Noel Grealish (Galway West, Independent)

I have been asked by the Minister for Health to respond on the Senator's Commencement matter this morning. I thank the Senator for the opportunity to address the House on hospital provision in the mid-west region.

The mid-west currently has one model 4 hospital, namely, University Hospital Limerick, and three model 2 hospitals. In 2013 the smaller hospitals framework defined the activities that can be performed in the smaller model 2 hospitals in a safe, sustainable, and efficient manner. The framework ensures that patients who require emergency or complex planned care are managed safely in a larger hospital environment, such as UHL. Model 2 hospitals such as those in Ennis and Nenagh provide inpatient medical beds, medical assessment units, injury units and day surgery. St. John's Hospital is classified as a model 2S hospital and can carry out intermediate surgery and day case surgery. The model 2 hospitals play a pivotal role in the delivery of safe, high-quality patient care in the mid-west. They accept transfers of appropriate patients from UHL. These patients can either be stepped down from an inpatient ward or, where a clinician has decided it is appropriate, transferred directly from the emergency department, ED.

In May 2024, HIQA was requested by the then Minister for Health to conduct a review of urgent and emergency care in the mid-west region with the primary objective of ensuring safe, quality acute care. As part of this review, HIQA was requested to consider the case for a second ED in the context of the population changes in recent years and ongoing pressures at the ED at University Hospital Limerick. HIQA submitted an interim briefing on 28 February 2025 and the report was published on the Department of Health website on 19 March. The interim briefing provides a progress update on the various workstreams of the ongoing work programme. The final report of the review is expected by the end of May 2025. This report will contain advice for the Minister, informed by the evidence compiled across the various workstreams, to support decision-making around the design and delivery of urgent and emergency healthcare services in the mid-west region.The review is ongoing against a backdrop of continued investment in the capacity and reform of the mid-west health system, particularly at University Hospital Limerick. In December 2024 a fast-track 16-bed inpatient block opened at University Hospital Limerick. Another 16-bed unit is due to open in June and a 96-bed block will be delivered by September. Enabling works are also under way for a second 96-bed block. In total, including further beds planned for the acute hospital inpatient bed capacity expansion plan, up to 308 new beds will be opened at University Hospital Limerick by 2028.

This expansion is supported by the increase in staffing and hospital reforms. Whole-time equivalent staffing at the hospital has grown by 43% since December 2019. That is 255 more doctors and consultants and 455 more nurses and midwives across the mid-west region. Fewer patients are now waiting on waiting lists, with a total reduction of 30% from December 2021 to March of this year. The Government will continue to focus on delivering the necessary reforms and improvements in health services for the mid-west region.