Joe Carey (Clare, Fine Gael)
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104. To ask the Minister for Health if he will report on efforts to address severe overcrowding at University Hospital Limerick; and if he will make a statement on the matter. [59224/21]

Joe Carey (Clare, Fine Gael)
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I seek an update on the ongoing overcrowding at the emergency department in University Hospital Limerick and on the efforts by the Minister and the HSE to address the situation, particularly as we face into a very difficult winter period.

Stephen Donnelly (Wicklow, Fianna Fail)
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I am acutely aware of the scale of the challenge facing our emergency departments across the country this winter and the extra demands Covid is placing on them. Our front-line staff are exhausted from 20 months of dealing with Covid yet continue to deliver a high standard of care to all. I wish to thank them and acknowledge the distress that overcrowded emergency departments cause to patients, their families and the incredible front-line staff who have to work in those difficult conditions.

UHL of course has one of the busiest emergency departments in the country and more than 63,000 individuals have attended so far this year. Increased attendances and Covid-19-related patient safety protocols are contributing to slower progress of patients through the system, and this impacts on waiting times and patient experience in the emergency department. However, despite an increase in attendances of 7% up to October of this year compared with the same period in 2019, the number of patients on trolleys is 35% lower. That is despite an increase in patients and all the additional pressures of Covid-19. Huge thanks and acknowledgement goes to our frontline healthcare workers right across the system, including those in acute, primary and community care, for putting in so much effort to make that possible.

I published the HSE winter plan on 15 November. The Government already allocated an additional €1.1 billion in additional funding to support health services and this is being maintained into next year. The winter plan is designed around a whole-system approach involving acute hospitals and the community and primary care sectors. It has three key objectives: emergency department avoidance; patient flow; and hospital egress. It is aligned with the Sláintecare principle of "Right Care, Right Place, Right Time". Specific measures for UHL include an extension of the National Ambulance Service pathfinder initiative and paediatric patient flow initiatives to ensure timely discharges.

Joe Carey (Clare, Fine Gael)
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I thank the Minister. I join him in complimenting our frontline staff at UHL. They are under extreme pressure. We are unfortunately a permanent fixture at the top of the Irish Nurses and Midwives Organisation's Trolley Watch figures. Today there are 47 people on trolleys in the accident and emergency department of UHL. It is a frightening figure. The next highest figure is in Cork University Hospital where there are 26 people on trolleys. I recognise the work, including the addition of 98 more beds to the system over the last year, since the advent of Covid, to help us fight it. There is also a critical project planned there. It is a 96-bed permanent ward block. It is important this project is fast-tracked. We only have 533 inpatient acute beds in the mid-west region. It is important this project is brought online as quickly as possible. I ask the Minister to take a personal interest in this to drive it on because we just do not have enough bed capacity to deal with the admissions to the hospital.

Stephen Donnelly (Wicklow, Fianna Fail)
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I thank the Deputy. As he rightly acknowledges, very substantial additional capacity has been added in UHL but as he also rightly says, still more is required. We are still looking at patients waiting on trolleys at a level we must move away from. In 2017 a new €24 million emergency department opened. Since the start of last year, 132 additional beds have been provided, which is a very significant number. As the Deputy referenced, 98 of those beds are in recent developments. On top of that, there is full planning permission for the 96-bed development and the project is currently out to tender. UHL is also accessing private hospital capacity as well.

Joe Carey (Clare, Fine Gael)
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I thank the Minister, including for his commitment to the 96-bed unit. It is a really important project. However, with respect to the short and medium term, will the Minister explain what efforts are being made to deal with this in the coming weeks to avoid the really chaotic scenes we have seen in recent times, when there were 98 people on trolleys at UHL? What measures are going to be introduced to ensure that situation is not replicated in the coming weeks and months?

Marc Ó Cathasaigh (Waterford, Green Party)
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Deputy Griffin is going to come in with a supplementary question.

Stephen Donnelly (Wicklow, Fianna Fail)
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I thank Deputy Griffin. He was not right but I must take advice from the Acting Chairman on this. The Deputy's question is a fundamentally different one. The question posed is about UHL. The Deputy is asking a completely different question. It is a very valid one about UHK and I would like to answer but it is not supplemental to this question. I can send him a detailed note. He and I have obviously discussed this. The Minister for Education, Deputy Foley, and I are in regular communication on this. As the Deputy will be aware, the national director of acute operations has been in UHK and there is a very comprehensive review going on. For example, a figure I think I shared with the Deputy recently was there has been a 33% increase in the consultants added to UHK. At the same time as we have had a one third increase in our doctors, fewer patients are being seen. We need to understand what is going on there, whereby we can substantially increase our medical workforce-----

Stephen Donnelly (Wicklow, Fianna Fail)
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-----and fewer patients get seen. With the Acting Chairman's indulgence-----

Stephen Donnelly (Wicklow, Fianna Fail)
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-----I do not know if it is possible-----

Stephen Donnelly (Wicklow, Fianna Fail)
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-----to get 60 seconds to respond to the Deputy.

Marc Ó Cathasaigh (Waterford, Green Party)
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Quite a bit of latitude has been given in terms of putting the question in the first place, Deputy Griffin, to be fair. I am afraid our time for that question has elapsed. Perhaps the Minister will reply to Deputy Carey in writing, if he can.

Stephen Donnelly (Wicklow, Fianna Fail)
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I apologise to Deputy Carey.