Denis O'Donovan (Fianna Fail)
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I welcome the Minister of State

Kieran O'Donnell (Fine Gael)
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I welcome the Minister of State. The accident and emergency department at University Hospital Limerick is the busiest in the country. By the end of the year approximately 64,000 patients will have presented in the department. Since 2014, the number of people presenting has gone from approximately 55,000 to the expected approximately 64,000 this calendar year. One can compare this with Cork University Hospital, which has seen slightly fewer people presenting this current year, with the figure of approximately 60,000. Cork University Hospital has 800 beds, which is double the number of beds in University Hospital Limerick, which has 400.

Reconfiguration occurred in 2009, with the full-time accident and emergency departments at Ennis, Nenagh and St. John's Hospital closing, meaning 18 beds were eliminated, as they had six beds apiece. All patients were then put into University Hospital Limerick, which had only another 17 bays in the accident and emergency department. There was a loss of 50 beds at Ennis, Nenagh and St. John's Hospital as well. There is an urgent need for 96 acute beds to be provided at University Hospital Limerick as a result. This proposal has been submitted and it is in the Health Service Executive, HSE, national capital plan. I am asking for it to be fast-tracked and that the Minister, Deputy Harris, would allow seed money to be provided to the HSE national estates to allow design work to get under way to build facilities for these 96 urgently-needed acute beds.

We have a new state-of-the-art accident and emergency department, which will be opened in May 2017, but that is only one piece of the jigsaw. The other piece is the building of the facilities for the 96 acute beds that are urgently required. They can be fast-tracked, even structurally, on the basis that we currently have a dialysis unit that has been operational since last Monday. It is in a single-storey building and beside it there is a critical care block, which is a four-storey building with the new accident and emergency department on the ground floor and critical care units above it. We can build the facilities for the 96 accident and emergency beds above the dialysis unit, making it a four-storey building, with 24 beds per floor.

I ask the Minister, Deputy Harris, to facilitate two actions. The first is that seed money could be provided to University Hospital Limerick and the HSE national estates to allow design work to get under way for the 96 acute beds that are urgently required. When the capital review occurs in 2017, I ask that this project to provide the 96 beds be funded. More immediately, I would like an update on the winter plans in place to cater for the accident and emergency departments. Many people in Limerick have contacted me as the scenes in the emergency department now are chaotic. The Minister, Deputy Harris, has seen this and the department in Limerick is continuously under pressure. It is not fit for purpose but until the new department opens in May 2017, we need emergency measures put in place to ensure we can deal with the deviation. The second action relates to progressing the facilities at which the 96 acute beds will be provided. That is a two-stage process. The first is to give the seed money to allow the design work to get under way. The second is for it to be funded and included in the mid-term capital review plan for 2017. The project will cost €25 million. The accident and emergency department at University Hospital Limerick has more patients going through it than any other hospital in the country but it only has 400 beds. The hospital in Cork - literally down the road from University Hospital Limerick - has slightly fewer admissions, approximately 60,000. We have approximately 64,000 and yet the hospital in Cork has double the number of beds, 800. We need equity for University Hospital Limerick.

Denis O'Donovan (Fianna Fail)
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The Senator's case is well made

Marcella Corcoran Kennedy (Offaly, Fine Gael)
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I thank Senator O'Donnell for this important and timely question. The Minister for Health, Deputy Harris, has asked me to convey his apologies to the Senator because he cannot be here. He has a prior engagement to which he is committed today. If he could have come back for this, he would have done so.

I welcome the opportunity to address the House on this matter. The emergency department at University Hospital Limerick is one of the busiest in the country with over 60,000 attendances annually.

Kieran O'Donnell (Fine Gael)
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It is the busiest.

Marcella Corcoran Kennedy (Offaly, Fine Gael)
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The numbers presenting continue to increase year on year, with figures for October showing an increase in emergency department attendance of 6.1% in comparison with the same period last year. This amounts to 3,063 more patients.

The Deputy will be aware that a new emergency department is currently being fitted out at University Hospital Limerick and will open next year. The new facility will triple the size of the current emergency department and will improve the experiences for those attending immeasurably, particularly in terms of comfort, privacy and dignity.

On 9 September, the HSE published the winter initiative play 2016-2017. The plan provides €40 million of additional funding for winter preparedness and to help to alleviate the pressures on our emergency departments during this time. As part of this initiative, University Hospital Limerick has been identified as one of the nine focus sites experiencing the greatest challenge in terms of emergency department pressures. I know that Senator O'Donnell is well aware of this. Consequently, these sites need specific support measures to enable them to respond more effectively to expected surges in demand for emergency care during the busy winter period.

The winter plan for the University of Limerick hospital group identifies the key actions needed to address the anticipated surge in activity during the winter period. This includes measures around avoiding hospital, improved patient flow, timely access and discharge. Actions will be taken to increase early discharges, to address delayed discharges, fast-track triage for patients over 75 years of age and improve access to inpatient MRI capacity. In early November, the operational hours of the medical assessment unit at University Hospital Limerick was extended by three hours per day and is now exclusively allocated to patients presenting to the emergency department. This will facilitate the immediate assessment, diagnosis and treatment of patients presenting with medical conditions such as chest infections, chronic obstructive pulmonary disease, pneumonia, urinary tract infections, fainting episodes, clots in the leg, anaemia or non-acute cardiac problems.

The University of Limerick hospital group is also working to maximise the use of the model 2 hospitals in the region - in other words, the hospitals in Ennis, Nenagh and St. John's Hospital - to free up beds in University Hospital Limerick. The group aims to ensure the safety of patients and staff, as well as to minimise absenteeism and agency costs through staff vaccination for the flu virus.

The winter initiative has allowed for the provision of 50 additional home-care packages per week to ten specific hospital sites, including University Hospital Limerick, which will be receiving an additional six home-care packages per week until the end of February 2017. University Hospital Limerick will also benefit from measures in the winter initiative that are available to all hospitals, including an additional €10 million for home-help and home-care packages, the increased availability of aids and appliances and increases in availability of transition care beds.

Denis O'Donovan (Fianna Fail)
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An bhfuil tú sásta? Are you happy, Senator?

Kieran O'Donnell (Fine Gael)
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No.

Denis O'Donovan (Fianna Fail)
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The Senator may comment briefly. We have gone two minutes over time already.

Kieran O'Donnell (Fine Gael)
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I thank the Minister of State for coming back on the winter initiative. No one should have to endure what patients and staff have to endure at the accident and emergency department in Limerick. The Minister for Health, Deputy Harris, has been there. The new accident and emergency department will be on stream in May 2017. I hope that the beds recently closed at St. John's Hospital will be reopened as quickly as possible in order to alleviate pressure.

I will be writing to the Minister for Health and the chief executive of the HSE, Tony O'Brien. I will urge them to fast-track the seed money to allow the design work to be done for the facilities relating to the 96 acute beds, which are critical for the region. We cannot have a situation whereby we have fewer than half of the beds that Cork University Hospital has while having a greater number of accident and emergency admissions. In fact, we have the largest number in the country.

Marcella Corcoran Kennedy (Offaly, Fine Gael)
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I assure the Senator that I will convey his two points on the seed money and the capital review to the Minister