Ruairí Ó Murchú (Louth, Sinn Fein)
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I thank everyone who facilitated me to do this. I have just made my way up from the civic reception in Dundalk to celebrate the Louth Ladies Gaelic Football Association, the Louth senior team and the under-20 team after a spectacular year. Hopefully, there will be more of that to come. I had to leave Jarlath Burns and Marty Morrissey, but this is obviously an incredibly important issue.

This Topical Issue arises from the retirement of the clinical specialist sonographer in ultrasound at Louth County Hospital in Dundalk. The position was advertised in the summer and there were a number of applications, but there has been no progress in filling the position. There is now serious concern among the staff and public that the position will not be filled at the hospital and that the service, which has been incredibly well used over the years and is growing in demand year on year, will be run without on-site management. This situation is not recommended by the Irish Institute of Radiography and Radiation Therapy, IIRRT, which recommends that there be a clinical specialist sonographer working on site, especially in a hospital the size of Louth County Hospital. This is because such staff play a vital role in managing and supervising the unit.

The previous clinical specialist sonographer in ultrasound at the Louth hospital was the only full-time radiographer who worked in ultrasound at the hospital. Her retirement leaves vacant three-and-a-half posts, two of which also look after all other scanning such as general X-ray, CT and DXA. A fourth person is due to start at the Louth hospital in January but it will still mean that two of the four at the Louth hospital will be basic-grade radiographers.

To put it in perspective, the HSE's own numbers are stark. The recently retired clinical specialist sonographer completed 2,000 ultrasounds herself at the Louth hospital in 2024. In the first ten months of this year until her retirement, she had completed 1,465. At the same time, the waiting list for ultrasounds in the hospital's group is the largest it has ever been, with 5,000 outpatient appointments needed at the moment and 35 referrals a day coming into the Louth hospital. The total number of ultrasounds done in Louth County Hospital in 2024 was 7,825, up from 7,608 in 2023.

The real scandal is that there has been considerable outsourcing of ultrasound scans happening in the north east of the State for many years, with 5,348 ultrasounds done in one private clinic in 2024 alone. Many of these scans are being recorded by HSE radiologists, which they are allowed to do under their HSE contracts. The public waiting list continues to grow and the outsourcing of ultrasounds to private clinics where the HSE is paying a huge amount of money grows also. Instead of putting in jeopardy the ultrasound service at Louth County Hospital, the HSE should be developing it. The best equipment is there but there are two rooms that are not being used to their full capacity due to lack of staff at the hospital.

Four years ago, a radiologist was on site at Louth County Hospital. Now, there is none. Instead, they are on the phone. It cannot be the case that a clinical specialist position at Louth County Hospital remains unfilled. The clinical specialist sonographer not only does the bulk of the ultrasound scanning but also does the organisation of the list, the management of the service to the public and the oversight and training of other scanning staff. As per guidance from the IIRRT, it is not best practice to run an ultrasound scanning service for Louth County Hospital without a clinical specialist sonographer being on site.

There are real fears that the whole ultrasound service will be downgraded and frittered away until there is no service. Everything that is needed in order to continue the great service that was being done before the retirement of the clinical specialist sonographer is there, except for the replacement sonographer. Ironically, Louth County Hospital was the first hospital in the State to get a clinical specialist in ultrasound when the service was established all those years ago. It cannot be the case that it does not get one now when it needs it more than ever.

Robert Troy (Longford-Westmeath, Fianna Fail)
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I thank Deputy Ó Murchú for raising this issue and giving me an opportunity to speak to it. I am advised by the HSE that a clinical specialist radiographer vacancy has arisen in Louth County Hospital, Dundalk.

A recruitment process to fill this vacancy has commenced, a number of applications have been received and interviews for this position are due to take place later this month.

I am assured by the HSE that while this recruitment process is ongoing there will be no disruption to patient care or service delivery. All clinical services continue to operate as normal, ensuring that patients and service users experience no change in access, quality, or continuity of care. I also understand that enhanced governance arrangements are being implemented for this position. These are designed to strengthen oversight, improve co-ordination and ensure clearer lines of accountability across LCH and Our Lady of Lourdes Hospital, Drogheda.

As the Deputy will be aware, LCH is part of the HSE Dublin and North East Health Region. In conjunction with Our Lady of Lourdes, Drogheda these hospitals operate with an integrated managerial and clinical governance system, care pathways and support functions. These hospitals are planning for the future to safeguard against increasing demand including anticipated population growth, particularly among those aged over 75.

