Seanad debates

Thursday, 9 March 2023

Nithe i dtosach suíonna - Commencement Matters

Hospital Overcrowding

9:30 am

Photo of Kieran O'DonnellKieran O'Donnell (Limerick City, Fine Gael) | Oireachtas source

I am taking this Commencement matter on behalf of the Minister for Health, Deputy Stephen Donnelly. The Senator and I are colleagues in Limerick and I am fully aware of this issue. Senator Gavan will know that I, along with colleagues, have looked to highlight the issues at UHL with overcrowding. I intend to explain the difference and then I will deal with the more local, substantive issues.

I welcome the opportunity to address the House on this important issue, which has been raised by Senator Gavan. Although both the HSE's TrolleyGAR and the INMO's trolley watch counts provide daily reports on the number of patients waiting on trolleys for admission in acute hospitals, there are notable differences in their inclusion criteria. The HSE's TrolleyGAR is a count of all emergency department patients who are waiting to be admitted to an inpatient bed and for whom an appropriate bed space is not yet available. The definition of an appropriate bed space agreed between the HSE and the INMO is that it must have a bed, curtains, access to bathroom facilities and oxygen and suction facilities, must have a named consultant and nursing team assigned and the patient must be on a documented pathway of care. As such, TrolleyGAR includes patients waiting on trolleys in the emergency department and in wards but does not include patients in designated surge capacity beds, which are recorded and reported separately by the HSE. It is my understanding that it does not include people in cubicles. It is our understanding that the INMO may include some surge capacity beds within their trolley counts. There is a definition. I likewise had a look at the figures. In the last two days, the TrolleyGAR recorded Limerick at the figures of 26 and 18. respectively. I do not know what the INMO's figure was this morning because it was not up, but it was 90 yesterday, it was 80 on Tuesday and it was 77 on Monday.

For me, it is a matter of how they are counted, as well as about treatment. I would prefer for someone to be treated in a cubicle than for them to be on a trolley, but it is about dealing with overcrowding in UHL. Whatever metric is used, there is still overcrowding. We have looked to address it through the new emergency department. Some 98 additional acute beds have gone on-site in the last two years. In last three years, there has been a 60-bed acute ward, plus an additional 38 units have been put in during Covid-19. There is a 89-bed acute bed ward that is under construction at the moment. We are looking to get another 96 beds. There is a new consultants' contract coming in.

The numbers went up by a great deal between January and February. That is because electives were restarted and we need to do electives. What I would like to see and what we need to look at - and I hope this will happen under the new contract - is for there to be consultants on duty. There are now 11 consultants in the emergency department. Can we have a mechanism where there is a consultant who is on duty at later times, perhaps up to 12 midnight? Furthermore, will there be discharges over the weekend?

The point is, however, that whatever metric is used, there is overcrowding in UHL. I am conscious of that for the patients and their families who come in. It is something I acknowledge. I am committed to working with the Government, with the Minister for Health, Deputy Stephen Donnelly, and the Taoiseach in order that we get the numbers of trolleys down. Whatever count that is being used, the numbers are too high.

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