Peadar Tóibín (Meath West, Aontú)
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215. To ask the Minister for Health the investigations that HIQA has carried out into the decisions made by senior HSE management to close capacity in the health service that has directly led to overcrowding in hospitals (details supplied); if he has investigated this and the contribution these closures had on the overcrowding in Limerick; and if he has investigated the people who made the decisions to close them. [31146/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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HIQA is an independent statutory authority established under the Health Act 2007 to promote safety and quality in the provision of health and social care services for the benefit of the health and welfare of the public. Since its establishment in 2007, HIQA has regulated and monitored certain health and social care services across Ireland. HIQA’s role in monitoring healthcare services is directed by its legislative remit, national standards and evidence of what interventions reduce risks for patients and promote safe, effective and quality care. Engagement with interested parties, international research, guidelines and best practice all help to inform HIQA’s monitoring programmes.

The Health Act 2007, Section 8(1) (c) confers the Health Information and Quality Authority (HIQA) with statutory responsibility for monitoring the quality and safety of healthcare services.

HIQA has been engaging with the UL Hospitals Group since July 2020 in relation to overcrowding in the emergency department at University Hospital Limerick. HIQA believed that an investigation of the overcrowding at University Hospital Limerick would be inappropriate while the hospital was challenged with the management of COVID-19 related activity. HIQA sought further information and assurances from the hospital group relating to their evaluation of the factors influencing the continued overcrowding in the hospital’s emergency department.

Having flagged their intention to include Limerick as an early inspection once their new programme of monitoring commenced, HIQA conducted a risk-based unannounced inspection of the emergency department in University Hospital Limerick on 15th March 2022. The report of that inspection is due for publication on Friday 17th of June, 2022.

University Hospital Limerick has experienced a substantial increase in attendances in recent months and recorded a 10% increase in attendances in the first quarter of this year, as compared to the same timeframe in 2019.

I visited UHL in February and met staff, patients and management, and subsequently requested the HSE CEO to appoint an expert team to review ED operations at the hospital. The Review Team reviewed the day-to-day functioning of UHL within a leadership, management, operational and clinical context to consider how improvements in UHL may be enabled in the short term. Critically, it sought to identify what is required locally, regionally and nationally to support operational and clinical effectiveness on a sustained basis across UHL. Key drivers of the Review Process were the delivery of safe effective care for the population served by UHL and the close, integrated and patient centred collaboration with Community Operations in CHO Midwest.

Separately the hospital management has commissioned an external review (Deloitte) to review and advise on unscheduled care and patient flow in the hospital and the HSE review team will also consider the outputs of this work in its review. I am awaiting the findings of the HSE review team.

I am aware of the sustained increase in ED attendance in 2022, and have also has met with the Chair, CEO, and senior management in the HSE and requested the development of comprehensive plans for each ED which will set out short term and long-term measures to be taken locally and nationally, including at each Community Healthcare Organisation, to ensure sustainable improvements in ED performance. I and my department are working closely with the HSE on developing the plans which will be published in due course.