To meet this challenge, projects have been developed in LCH which include theatre access for ear, nose and throat procedures and a Uroflow clinic for urology services. Additionally, a new procedure room will open in 2026 to enhance day services. These developments complement the already significant investments in Drogheda. There has also been an introduction of additional consultant coverage during weekends, extended consultant presence on weekdays and public holidays and expanded specialist availability to support inpatient care and consultations. Likewise, enhanced access to key diagnostics, including imaging at weekends will accelerate treatment pathways.

More broadly, I would like to outline the positive developments in LCH and Drogheda. This Government is committed to building on the significant investment and improvements made at both hospital sites. This significant investment is demonstrated by the 39% increase in the budget for LCH since 2020. In 2025, the budget was over €31 million, an increase from €23 million in 2020. In the same period, there was a 48% increase in the budget for Drogheda. In 2025, the budget was over €303 million, an increase from €204 million in 2020.

The Acute Inpatient Bed Capacity Expansion Plan 2024 - 2031 aims to deliver an additional 4,367 acute inpatient beds nationally including an additional 141 beds for Drogheda. LCH has 93 inpatient beds, encompassing both adult and paediatric. Since 2020, eight beds were delivered for LCH. Drogheda has 500 beds an increase of 15.7% since 2020. We have also invested in staffing at both hospitals which has increased by 2% in LCH and by 13.5% in Drogheda since 2020.

I hope all this positive news will be welcome for the Deputy, who so ably represents the constituency.

Ruairí Ó Murchú (Louth, Sinn Fein)
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Go raibh maith agat, a Aire. I welcome some of what the Minister of State says but I am not sure it is going to give the answer we need. As I said, there is serious concern among the staff and the public that the position that I am talking about - the clinical specialist radiographer - will not be filled. We need to make sure this happens and I would like to think the Minister of State will come back to me. I welcome that he says the recruitment process is ongoing, that there will be disruption to patient care or service delivery and all clinical services continue to operate as normal. That is all fine.

He also said that a recruitment process to fill this vacancy has commenced, a number of applications have been received and interviews for this position are due to take place later this month. However, that does not necessarily answer where this position is going to be. I want and hope that surety can be provided that this specialist position will make its way to the Louth County Hospital where it is necessary from the point of view of the work that has to be done. It is also necessary from the point of view of ensuring that we have the correct level of supervision that is dictated by the Irish Institute of Radiography and Radiation Therapy.

I am not sure that the Minister of State will be in the position to give that answer, but I will be chasing up the Minister of Health. I also ask that the Minister of State engages with the Minister, Deputy Carroll MacNeill. We need to ensure that this is not a further downgrading of Louth County Hospital or the downgrading of the very important works that need to be done whether we are talking about the necessity of everything from ultrasounds through to X-rays, CT scanning and Dexa scanning. We need to make sure that this necessary facility is maintained. As much as we went to see Our Lady of Lourdes operating at full capacity, we do not need to lose this service in the Louth County Hospital.

If the Minister of State can give me the answer - brilliant stuff. If he cannot, he needs to chase it up with the Minister. I will be doing the same because it is not good enough that we let down the people of Dundalk.

Robert Troy (Longford-Westmeath, Fianna Fail)
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I thank Deputy Ó Murchú again for raising this issue so forcefully and giving me an opportunity to speak on this matter. It is important to recognise that significant investment has been allocated to LCH and Drogheda in recent years which has uplifted capacity, staffing and bed numbers at each of the hospital sites. Projects that have been delivered in LCH include theatre access for ear, nose and throat procedures and a Uroflow clinic for urology services. Additionally, a new procedure room will open in 2026 to enhance day services. These developments complement the already significant investments in Drogheda. These two hospitals operate co-jointly and provide a comprehensive suite of services for the people of Louth.

I want to emphasise that the ongoing assessment of the needs of this region is a priority for this Government as evidenced by the major capital investments in both LCH and Drogheda. The Government is committed on building on the already significant improvements made in these hospitals. In relation to the post of clinical specialist radiographer at LCH, it is good to hear that there has been a number of applications received and interviews will take place later this month. We all know recruitment processes can take time, but I wish to assure the Deputy that progress is being made in this process. I reiterate that the HSE has confirmed that there will be no disruption to patient care or service delivery. All clinical services will continue to operate as normal ensuring that patients and services users experience no change in access, quality, or continuity of care.

Ruairí Ó Murchú (Louth, Sinn Fein)
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Will the Minister of State go back to the senior Minister to find out if this position will be in Dundalk?

Robert Troy (Longford-Westmeath, Fianna Fail)
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I will most definitely, and will relay the Deputy's points to the Minister.