Richard O'Donoghue (Limerick County, Independent)
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I want to continue to speak on the points I raised on 22 June with regard to the management of University Hospital Limerick. What is the true number of potential patient safety incidents and deaths that have occurred in the hospitals under the management of the University of Limerick Hospital Group? Serious safety incidents reported by conscientious professionals in University Hospital Limerick have not received attention. Patients have raised concerns and staff members have brought concerns to hospital management without officially reporting the incidents for fear of the impact it might have on their careers. These concerns are often ignored and buried without following protocol. Some of these incidents have led to serious injury and the deaths of patients. Families are not aware of how their loved ones were injured or died. This became very clear to me when a young 18-year-old girl, Jessica Sheedy, from my local area died in University Hospital Limerick following surgery. She would not have died if management had done its duty and reported previous serious incidents through the proper channels. This is how serious the situation is in the hospital.

Whistleblowers in University Hospital Limerick are silenced by management. They are worn down until they sign non-disclosure agreements. How many protected disclosures are investigated properly? If proper procedures had been followed by University Hospital Limerick management, it would not be in the catastrophic state it is in because the State authorities would have been alerted much earlier to the dangers to the public in the accident and emergency department and the six hospitals under the management of the hospital group. I am asking for a public inquiry into the number of incidents recorded in University Hospital Limerick that have not been reported nationally.

University Hospital Limerick management has a duty of care to the public. It should be made accountable, criminally accountable if necessary. A public inquiry should not be carried out by past or present HSE employees. This is always the case when families are informed that a so-called independent investigation will be carried out. So-called external investigations are often misleading and inaccurate. External organisations should investigate. Should University Hospital Limerick management be allowed to risk the safety of the public to hide dangers? It has tried to cover up incompetence and negligence through deceit and corruption. It has not been made accountable. What will the Minister for Health do to prevent future harm to the public in this hospital in the meantime? Will the Minister for Health ask the Garda to conduct a criminal investigation into the situation? The people of the mid-west have the right to attend a hospital where patient safety comes first.

Catherine Connolly (Galway West, Independent)
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Allegations of corruption are very serious.

Richard O'Donoghue (Limerick County, Independent)
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I understand that. The death of an 18-year-old girl is also very serious.

Catherine Connolly (Galway West, Independent)
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I am not here to argue with the Deputy.

Richard O'Donoghue (Limerick County, Independent)
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I understand that.

Catherine Connolly (Galway West, Independent)
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I have to point it out with regard to what the Deputy is saying.

Richard O'Donoghue (Limerick County, Independent)
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I thank the Leas-Cheann Comhairle but I feel passionate about what has happened in the hospital. The first statement I made in the Dáil when I arrived here two and a half years ago was on the mismanagement of University Hospital Limerick. People have come to me in the meantime because of alleged incidents that have happened there. As a public representative, I want to protect the people of the country. I want to protect those who go into University Hospital Limerick. I also want to protect the staff there.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank the Deputy for raising this very important issue. I acknowledge his interest in University Hospital Limerick and the important role it plays in delivering healthcare in the mid-west region. We are all familiar with the difficulties faced by University Hospital Limerick. It was because of these difficulties the Minister for Health, Deputy Donnelly, visited the hospital in February. Following that visit he requested that a HSE expert team review the day-to-day functioning of the emergency department in University Hospital Limerick in a leadership, management, operational and clinical context. The report from the review will seek to identify what is required locally, regionally and nationally to support sustained improvement in the emergency department. The expert team will also continue to support and work closely with University of Limerick Hospital Group and the CHO in the mid-west to support improvements in unplanned emergency care and access to scheduled care.

In addition to the review requested by the Minister, Deputy Donnelly, University Hospital Limerick commissioned Deloitte to review and advised on unscheduled care and patient flow in the hospital.

The review is still in train. When available, the expert team will also consider the recommendations in its own report.

As the Deputy is aware, we recently saw the publication of HIQA's report of the unannounced inspection of the emergency department at University Hospital Limerick against the national standards for safer better healthcare. The Minister has welcomed the report and expressed his concern about the significant risk identified to service users in it.

On Wednesday last, the Minister met with senior officials from his Department and the HSE to discuss immediate responses to the pressures currently faced by emergency departments throughout the country. Those discussions included a specific engagement in respect of the emergency department at University Hospital Limerick, in the context of the specific pressures being experienced by the hospital, and the reports by both HIQA and the HSE expert team recently deployed to Limerick at the Minister's request.

