Róisín Shortall (Dublin North West, Social Democrats)
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1518. To ask the Minister for Health if there are plans to provide a model 3 hospital in the UL Hospitals Group region; if so, if he will provide details of same; and if he will make a statement on the matter. [1580/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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There has been, and continues to be, substantial investment in the University of Limerick Hospital Group. In October 2022, I broke ground on the new 96-bed inpatient block project at University Hospital Limerick. This €90m capital project will deliver a 4-storey, 96 single bed acute inpatient ward block, which will go some way toward addressing capacity issues in the region.

In 2021, a new 60-bed modular ward block opened at UHL, which provides modern, single-room inpatient accommodation with improved infection prevention and control capabilities as well as patient flow throughout the hospital. This follows the completion of two separate rapid-build projects, constructed in response to the Covid-19 emergency, which provided an additional 38 inpatient beds on site at UHL. 

The new €2m Injury Unit at Ennis Hospital opened last April bringing an immediate improvement in the clinical environment and experience for healthcare staff and the thousands of patients who use this service every year. In addition, a €9.95m theatre upgrade was approved for Ennis Hospital as part of the HSE’s Capital Programme for 2022.

A modern state-of-the-art ward complex, with 24 en-suite single rooms opened at Croom Orthopaedic Hospital in March 2021. A new €15m theatre suite, complete with four new operating theatres, a first stage recovery room and reception area, as well as a new Sterile Services Department and other ancillary support spaces also opened during 2021.

On 7th  December 2022, the Government approved the next stage of the Enhanced Provision of Elective Care Programme. As part of this Programme, new national Elective Hospitals will be delivered in Cork, Dublin, and Galway. The new Elective Hospitals will provide significant additional capacity, enabling the separation of scheduled and unscheduled care. The introduction of this new delivery capability into the Public Healthcare System will benefit the whole population, including those who do not fall within the immediate traditional geographical catchment. It is envisaged that the new Cork and Galway facilities combined (which will treat patients from the mid-west) will cater for up to 350,000 patients/procedures annually.

Complementary to the development of the new Elective Hospitals, the HSE also plans to work with Hospital Groups and forthcoming Regional Health Areas to progress proposals for a shorter-term measure by developing ‘Surgical Hubs’ in Cork, Galway, Limerick, Waterford and Dublin with a narrower scope of procedures. This intervention will also support efforts to consider the necessary reforms and enablers needed to separate unscheduled and scheduled care pathways that will be required by the longer-term provision of the Elective Care programme.

The UL Hospitals Group comprises six hospitals, led by University Hospital Limerick, which is a Model 4 Hospital. There are two Model 2 Hospitals, Ennis, and Nenagh Hospitals, while St John's Hospital is classified as a Model 2S Hospital, i.e., St. John's can carry out intermediate surgery, which requires in-patient stay and accommodation in addition to day case surgery. The UL Group also includes Croom Orthopaedic Hospital, and University Maternity Hospital Limerick. The model 2 hospitals accept transfers of appropriate patients from UHL daily. These patients can either be stepped down from an inpatient ward in UHL or they may, where a clinician has decided it is appropriate, transfer to Ennis, Nenagh or St John's directly from the ED in UHL.

A recent development in Ennis Hospital and for the Mid-West region has been the introduction of the Medical Assessment Unit (MAU) pathway for 112/999 patients, which commenced on January 9th. It allows stable medical patients that meet the agreed clinical criteria to be treated in a Model 2 hospital. This pathway will result in patients receiving medical treatment in a hospital closer to their home, will reduce patient presentations to Emergency Departments and will release ambulances more quickly to respond to other emergency calls. The MAU in Ennis Hospital treats patients referred by GPs, ShannonDoc, and now National Ambulance Service paramedics. 112/999 patients that do not meet these clinical criteria will continue to be transported to Emergency Departments for assessment and treatment.  

I have expressed concern about overcrowding in the ED in Limerick and acknowledge the distress caused to patients, their families, and frontline staff working in very challenging conditions in emergency departments in UHL and throughout the country. I visited UHL in February last year to meet with patients, staff, and management. The HSE’s Performance Management and Improvement Unit (PMIU) led an intensive engagement with UHL team members throughout the summer in response to my concerns about the hospital and the findings of the HIQA report following an unannounced inspection of the ED in Limerick in March. The engagement supported the hospital and community services in driving a programme of work to respond more effectively to the pressures at the hospital.  UHL continues to engage with the support team, working jointly with HSE Mid-West Community Healthcare to respond to pressures faced at UHL.  

There are no plans to provide a model 3 hospital in the UL Hospitals Group at this time, but I would like to assure the Deputy that my Department continues to work closely with the HSE to ensure that the UL Hospitals Group is fully supported and that the necessary improvements to address capacity issues are actioned in a timely manner.