John Cummins (Waterford, Fine Gael)

I thank Senators Conway and Ryan for their question, which I am taking on behalf of the Minister for Health. I also thank Senator Conway for his kind words, which are much appreciated.

On the topic at hand, the final report of the review of urgent and emergency care in the mid-west region is due to be submitted to the Minister for Health by HIQA very shortly and published soon thereafter. I will take a moment to explain the sequence of events since May 2024 when the Minister requested a review of urgent and emergency care within 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 emergency department in the context of the population changes in recent years and ongoing pressures at the ED at University Hospital Limerick.

The terms of reference, which were published in August 2024, stated, "... a final report will be provided to the Minister in Summer 2025 ..." and a more specific timeframe of the end of May was agreed. HIQA submitted an interim briefing on 28 February, which was published on the Department of Health website in March. It provided a progress update on the various streams of the ongoing work programme. HIQA next wrote to the Minister for Health in May 2025 to update on the timeline for completion of its report. Overall, the HIQA work on the review of urgent and emergency healthcare services in the HSE mid-west region has progressed very well and the work streams undertaken by HIQA to inform the advice to the Minister had been completed. A critical dependency for completion of the final report from HIQA is the input from the national and regional demand and capacity projections being undertaken by the ESRI for the Department of Health. The first of these three ESRI reports, on projections of national demand and bed capacity requirements for public acute hospitals, was published on 28 May. The second report, on future capacity requirements for GP services, was published on 18 June. The third report, on future capacity requirements for older persons' care, was published on 30 June. The ESRI is due to publish a further regional analysis very shortly. It is these analyses and projections that are obviously feeding into the report which is being compiled for the Minister and will feed into the question of whether a second ED in the mid-west region is warranted. It should be with the Minister very shortly and she has committed to publishing it thereafter.

I know full well the pressures within the mid-west region and University Hospital Limerick, but it is important to say there has been significant funding and investment in the region and the hospital in recent years. From 2019 to 2024 there was an increase from €265 million to €507 million. There has been an increase in the staff ratio by 50%, with 57 more whole-time equivalent doctors, including consultants, 576 more nurses and midwives, as well as 155 more health and social care professionals. Senator Ryan mentioned the 96-bed block, which is due to open imminently, and the second 96-bed block, for which some enabling works are already under way. They will have a positive impact, but it is true that patient flow within University Hospital Limerick is very important when it comes to managing ED admissions and ensuring people are not on trolleys. I will make a couple of further comments in my closing remarks.