Aisling Dolan (Fine Gael) | Oireachtas source

I welcome the Minister to the House to speak about the issue of emergency departments, which is crucial across many areas. I thank Senators Conway and Maria Byrne for bringing forward the motion. There is pressure on emergency departments. Senators have raised issues, particularly in respect of University Hospital Limerick. I want to speak specifically about the Saolta University Health Care Group area in CHO 2, which includes Portiuncula University Hospital, Roscommon University Hospital and University Hospital Galway. There are three issues, the first of which is capacity in our emergency departments, how space is used within hospitals and how hospitals are trying to manage. The second issue is the reduction in the number of nursing beds, the step-down facilities that hospitals can use when community intervention teams are coming to help people discharge. The third issue relates to GPs in the community.

The Minister will be fully aware that the catchment area of Portiuncula University Hospital contains almost 400,000 people. It is based in east Galway but covers an enormous area. It is the hospital for Athlone, a town of more than 20,000 people. It also covers counties Roscommon, Westmeath, Offaly and Tipperary, as well as Galway. It experienced its worst ever January for the number of patients on trolleys. The hospital, based in Ballinasloe, has close to 1,000 staff. I fought hard in 2019 to secure a meeting with the then Minister for Health, Deputy Harris. At that meeting, we were able to move forward a project of the senior clinical team in Portiuncula for a 50-bed ward block. Funding was allocated to move that project on to the next stage. The ward is now under construction. People in Portiuncula can see that the new ward is under construction, which is wonderful, but the process started back in 2019. It should have started five or six years earlier. The new ward is now under construction but the hospital does not have any additional beds right now. There are 13 single beds. Enormous pressure has been put on services. The hospital is converting the outpatient department to allow for eight single en-suite rooms. It will also have two additional rooms. Staff are trying to make these changes within the hospital but the hospital dates back to the 1940s and contains multi-bed wards and so on. One can only imagine the situation. There is, however, an amazing team there who have been striving for years to cope.

The general manager and the senior clinical team at the hospital have now applied for ten additional bays in the emergency department. That submission has gone from Saolta on behalf of Portiuncula University Hospital to the Department. The Minister will be looking at the issue with the HSE and its new interim chief executive, Bernard Gloster.

It is crucial that we consider capacity issues, modular construction or the building of some type of additional accommodation around emergency departments. There is enormous pressure here. The emergency department in Portiuncula University Hospital cannot cope with the pressure, which is the result of Covid-19, respiratory syncytial virus, RSV, and the other viruses that are circulating.

The Minister will also be fully aware of the other challenge in my area, that is, our older population. It is a regional area. It does not have a large, city-centre, urban population. We are spread out and managing a more regional, sparse and widely dispersed population. The population is older and has different needs. The challenge is the reduction in the number of nursing home beds available in the Saolta area. I am sure the Minister is aware that we have lost nearly 150 nursing home beds. Small nursing homes in Roscommon and east Galway have closed. Areas such as Kiltormer and Dysart have been affected. These were small nursing homes and I understand there are issues in respect of their feasibility. I am asking for innovation around how we support nursing homes that have beds available as step-down facilities. We cannot lose more beds in an area that is struggling so much at the moment. We simply cannot lose more beds. Is there any type of co-operation model within smaller independent nursing homes? I know there are also larger corporate entities. I am asking about how we look at this. I urge the Minister to come up with some other solutions around nursing homes and how we access those beds.

I also raise the issue of GPs. I thank the Minister. We worked hard with the Minister of State, Deputy Rabbitte, on the issue before Christmas. We had meetings with GPs in our area and €436,000 was allocated, with the support of the Minister and the Government, to help GPs in that area. The money provided Westdoc facilities for GPs all around the Ballinasloe and south-east Galway area. We hope that will relieve the pressure on hospitals and emergency departments. It is crucial that the access to diagnostic services that has been provided for GPs under the winter service plan can be continued.

There are phenomenal multidisciplinary teams in Roscommon University Hospital. The National Ambulance Service, as it has in Ennis hospital and University Hospital Limerick, is looking at how to identify patients on the basis of their level of need and considering whether Roscommon University Hospital can support those patients. It is important that there is a referral for these medical assessment units.

The Mayo Roscommon Hospice Foundation is wonderful. The Minister attended its Roscommon palliative care unit in November 2021 and we had a wonderful launch. The facility is due to open shortly. The staff are being trained there in the coming weeks. There will be an additional eight beds. Staffing will come from Roscommon University Hospital to allow the hospice to operate. Like many other things, it has taken too long. I know there are many challenges involved, but we need access to those beds. It will be crucial for that to happen in the coming weeks. The staff will be trained and we need the facility to open shortly.

I also ask that consideration be given to Sacred Heart Hospital and that 50-bed unit. It is all about capacity. I know that the brand-new chief executive of the HSE will be working hard to consider how to provide immediate capacity.

To conclude, there is €24 billion in the budget. The Minister has a lot of support. There has been a 17,000-strong increase in staff. We have nearly 140,000 staff in the Minister's area. Three is so much we can do. We need to consider immediate access to additional and modular accommodation and the expansion of emergency departments.