Catherine Connolly (Galway West, Independent)
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With the greatest of respect to the Minister of State, Deputy Feighan, the Minister for Health should be here. I realise he is a very busy man but what is happening in the hospital in Galway, which we call a crisis, is not a crisis; it is a chronic problem that has been going on for a very long time. In 2015, former Taoiseach Enda Kenny said it was not fit for purpose.

That sentence has been repeated ad nauseamby just about every Minister who has visited University Hospital Galway. What is the latest focus of the problem in Galway? Four nurses have resigned and left their positions because it is unsafe. We have learned of their resignations from reports in the media, which is interesting. We have not been informed of this by management.

I know the subject is extremely serious. However, I am reminded of Russian dolls when I think about the hospital in Galway. We have an emergency department, ED, that is not fit for purpose, and because of this, there are plans to build a new department, but it will not be delivered until some time in 2026. In the meantime, there will be a temporary emergency department, but it will not be delivered until 2022, with a temporary department serving as an enabling works project, facilitating the department that will be delivered some time in 2026. If that were not enough layers of the Russian doll, there is also a temporary temporary emergency department within it for Covid and non-Covid patients. Four nurses have left their positions. Dr. Fergal Hickey, the president of the Irish Association of Emergency Medicine, stated yesterday that all of the emergency departments in the west of Ireland are unsafe. Imagine that for a statement. Dr. Hickey has spoken of the lack of staff. In University Hospital Galway, there are 250 vacant nursing positions. I am standing here and I have difficulty in believing what I am saying. The hospital needs 250 staff. We know this from reports in the press, and from the nurses and the doctors, but not from management.

Dr. Hickey, who is a specialist in emergency medicine at Sligo General Hospital, has repeatedly spoken out. He spoke out again yesterday. However, I refer to a statement he made in 2017. He said that up to 350 people would die in the following year if the situation did not improve in the health service. Yesterday, he said that the department is unsafe. The staff and the INMO have said it is unsafe. Dr. Hickey said on the radio yesterday that staff have to search for space, whether it is a cubicle or a chair, in the emergency departments to treat patients. Can you imagine that? University Hospital Galway is supposed to be a centre of excellence. I have been corrected in that and have been told that it is only a centre of excellence for cancer care. Can you imagine these type of distinctions being made in a public hospital?

What am I asking for? I am asking for the Minister for Health to take a hands-on approach in relation to the hospital in Galway. I have documentation in front of me demonstrating the attempts made to elicit details of the problems and the positive steps that can be taken. There are plans upon plans, but the emergency department is positively dangerous. It is no reflection on the staff. The nurses have said that. Usually, nurses put up with things, work their 12-hour shifts and do not complain. They are complaining not just on their own behalf, but on behalf of the patients who are needlessly suffering and dying in the 21st century in a hospital that is supposed to be a centre of excellence.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I welcome the opportunity to address the House on the issues raised by the Deputy, on behalf of the Minister of Health.

At the outset, I wish to acknowledge the distress that overcrowding in emergency departments causes to patients, their families and to front-line staff working in very challenging conditions in hospitals throughout the country. I also acknowledge the work and commitment of staff to ensuring the uninterrupted provision of emergency care throughout the pandemic.

The HSE reports that emergency department attendances nationally have returned to 2019 levels and are exceeding them at some sites. The continued requirement for separate Covid-19 and non-Covid-19 patient pathways and ongoing infection prevention and control measures present additional challenges to patient flow in all hospitals, including University Hospital Galway. Unprecedented numbers of ED patients were reported as waiting on trolleys for admission in University Hospital Galway in September, with significant congestion in the ED due to high attendances, low patient discharges in the hospital, and a significant number of beds blocked for infection prevention and control measures. The HSE is actively working with University Hospital Galway and the Saolta Hospital Group to ease congestion in the ED. We continue to invest in University Hospital Galway to improve services to patients.

Approval has been granted to complete a temporary extension to the emergency department to provide additional accommodation. The temporary emergency department extension building will be single-storey, with a rooftop plant room and will be connected to the main hospital block at the existing emergency department entrance. Site works on the project commenced in May 2021. The phased handover of the temporary ED is expected in early 2022. The temporary ED project and associated works will also serve as an enabling works project for the proposed permanent new ED by helping to free up the site required for the proposed new block.

