Seanad debates

Thursday, 26 January 2023

Emergency Department Waiting Times and Hospital Admissions: Statements

 

9:30 am

Photo of Martin ConwayMartin Conway (Fine Gael) | Oireachtas source

I welcome the Minister to the House. I appreciate how extraordinarily busy he is, so when he comes here it is noted and appreciated.

The situation in emergency departments in recent months nationally has been very difficult. When we speak of it, we must take a moment to think of the people who are on trolleys: those who are very sick, and their anguish and suffering, and the worry and concern of their loved ones, especially as we come towards the end of the pandemic where there is still an element of fear. We must take a moment to tell people we are thinking about them, and we want to make it better.

I echo what Senator Dooley said about the mid-west. The Minister has been there, and he knows the issues and problems; he also knows the solutions. It is about capacity and process. Capacity can be addressed in the short, medium, and long term. In the short term we can requisition more private capacity for the UL Hospitals Group. Some 187 beds were requisitioned from private hospitals. We should have been able to get lot more. We were able to do it during Covid. We could have built more capacity in the short term. I was very annoyed to hear that only five of those beds were used by the UL group, given that this area was the worst affected in the country and had the highest number of patients on trolleys. I would love to know why the number of beds used by the UL group was not higher. Perhaps we might get an answer to that at some stage.

In the context of medium-term solutions, I fully agree with my colleague that we must set aside planning laws. The hospital group must make a proposal to the Minister urgently and he must sign off on it within days, as opposed to weeks. We then need the planning laws to be set aside so that construction can commence. We expect another 96-bed block to be built in addition to the block that is currently being constructed. However, we also need a third 96-bed block. That should be signed off and agreed this year as well to deal with capacity.

To be fair, there have been improvements in the process within hospitals. I refer to protocols for front door, back door, discharge and patient flow. There have been significant improvements in terms of effort but that is not evident due to the serious increase in numbers presenting.

I very much welcome the decision to introduce new blue light protocols in Ennis General Hospital. Ennis is underused. There is significant capacity there that we could utilise. The Minister might tell us how the new protocols are working and what numbers are being redirected to Ennis as opposed to Limerick. I am interested in hearing statistics given that it is two or three weeks since the protocol was introduced.

We must consider introducing a similar protocol in Nenagh. People, including medical experts in Tipperary are looking for that. Perhaps it could be introduced in St. John's Hospital as well. We must be imaginative and creative. We must also remember that since reconfiguration, we now have advanced paramedics in most if not all ambulances and they are well capable of making a diagnosis and deciding where it is best to redirect patients. In the past, there was an ambulance driver and a nurse, who did great work, but now it is an ambulance driver and an advanced paramedic, which is the reason we can redirect patients in need of non-critical care to places like Ennis and Nenagh. The people who need to go to the emergency department in Limerick should go there.

I have a couple of practical proposals. One relates to the location of Shannondoc in the campus in ULH. That could happen very quickly. The 50% of people who show up at the emergency department with a referral letter could be redirected to Shannondoc to get a letter of referral. That is also causing a lot of problems. People are going to the emergency department because they cannot get a GP or they get frightened for one reason or another, but it could help if a GP was on site in the hospital in Limerick. That is something that should be piloted. I know the consultants in Limerick are looking for that as well.

I am conscious that the debate started late. The Minister has heard my suggestions and proposals umpteen times so I will leave it now to other speakers.

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