As a result of the intervention requested by the Minister and the recent HIQA report, the chief operations officer of the HSE has written to the CEO of the University of Limerick Hospital Group and the chief officer of mid-west community healthcare to inform them that she has mandated the performance management improvement unit, PMIU, of the HSE to engage urgently with the hospital group and the CHO under the HSE's performance accountability framework. The PMIU will provide intensive support to both hospital and community teams to ensure that the safety issues identified in the recent assessment and the HIQA report, including chronic overcrowding, are addressed as a matter of urgency. A detailed plan will be developed as a matter of urgency in order to ensure that they do not reoccur. This plan will cover issues including admission avoidance, pre-admissions, community interventions and alternative pathways, as well as issues with regard to patient flow through the hospital and emergency department.

I assure the Deputy that the work under way to address the issues that University Hospital Limerick faces, including those highlighted by HIQA's report, will make a significant difference to patient experience at University Hospital Limerick. The Department of Health continues to work closely with the HSE to ensure University Hospital Limerick is fully supported and that the recommendations of the expert review team are actioned in a timely manner. The Deputy raised some very pertinent and disturbing issues that I will bring to the Minister's attention in the morning.

Catherine Connolly (Galway West, Independent)
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The Deputy made serious and specific allegations regarding corruption. There is a risk of individuals being identified with those allegations. I ask that the Deputy withdraw them. I understand his passion.

Richard O'Donoghue (Limerick County, Independent)
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I will withdraw the allegation of corruption, but I will not withdraw the one relating to risk. I will tell the Leas-Cheann Comhairle why.

Catherine Connolly (Galway West, Independent)
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That is okay. The Deputy will withdraw the allegation.

Richard O'Donoghue (Limerick County, Independent)
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I will withdraw the allegation relating to corruption at the Leas-Cheann Comhairle's request.

The question here is of how many risk assessments were reported to the national incident management system. If this risk assessment had been reported nationally, University Hospital Limerick would have been under investigation sooner. Many Deputies asked for University Hospital Limerick to be investigated. The Minister went down at the time and found nothing wrong. I spent nights in that hospital after having a serious accident in February. I saw first-hand all the people on trolleys. It was being denied in different places that people were on trolleys, but I saw it first-hand. I have spoken about this to the parents of the person I named. My issue is that if a risk assessment had been taken out on Jessica Sheedy's operation, she would be alive today. That is my concern regarding the hospital. I have always said that the staff of University Hospital Limerick are not the problem.

Some €76 million has been used in legal costs since 2018 to cover up illegalities within the hospital. That €76 million could have been spent on nursing care and healthcare within the hospital. That is how passionate I am about this matter. I will not apologise if I come across as too passionate, particularly when a person could have lived if a risk assessment had been carried out. There is not one person here tonight, or in the Dáil in general, who would not want a proper risk assessment done. If such an assessment had been done through the proper channels, this hospital would not be in the catastrophic state it is at present. On the day I arrived to this Dáil, my maiden speech was about University Hospital Limerick. I am sorry if I have to roar it out but, by God, it galls me that it took two and a half years for the Government to finally listen and for a report to be done in respect of the hospital.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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The Deputy has raised issues with regard to risk assessment. I will bring them to the attention of the Minister. The Government and the Department of Health remain fully committed to improving services in Limerick and throughout the country. It is clear that after what has been a very difficult couple of years at University Hospital Limerick, significant efforts are now being made to ensure that issues such as overcrowding in the emergency department and delays for elective care are being considered and addressed as matters of priority.

The Minister has met and had discussions with senior officials from his Department and the HSE regarding the situation at University Hospital Limerick. As a result of the Minister's intervention, the PMIU of the HSE has been mandated to engage urgently with the hospital group and the CHO under the HSE's performance accountability framework. The PMIU will provide the intensive support needed to ensure that all necessary immediate steps are taken to address the safety issues identified, included chronic overcrowding. On foot of the PMIU's engagement, a detailed plan will be urgently developed to ensure that they do not reoccur.

I assure the Deputy that the Government is fully aware of the impact on patients, their families and the mid-west. Intensive efforts are under way to address difficulties currently facing University Hospital Limerick. I also thank the Deputy for the way he put this matter across. It has been very emotional and I will bring his views to the Minister. The Department of Health continues to work with the HSE to ensure support for the improvement of services for all patients attending the hospital.