Dáil Éireann Debate, Thursday - 20 April 2023
14. Deputy Cathal Crowe asked the Minister for Health if he will provide an overview of how the new admissions protocol relating to the medical assessment unit at Ennis General Hospital has functioned since January 2023; how he proposes to further enhance the functionality of this facility; and if he will make a statement on the matter. [17943/23]
View answerMy question relates to Ennis General Hospital and the new protocol introduced in January of this year whereby patients could be brought to the medical assessment unit by ambulance to alleviate the pressure being felt at the time at University Hospital Limerick's emergency department. I would like an update on how that has worked so far and what other plans the Minister has to improve this facility and indeed emergency healthcare in the mid-west.
I acknowledge the Deputy's ongoing advocacy for Ennis Hospital to improve resources and, ultimately, services for his constituents. The medical assessment unit, MAU, pathway for 999 patients was introduced in Ennis Hospital on 9 January and Nenagh Hospital on 7 February. This pathway allows patients who meet agreed clinical criteria to be transported to an MAU rather than an emergency department. It is resulting in patients in the mid-west receiving treatment in a hospital closer to home. It is ensuring that patients can receive less complex care without the need to attend an emergency department. The aim is to reduce patient presentations primarily, in this case, at University Hospital Limerick, UHL, and release ambulances more quickly to respond to other calls.
The HSE has advised me that, to date, 72 patients have been referred to Ennis and Nenagh hospitals via this pathway, which is already helping to reduce emergency department presentations at UHL. The MAU at Ennis Hospital continues to operate seven days a week and the MAUs at St. John’s and Nenagh hospitals are also now operating seven days a week. Recruitment is in progress in the MAUs nationally for an additional 51 staff, who will be whole-time equivalents, WTEs, across a range of specialties. As these staff take up their posts, the number of assessment slots available for patients will increase. Once all staff are in post, the effect of this investment will be the creation of an estimated just over 7,000 additional assessment slots per year across the three MAUs in UL Hospitals Group.
I thank the Minister. When the protocol was introduced, it was quite positive. It was at a time when we were at an all-out crisis at UHL. The figure of 72 patients between Ennis and Nenagh hospitals is a combined figure. I would love to hear a figure for Ennis in particular because, in the first month following the protocol, we were still down to single-digit figures for how many were coming in there. We would love to be transformative but there is a huge caveat: this cannot be at the expense of those waiting for day surgery at Ennis. It cannot tie up other hospital capacity. We would love to hear what is happening in that regard and how the two are being separated. How do the two coexist so the hospital is able to function day to day?
The Minister might offer some commentary on the additional funding for Ennis, Nenagh and St. John's hospitals announced the other day. That was a bundled figure. We would love to hear that the MAU - the local injuries unit - will move to more hours per day, although it already runs on a seven-day basis. Perhaps it could move to 18 hours per day, eventually moving up to a 24-7 facility.
I will correct what I said. The 51 WTEs are not a national but a regional deployment. It is just within the hospital group. Ennis Hospital will see an additional 20 WTEs just for this programme. It is a very significant increase in investment. The hospital group has been approved for more than €5 million in funding to essentially extend the opening hours, as the Deputy quite rightly said. This is part of an ongoing investment in Ennis Hospital. The Deputy will be very aware of the new €2 million minor injury unit that opened in April of last year to replace the existing unit, which had been in the main building for a very long time, since around 2013. As these extra 20 staff are brought in, relevant staff in Ennis Hospital will be in discussions with the HSE and the hospital group to see whether the hours can be expanded further and if patient demand warrants it.
I do not blame the Minister for the woes of the mid-west health crisis. I blame certain decisions taken by previous governments, particularly the 2009 decision to reconfigure acute hospitals in the mid-west region to deliver centres of excellence that have never materialised. If someone had said 12 or 18 months on that we were working towards excellence that might have been credible, but we are now 14 years on. The Minister is doing a damn good job in trying to build capacity but it has to be admitted on the Dáil record that the 2009 decision was a major mistake.
I would love to know more about those opening hours for Ennis. It has been alluded to that the opening hours of the MAU will improve but we would love to hear whether it will be 18 or 24 hours a day. That is really what people want to hear today.
An application for the University of Pittsburgh Medical Centre, UPMC, to have an elective hospital in the region has been on the Minister's desk for a number of months. Will he tell us where that is at? We see that as being a game-changer in unburdening some of the day and elective surgery cases from UHL. For the record, because it is often put by Sinn Féin that this is for profit, this is not for profit. It is a charitable hospital that will take huge pressure off public healthcare in the region.
I thank the Deputy very much for that. There has been and will continue to be ongoing investment in Ennis Hospital. We will need to see exactly what the final opening hours for the MAU will be. Local clinicians will gauge patient demand. If we are to have staff there at night, patients need to be coming in to warrant them being there. Otherwise, we would employ them during the day to provide patient services. At this point, the important thing is there is very significant investment in expanding the team at Ennis. To have an extra 20 people there is a very significant advance. We will keep a close eye on that.
The new outpatient department at Ennis Hospital has been equipped with X-ray rooms and other diagnostics. The redevelopment of Ennis Hospital is at phase 1b. That will make a big difference. There are also redevelopment works on the two replacement theatre-supporting facilities, including theatre suites and other redevelopment works at the hospital.
The Deputy asked a broader question regarding UPMC that I will come back to him on.
