Martin Conway (Fine Gael)
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I know that the Minister of State, Deputy Calleary is taking this on behalf of the Minister for Health but I also know he will be well aware of the ongoing challenges and issues with healthcare in the mid-west. I have not tabled this Commencement Matter to look for a 24-hour consultant-led emergency department at Ennis Hospital. In the engagement the health committee had recently with all the stakeholders, including unions and medical professionals, none of them were looking for that, and neither, obviously, was the HSE. People want increased services in Ennis Hospital, which makes complete sense because if we can move non-critical healthcare services from UHL to places like Ennis, it will make a huge difference.

I have raised here on a number of occasions the need for a dialysis unit in Ennis. I tabled a Commencement matter on this as recently as three weeks ago. We were told the earliest it would happen was 2025. There are at least 70 or 80 people from County Clare who travel in a taxi, some leaving places like the Burren and spending two hours to get to Limerick, and then have to get their dialysis for another six hours. It takes another two hours to travel home. If that service was available in Ennis, it would cut a significant amount of time off their journey. That is one example. I spoke to someone recently who had to have some cardiovascular work as an outpatient. They were travelling into UHL and could not get parking so they missed their appointment as a consequence. There is no excuse for that type of thing when we have the capability to increase capacity at Ennis Hospital. It has the minor injuries clinic and a number of other services and supports but there is so much more that could be done which would free up space in the main hospital in Dooradoyle in Limerick. What are the plans? What are the short-term, medium-term and, indeed, long-term plans to scale up non-critical care services in Ennis Hospital?

Dara Calleary (Mayo, Fianna Fail)
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I would like to thank Senator Conway for raising this matter. The Government remains fully committed to improving services in Ennis and the mid-west region. The Minister for Health has engaged extensively with the University of Limerick Hospitals Group and the HSE. He has announced a series of measures to increase capacity and improve services across the region, including over the last 48 hours and including in Ennis Hospital.

The smaller hospital framework, which was published in 2013, provided a stronger role for smaller hospitals like Ennis Hospital. They are delivering higher volumes of less complex care, in many cases closer to patients’ homes. This ensures that patients who require true emergency or complex planned care are managed safely in a larger hospital environment. Ennis Hospital provides inpatient medical beds, a medical assessment unit, MAU; a local injuries unit, LIU; and day surgery. Patients are admitted to Ennis Hospital via the MAU injury unit and transfers from UHL for step-down care.

There has been significant investment in the mid-west model 2 hospitals in recent years, with budgets increasing in all three hospitals. The total 2024 budget for all three hospitals is €350 million. Staffing levels in Ennis Hospital have increased from 235 whole-time equivalents in December to 290 in March of this year. This represents a 23% increase in staffing. There was €1.57 million allocated in 2023 to recruit an additional 19.95 whole-time equivalents to extend the opening hours of the MAU at Ennis Hospital to 12 hours a day, seven days a week. This investment has enabled attendance at the MAU to increase from 6,228 in 2020 to 7,735 in 2022.

Recently announced measures will see the opening hours extending to 24-7 on a phased basis. In terms of capital infrastructure investment, Ennis Hospital received €2 million for a new purpose-built LIU, which opened in 2022. This unit has managed a 32% increase in LIU attendances from 11,517 in 2019 to 15,245 in 2023. Also in 2022, the new outpatient department was equipped including an X-ray room and other diagnostics at a cost of €1.29 million.

To come to the Senator’s point, work is under way to establish a haemodialysis service in Ennis. The HSE has advised that this service is proposed to be operational towards the end of 2025.The HSE has also advised that a preferred supplier has been identified for this externally contracted service. The Minister continues to work closely with the HSE to ensure that Ennis Hospital and the University of Limerick Hospitals Group are fully supported in respect of the delivery of healthcare services for the region.

Martin Conway (Fine Gael)
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I thank the Minister of State for his fairly detailed reply. The small hospitals framework is something that I very much support and welcome. I would like to see services scaled up much quicker than is currently the case. In the of previous Commencement matters I tabled, I was told that the dialysis unit would be operational by the end of 2023, and certainly by quarter 1 or 2 of 2024. I welcome the confirmation that it will be operational by the end of 2024. If we meet that timeframe, it would be a reasonable outcome. I always add six to 12 months to any date I am given. I have already added it with this one, so I sincerely hope it happens by the end of 2024.

The staff and management at Ennis Hospital do a terrific job. The feedback from people who go there, either to the minor injuries clinic, the MAU or any of the other units, is that they are well looked after and have a very positive experience of engaging with the health service on the campus of Ennis Hospital. The management at Ennis Hospital are willing and able to scale up and provide non-critical medical supports to the people of County Clare.

Dara Calleary (Mayo, Fianna Fail)
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I echo the Senator's comments and tributes to the staff and management at Ennis Hospital. As Senators can see from my opening remarks, we have made significant capital and personnel investment in Ennis Hospital over the past number of years. I have no doubt that the Minister, Deputy Donnelly, will continue with his commitment to the hospital.