Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I welcome this opportunity to address the House on the issues raised by Senators Byrne, Conway and Ahearn. Senator Ahearn cannot be present and I acknowledge that he has also raised this issue previously.

I acknowledge the distress that overcrowded emergency departments, EDs, cause to patients, their families and front-line staff working in very challenging conditions in hospitals throughout the country. Senator Byrne spoke about the case of an elderly gentleman who spent three days on a trolley. That is just not acceptable to anyone and is definitely not good enough. On top of extremely high emergency department attendances, the health sector is also under significant pressure from Covid-19, as was mentioned.

Yesterday there were 1,308 Covid patients in hospital, 83 of whom were in UHL. The emergency department in Limerick is one of the busiest in the country, with over 76,000 attendances in 2021, up 16% compared with 2020 and 7% compared with 2019. However, the numbers of patients waiting on trolleys for admission in UHL in 2021 were 4.7% lower than in 2020 and 35% lower than in 2019.

The University Limerick Hospitals Group has reported that it is continuing to deal with high volumes of patients attending the UHL emergency department, a pattern that has been sustained over a number of months and is being replicated around the country.

UHL is working to ensure that care is prioritised for the sickest patients. As part of its escalation plan, additional ward rounds, accelerated discharges and identification of patients for transfer to UL Hospitals Group model 2 hospitals are all under way. There has been continuing substantial investment in UHL and the wider hospital group in recent years to address capacity issues, including a new emergency department that opened in 2017. This was referred to by Senator Conway.

Since the start of 2020, 98 new beds have opened at UHL. This included a 60-bed modular ward block, which became operational in November 2020, established to provide a rapid-build interim solution to begin to address the bed capacity issues.This also included a 24-bed single-room block which functions as a dedicated haematology oncology unit, and a temporary 14-bed single-room block designated for confirmed and suspected Covid-19 patients, initiated in May 2020 under the national action plan in response to Covid-19.

The winter plan for 2021 to 2022 was published on 15 November. It builds on the significant investment in last year's winter plan and the additional capacity delivered in health services in 2021. The winter plan aims to address the significant combined challenges faced by the health service over the winter period and recognises that a whole-system response is required across primary, community and acute care. The scale of these challenges and the demands our health system faces require both a plan and an associated system of governance and accountability. The winter plan sets out the national, area and site level leadership and governance arrangements that are in place.

The matter of performance in hospital emergency departments is under constant review by the Department through ongoing engagement with the HSE. The situation is still very distressing. There is a situation where patients are in the emergency department on trolleys. Yesterday, there were 83 people in the hospital who have Covid. The most important thing we can do is to improve throughput in the hospital so that when a person is deemed well enough, he or she is discharged. We have put substantial investment into step-down beds, transitional beds and home care. The most important thing is that we can transition people through hospitals as quickly as possible.

It is very distressing for families, patients and staff when there are high numbers on trolleys, and I know this is happening daily in Limerick.