Wednesday, 13 March 2019

Questions (2)

Louise O'Reilly


2. Deputy Louise O'Reilly asked the Minister for Health the way in which he plans to address the overcrowding at University Hospital Limerick; the reason the full capacity protocol is in use at the hospital every day; when the 96-bed extension and 60-bed modular unit will be built and operational; and if he will make a statement on the matter. [12443/19]

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Oral answers (6 contributions) (Question to Health)

I assume the Minister for Health, Deputy Harris, is out of the country. Obviously, he should be here. I had thought I would have a chance to speak to him personally about the issue I am about to raise. I have put forward numerous Topical Issue matters and asked numerous priority questions and the Minister has never been in the Chamber to answer them.

How does the Government intend to address the chronic overcrowding at University Hospital Limerick? Will the Minister of State outline why the full capacity protocol, which is supposedly an emergency measure, is in use at the hospital every single day? Perhaps the Minister of State will let the citizens of Limerick and the mid-west region know when the 96-bed extension and 60-bed modular unit will be built and operational to ease the severe overcrowding that is now the norm in UHL.

I offer my apologies for the absence of the Minister for Health, Deputy Harris. I am taking this question and the remaining questions on the Minister's behalf as he is not in the country due to the week that is in it, as Deputies may understand. I will endeavour to answer the questions as best I can on his behalf.

The emergency department in University Hospital Limerick is one of the busiest in the country, with the number of patients attending growing year on year. The full capacity protocol was devised to direct hospital resources towards surges in demand for emergency care, thereby reducing emergency department waiting times. The decision to deploy the full capacity protocol is a matter for local hospital management, in line with the national escalation framework. The HSE advises that the full capacity protocol was deployed in Limerick for 336 days out of 365 in 2018. Limerick was identified as one of nine sites requiring additional investment, focus and supports as part this year’s winter plan.

The problem of overcrowding in hospitals requires a full system, patient focused response. Recognising this, the winter plan investment is targeted at both hospital and community services and supports. This includes additional home support packages and transitional care beds to support people to leave hospital and return home.

It is widely agreed that a key part of the solution for Limerick is additional beds. Over the past 18 months, an additional 23 beds have opened in Limerick, including five as part of this year’s winter plan. A capital allocation of €2 million has been granted in recent weeks and the HSE advises that this will facilitate the completion of enabling works for the 60-bed modular ward in 2019. In addition, the national development plan includes a 96-bed replacement ward block in Limerick and capital funding was provided in 2018 to progress the design phase of this project.

I have lost count of the number of times I have come into this Chamber to ask the Minister when substantial action will be taken to address the horrendous overcrowding in University Hospital Limerick, yet nothing has been done. The Minister of State indicated that five beds will be opened under the winter plan. That response sums up the lack of respect the Government has for the people of Limerick. The Minister of State is aware that the plan asks for much more than five beds. The situation has severely deteriorated. Limerick citizens are being treated as second class citizens. It is a simple fact that the desperate conditions in UHL, with 50, 60 or 70 people on trolleys every single day, would not be tolerated in other hospitals, for example, in Dublin. There are 60 people on trolleys in University Hospital Limerick as we speak. That is a national disgrace. Limerick is clearly at the bottom of the Government's list of priorities. Limerick people deserve quality healthcare facilities and our doctors and nurses deserve a safe place to work. University Hospital Limerick currently provides neither. The hospital is dangerously overcrowded. A constituent recently described the chaos in the accident and emergency department as being akin to a cattle mart. Will the Minister of State indicate when the Minister last met management of University Hospital Limerick to discuss solutions to this problem? Will he provide a reason for the delay in delivering new beds at the hospital?

I remind the Deputy that 23 new beds have been opened at the Limerick facility in the past 18 months. There was also a recent announcement of €2 million for enabling works to progress the 60-bed modular unit at the hospital. I will revert to the Deputy with information on when the Minister last met management at UHL.

The Minister of State said a number of beds had been opened at UHL. Will he indicate how many beds have been closed at the hospital? I understand a ward was closed which had a similar number of beds to the number that have been opened. As I said, a full capacity protocol is being used every single day. A total of 11,437 sick patients have spent time on trolleys in University Hospital Limerick in the last year. This is the highest figure in the State. As I stated, there are 60 people on trolleys in the hospital today, the highest number in the State, and 34,133 people are on waiting lists at the hospital. Fine Gael has been in government for eight years, during which time the situation at University Hospital Limerick has deteriorated substantially. The number of people on trolleys in University Hospital Limerick increased by 212% between 2011 and 2018.

I put it to the Minister of State that we need additional beds immediately in the form of the 60-bed modular unit and the 96-bed extension. It should not have taken this long. Will the Minister of State ask the Minister to agree to prioritise the fast-tracking of the additional beds that are urgently needed in Limerick?

We are fast-tracking beds through the allocation in recent weeks of €2 million to facilitate the 60-bed modular unit. The Deputy will be aware there has been a significant increase in the number of presentations at the accident and emergency department in University Hospital Limerick which compounds the difficulties. We have to plan ahead to try to deal with those increases. A whole suite of issues and solutions have to be taken into consideration. It is not simply a matter of providing more beds and capacity, although that is one element. We must also address delayed discharges. We had a report done on that issue at the end of last year and we now have an implementation team set up within the HSE. The terms of reference for the team are being drafted in order that it will address the issue of delayed discharges and ensure more timely discharge from hospitals. Delayed discharges contribute significantly to overcrowding at University Hospital Limerick and many other hospitals. We also have more proactive measures in Sláintecare to ensure people are treated in their communities and to reduce the numbers of presentations to accident and emergency departments. These protocols, when implemented, will impact on the University Hospital Limerick and other sites throughout the country.