Denis O'Donovan (Fianna Fail)
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The Minister of State at the Department of Health, Deputy Finian McGrath, who has been waiting for some time, will take the final Commencement matter. Cuirim fáilte roimh an Aire Stáit.

Maria Byrne (Fine Gael)
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I thank the Cathaoirleach for selecting this Commencement matter. As the Minister of State will be aware, University Hospital Limerick, UHL, is in the news every day of the week for many negative reasons. I pay tribute to the staff who work really hard at trying to make conditions perfect for the people who attend the hospital's accident and emergency unit. Recently, I wrote to the Minister for Health asking that he appoint an independent person to get an overview of the hospital, identify which areas are working properly and set out how to resolve the issues in the accident and emergency unit because that is the kernel of the problem. I ask the Minister of State to outline the process that will be used to resolve the issues in the accident and emergency unit of University Hospital Limerick as soon as possible.

Finian McGrath (Dublin Bay North, Independent)
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I thank Senator Maria Byrne for raising this very important issue concerning University Hospital Limerick. I also welcome the opportunity to address the House on behalf of my colleague, the Minister for Health, Deputy Simon Harris.

The Minister for Health and I fully acknowledge the distress overcrowded emergency departments, EDs, cause to patients, their families and front-line staff working in very challenging working conditions in hospitals throughout the country. The number of patients attending emergency departments continues to increase year on year. In the first quarter of 2019, the number of patients attending hospital emergency departments increased by 7.6% and the number of admissions to EDs increased by 4.7% compared with the same period last year. University Hospital Limerick is one of the busiest in the country and, as such, the hospital and community healthcare organisation, CHO, mid-west were identified as one of the nine focus sites requiring additional investment, focus and support this winter.

The problem of overcrowding in hospitals requires a full system, patient focused response. Recognising this, in the winter plan for 2018-19, the HSE sought to maximise the use of existing resources across hospital groups and CHOs to target additional investment at both hospital and community services supports. The approach adopted by the HSE over the winter period for 2018 and 2019, within the financial and capacity parameters and having taken into account the increased demand, supported an improvement in patient experience and a reduction in the number of patients waiting on trolleys. The health service capacity review published last year highlighted the need for investment in additional capacity. Progress has been made on increasing capacity in UHL. The average number of open inpatient beds increased by 4% between 2017 and March 2019. Since 2017, an additional 25 beds have opened in UHL, including eight as part of this year's winter plan. A capital budget of €19.5 million has been approved for the provision of a modular 60-bed inpatient ward block at UHL, with funding of €10 million allocated in 2019. Enabling works commenced in March and the HSE advises that the main works are expected to start in quarter 2. In addition, the national development plan includes a 96-bed replacement ward block in UHL and capital funding was provided in 2018 to progress the design phase of the project.

Planning for winter 2019-20 has already commenced. The HSE is undertaking a review of performance across all hospital groups and CHOs over the winter period to inform planning for next winter. This review will enable an assessment by the HSE of the overall performance from a planning, implementation and outcome perspective, year on year and against targets. In addition, it will encompass a review of the relative performance of the hospital group and the CHOs in comparison with other sites.The HSE advises me that this process will include an independent expert review of clinical, analytical and management capability in UHL and CHO mid-west as well as the other eight focus sites and CHOs.

Maria Byrne (Fine Gael)
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I thank the Minister of State. While I welcome the modular beds and the fact the enabling works have started, as well as the 98 beds that are due to follow, no short-term solution is being offered. People are still on trolleys in University Hospital Limerick, not just in the winter but all year round. There has to be a short-term solution to resolve the overcrowding and the conditions being endured by both the staff and the people attending the hospital. The solution the Minister of State has given is a long-term one. It will be another 12 to 18 months before these modular beds are built, but something is needed in the short term to respond to the plight of both the staff and the attendees at the hospital, especially in the emergency department.

Finian McGrath (Dublin Bay North, Independent)
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Of course I accept the Senator's point about immediate short-term solutions. We need a process to resolve those issues. I will strongly convey that message to the Minister, Deputy Harris. It is widely accepted that additional beds are part of the solution for Limerick hospital. Over the past two winters, an additional 25 beds have opened in Limerick, including eight as part of this year's winter plan. The bottom line is that we need to move as quickly as possible. We must also examine the issues of staffing and productivity improvements, but additional capacity must be delivered in tandem if we are to have a realistic chance of meeting healthcare needs over the coming decades, particularly the needs of the people of Limerick.