The development of a new emergency department at University Hospital Galway is key to addressing unscheduled care congestion and associated risk issues and meeting service demands. The proposed new ED will address existing infrastructural deficits, ensure compliance with national clinical care standards and address service capacity and risk issues. A small part of the existing ED will be refurbished and form part of the overall new ED.

The main ED, women's and children's block development at University Hospital Galway is a complex project and is in the early stages of design progression. The project is of significant scale. The proposed project will accommodate a new permanent ED, including clinical areas and ancillary support spaces and acute surgical and medical assessment units. It will also accommodate the labour and delivery unit, operating theatres, a maternity day assessment unit and foetal assessment unit. Other proposed facilities will include a neonatal unit, antenatal and post-natal inpatient departments, a paediatric day ward and inpatient ward.

The Deputy raised the issue of the resignation of four nurses from the hospital. I do not have any detail on that, but I will bring it to the attention of the Minister. I will also bring to his attention the staffing issue raised by the eminent consultant, Dr. Fergal Hickey. I do not have any information on that issue in my response, but I will raise it with the Minister.

Catherine Connolly (Galway West, Independent)
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I do not mean it personally, but that response is exactly why the health service is in a mess. The appointment of the two gentlemen who have been put in charge of Sláintecare does not fill me with confidence.

I refer to University Hospital Galway pre-Covid. Back in 2015, the former Taoiseach told us that it was not fit for purpose. The emergency department remains the same as it was then, except there are more patients attending and fewer staff. Yesterday, Dr. Hickey made a very practical point. He said there are fewer staff, more patients and fewer beds. We have never reached the full complement of beds that we need. In addition, there are no respite services in Galway, as I speak. They have not been reintroduced following the pandemic. As I said yesterday, we can drink and be merry, but we cannot provide respite services. There are astronomical waiting lists. We try to ask questions in a positive way and to work with the system. We say orthopaedics has the longest list and ask what vacancies there are in orthopaedics, and we are told that there are no vacancies in orthopaedics. So, then we ask why there are long waiting lists in orthopaedics. Then we find out that 250 medical and nursing staff are required in the hospital and the Minister was not made aware of that. What type of management is in place that is not making the Minister aware of this? What type of Minister do we have if he is not aware of this? I believe that when we get a Minister who actually feels sick at what is happening, we might make progress. After he or she gets over his or her nausea, he or she might deal with the reality on the ground and start to take action on the matter.

I have a letter with me today from a woman regarding neurology services, and the absence of neurology nurses generally nationally. In Galway, we need 12 of them and we currently have four. I could go on, but I have been doing this since I was elected in February 2016. Perhaps if I stop talking, things might improve. At this point, I do not even want a response from the Minister of State; I would just like him to hear what has been said. Perhaps the Minister could come back to me on this debacle in Galway. Indeed, "debacle" is not even the word that best describes the needless suffering and death of patients on trolleys. There were 41 patients on trolleys yesterday.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I have heard the Deputy and I will bring her issues to the Minister. It is acknowledged, as the Deputy rightly said, that the current emergency department at University Hospital Galway is unable to meet demand, which is contributing to significant waiting times and high numbers of patients waiting on trolleys for admission to the hospital. The development of a new ED at University Hospital Galway is the key to addressing these accommodation and associated risk issues. The proposed new ED will, hopefully, be reconfigured in a way that provides maximum opportunity to address all the elements for future emergency medical provision and the evolution of services in the context of hospital groups.

There is no date yet for the planning application for the main building, but the Deputy rightly mentioned the issue of staff recruitment and retention. There are issues with that and the Covid-19 pandemic has certainly affected many of those. There will be, and is, a major online recruitment drive. We would like to see recruitment happening sooner rather than later. I see staff recruitment issues in hospitals throughout the country, including the hospital I advocate for in my area. It is a process that can sometimes seem never-ending and one would hope hospitals would be much quicker in recruiting staff.

There is a lot of work ongoing in University Hospital Galway and, hopefully, working together with Saolta, the HSE, the Minister and representatives on the ground, the Deputy's powerful message will be brought back and we will deal with this very serious issue.