Maurice Quinlivan (Limerick City, Sinn Fein)
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I want to put on the record that I am disappointed the Minister, Deputy Stephen Donnelly, is not here. I understand he sent me an email to say he would not be here, but I would expect somebody from the Department of Health to have been available. I have raised this concern on a number of occasions but at least this time I was told that nobody was coming. It is indicative of the Minister. He is dodging the discussion. In a previous Dáil I had years of conversation with the previous Minister, Deputy Harris, about not turning up for these discussions and debates.

I have been raising the issue of University Hospital Limerick in the Chamber since I was elected for the first time in 2016, and it has got worse and worse. Last year was the worst year ever, with more than 21,000 people on trolleys. Yesterday was the worst day ever, with 132 people on trolleys in University Hospital Limerick. It is an incredible number of people. We can get carried away sometimes when we are talking about numbers and statistics, but these are all people. They are family and people we know. They are relations, neighbours and friends, who are often in distress. The situation needs to be addressed. There needs to be Government intervention. The Minister of State will read out a script. I have probably heard the same script for the past seven years non-stop. We need Government intervention that will do something in the here and now, because the Minister is out of touch.

On 5 January this year, the Minister for Health was on "Morning Ireland" and he advised that there were five or six people waiting in the emergency department and another 36 people were on trolleys in wards. This demonstrated how out of touch he was, because the same day the INMO reported that 96 people were on trolleys in the hospital. The day before the number was 81, and the day before that it was 69. That is far more than the Minister's supposed 41 people. The Minister was quite happy to quote the INMO figures when he was on this side of the House, but now he is trying to distort the figures himself. January 2024 is already worse than the whole of the month of January 2023, and the record will be broken in University Hospital Limerick. As I have said, 132 people were on trolleys in University Hospital Limerick yesterday and 109 people are on trolleys there today.

I do not know if the Minister of State has been to the hospital. It has a new emergency department that opened in 2017, but the issue of capacity has never been dealt with. The reason for the number of people presenting at the hospital is because of the Fianna Fáil decision to close the emergency departments in Ennis, Nenagh and St. John's hospital. We were supposed to get a centre of excellence in Limerick but it was never delivered. That is why we have the ongoing problems.

What does it mean when people are on trolley? As I said, these are people who are deemed to be in need of a bed but there is no bed available to them. There were 21,000 people last year. There were 132 people yesterday and there are 109 people today. It is simply not good enough.

Healthcare assistants and nurses have to work in poor conditions. Recently in Limerick, our health spokesperson, Deputy Cullinane, and I met healthcare workers at the hospital. One told me she had 12 patients at that time. She was totally stressed. She did not want to leave the job because she knew there was nobody else there. There are many vacancies in the department. The Royal College of Emergency Medicine in the UK tells us that if people are waiting more than eight hours in an emergency department, one additional death will occur for every 67 people. I know it is slightly different in England from here, but it is a similar statistic. In January 2023, the BBC, quoting the vice-president of the Royal College of Emergency Medicine, reported that for every 82 patients who wait for more than six hours, there is one associated death. Being treated on a trolley in a hospital hallway is accompanied by at lack of privacy and dignity. It is frightening enough for people to be told they need to stay in a hospital, but having to do so in these conditions is terrible.

As per usual, the Minister for Health is not here. It is simply not good enough. He needs to face up to the fact that there needs to be a serious intervention from Government. The plan it has for the 96-bed unit will deliver 48 beds, believe it or not. It will not be there for a number of years. We are without any plan to deal with the here and now.

Maurice Quinlivan (Limerick City, Sinn Fein)
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I thank the Minister of State for his response, although it is clear not enough is being done in the area. We need to reduce the time people spend both waiting for a hospital bed and in hospitals. Those who are fit and healthy enough to return home should be allowed to do so, but in many cases this is not possible. The health Minister has previously stated that a seven-day-a-week discharge regime will be used and I concur with him on that, but as yet that has not been properly put in place. We must be creative and understand that care within the community can contribute to a reduction in wait times and a reduction in the number of days spent by individual patients on trolleys in UHL. The pathfinder programme to which the Minister of State referred and other community initiatives can help many elderly patients who are forced to present at emergency departments for issues that could and should be attended to at home or within the community. Such treatments lessen the stress on these patients associated with having to be present at the emergency department and improves the capacity of the hospital. Unfortunately, older people are attending the emergency department, and while I would encourage anybody who is sick to go there, they are spending hours and hours on trolleys. It is like a circus. Trolleys bash off one another, there is no space in the hallways, and staff cannot give appropriate care due to the lack of space, the number of people who are presenting and the failure of the Government over the years to deliver the services we need and the number of beds we need.

The Government’s plan has for a new 96-bed unit that will actually deliver 48 new beds. That is not going to happen for another two years, so we will be left with two more years of this crisis, which is only getting worse. There is no plan to get us out of this. We have been talking about it for seven years and, as I said, every year it is getting worse. Every month there is a new record. Every month last year, with the exception of one month when there was an intervention, which has already been passed, was a record-breaking month for the number of people on trolleys in UHL. It is incredibly difficult for the staff to work there. They are overwhelmed and understaffed and the hospital authorities tell us an additional 200 beds are needed to bring it up to the national average, but the Government has a plan for only 48 beds in the next two years.