Dáil Éireann Debate, Thursday - 2 May 2024
3. Deputy David Cullinane asked the Minister for Health if he will commit funding to 288 additional acute inpatient beds at University Hospital Limerick, UHL; the timeline for the full implementation of the coroner's recommendations following an inquest (details supplied); and if he will make a statement on the matter. [19773/24]
View answerThis question relates to the mid-west region and University Hospital Limerick. I will start by recognising the loss of Aoife Johnston. I pass on my heartfelt condolences again to her family and her parents. Aoife was one of many patients whom we know were failed in that hospital. As the Minister knows, her family are grieving. We have a real challenge and a real problem in UHL. What additional beds and capacity will be put in place in the mid-west and UHL to once and for all fix the problem for the people who live in the region?
I join the Deputy in offering my condolences to Aoife's family and friends. I met her mum and dad at the start of the year and offered my apologies as well as condolences because she was failed and she should not have died. It is heartbreaking.
The answer to the challenge of overcrowding in the emergency department in UHL is capacity and reform. We have made sure that UHL is the hospital that has had the biggest increase in money and staff in the country. It has had a bigger increase in budget and staff than any other hospital. The Deputy quite rightly asked about beds. To date, it has had an increase of 108 beds, 98 ward beds and ten critical care beds.
I was in UHL about four weeks ago, and we launched an additional 86 beds for this year, in advance of the first 96-bed block coming online. I have also authorised the building of the second 96-bed block as well. Of the 86 beds for this year, 70 of them will revert to the communities in counties Tipperary and Clare when the permanent beds in Limerick are opened. Some 16 of them will remain, which increases the net amount as well. The numbers are as follows, specifically in terms of the beds. We have already added 108. We have 86 more coming this year, so coming into next winter we should be up by 194 beds. Then on top of that there is a second 96-bed block being built as well. The total increase will be approximately 290 beds. As well as that, we have been investing in the community and in Ennis, Nenagh, St. John's and Croom.
The tragedy of all of this is that most of those beds have come far too late. There is no reason those beds should not have been funded years ago. Everybody knows that when the decision was made to close Ennis and Nenagh emergency departments, additional capacity was needed in Limerick. It was promised that it would be a centre of excellence. It has not been able to perform as that centre of excellence and the main trauma and emergency department service for Limerick because it does not have the capacity.
There is a number of things needed. The Minister needs to stay ahead of the problem, which is why we are saying more beds are needed. The hospital says it needs a minimum of 230 beds right now. We have to stay well ahead of that because we will have further population growth and demand on the healthcare system.
Ennis and Nenagh hospitals need to be examined. Their emergency departments were closed but there is no model 3 hospital in the region. I live in Waterford, as does the Minister of State, Deputy Butler. Wexford has an emergency department and a model 3 hospital. St. Luke's in Kilkenny has an emergency department and a model 3 hospital. We have a model 4 hospital and an emergency department in that radius. The mid-west has only one either model 3 or model 4 hospital, and that is Limerick, and it is struggling. We must have a much more holistic review of what is needed in the region.
I agree. The reconfiguration was not done right at all and the measures that the Government is putting in place should have been put in place before the reconfiguration happened. That is my view. What I can stand over is what the Government is doing. The Government has added a level of capacity into Limerick that has never been done before and there is no hospital in the country that has had more money or staff. The increase in staffing in UHL in the lifetime of this Government is nearly 1,200. It is vast. The beds are being added in Limerick more than in any other hospital with the two 96-bed blocks being built.
It is essential that we do not lose sight of the reform piece of this because the beds will only make a difference if they are being used properly. There are better reforms happening. There was an unannounced HIQA ED inspection. I believe that they will note that things are getting better but they hospital still has a ways to go. Weekend discharge is still too low. Limerick has the lowest uptake of any of the large hospitals of the new consultant contract.
Some important reforms have been happening. The new regional executive officer has been pushing on them and she has my full support. There are further reforms that we need to help the local clinical communities engage in.
The Minister will get a chance to come back in.
Sorry, a Leas-Cheann Comhairle.
I am all for reform in that hospital and every other hospital, but I was one of those members, including Deputy Crowe, who attended the briefing for the Oireachtas health committee. We met with the head of the HSE and clinicians, hospital management and healthcare trade unions. All of them, to a man and a woman, told us that the big problem in Limerick is capacity. We need reforms but every single day there are patients who are deemed sick enough to be admitted to a bed but the beds are not there. Approximately 200 staff are needed, including more nurses in the emergency department, according to the INMO.
We also need to look at the other areas. When the Minister says that the hospital has received more staff than any other hospital, that is because there is no other model 3 hospital. It is the only major hospital in the entire region. Of course, it will get, and needs, more staff. The problem is it is struggling. I hope that the additional beds and the staff will be the only solution that is necessary but I genuinely believe that we have to look at other hospitals in the region, and from a health, medical and clinical perspective, whether it is safe to do so, to serious look at a model 3 hospital for another part of that region as a prospect.
Let us bear in mind that when I say we have added more staff, we have increased the staff by more than 40%. This is not a few more staff. An additional 433 nurses, for example, are working in the hospital. It has been a vast increase.
In terms of a model 3 hospital, we should never rule anything out. The chief executive and I have asked all six of the regional executive officers, now that we are moving to regional health areas, to conduct a strategic review of their regions in terms of community care and hospital care in the round. We should never rule anything like that out.
It is, however, important that we in the Oireachtas keep the focus on reform. We are doing our bit in adding capacity. It is being added at a level it has never been added before but weekend discharge is not where it needs to be, the uptake of the public-only contract is not where it needs to be and basic patient flow approaches which are standard in other hospitals are not currently being used in UHL. What we are seeing around the country is a very encouraging reduction in the number of patients on trolleys, except in UHL where we are seeing a nearly 50% increase in the year to date. That difference is not about capacity. That difference is about running the hospital as well, as the Deputy referenced, his own hospital in Waterford.
