues raised by the nurses.

Finian McGrath (Dublin Bay North, Independent)
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Of course I will bring Deputy Quinlivan's points to the Minister for Health, Deputy Harris. I take the Deputy's point that it is very important for us to listen to the voices of the nurses on the ground. INMO has always been very positive and constructive in the negotiations, especially in the last 12 months, because both sides have the patient at heart. Their voices should be heard when we are involved in the development of the health service.

We have a problem in relation to filling nursing positions. It is a difficulty and the Government is working hard to tackle this. We have the money for it in the budget, but it is difficult to recruit some of the nurses. We are trying very hard, and the Minister, Deputy Harris, is working very hard on that matter.

The new emergency department in University Hospital Limerick is absolutely state of the art. It will be open soon and I wish everyone in it well. It shows that when we do things we can do them well. Let us hope we can always improve patient safety and best practice.