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Ceisteanna ó Cheannairí - Leaders' Questions (Continued)

Thursday, 4 April 2019

Dáil Éireann Debate
Vol. 981 No. 5

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(Speaker Continuing)

[Deputy Pearse Doherty: Information on Pearse Doherty Zoom on Pearse Doherty] Early in the week, there were serious problems at Cork University Hospital. There are still significant problems there, with 43 people on trolleys today, according to the Irish Nurses and Midwives Organisation, INMO. To top it all off, there was utter chaos yesterday at University Hospital Limerick, where the number of patients on trolleys reached a level never before seen in any hospital in the history of this State. The INMO recorded 81 people on hospital trolleys yesterday morning. By midday, the number had reached 92. Today, there are 76 people on trolleys in that hospital, while there are 531 people on trolleys in hospitals across the State. This is absolutely scandalous. We are reaching record numbers of people on trolleys and hospitals are in situations of utter chaos. The pictures on the front page of today's Irish Examiner are akin to the scenes in a hospital after a major natural disaster, but there is no natural disaster. These scenes of overcrowded hospitals and patients lying on trolleys in our corridors are becoming all too common. There are patients in University Hospital Limerick who have been waiting for days to get a bed, and all the while, right beside them, ward 1A is closed, padlocked and chained. The Government has put 17 beds in that ward out of commission and that makes absolutely no sense. My colleague, Teachta Quinlivan, has called for the immediate reopening of the ward, and I echo that. The Minister and the HSE should do this without delay.

  There are, however, bigger problems at University Hospital Limerick. I have seen correspondence provided to the health committee on behalf of the staff of the hospital. It makes for disturbing reading. The correspondence in question states that University Hospital Limerick continuously fails to adhere to national emergency department escalation policy and remains constantly in full capacity protocol. It states that the additional winter funding provided by the HSE has had no impact on overcrowding. It states that the consequence of all this is that nurses are struggling to provide safe care and cannot adequately monitor or assess patients to the level required. The staff go on to state that this is due to inadequate staffing and the extra trolleys on wards and in the accident and emergency department. This amounts to one thing: an unsafe hospital for patients. It is impacting on patients and putting them at risk and it is affecting the health and safety of staff. Both of these impacts are incredibly worrying. However, this is no longer just a winter problem; it is a problem all year round.

  What is going to happen to the patients in University Hospital Limerick on foot of the escalation over the past 48 hours? More generally, what is the Minister's plan to respond in a meaningful way to the capacity crisis right across our hospital network? Whatever he is doing is just not working. Not only is it not working; it is completely and utterly failing. We need serious action from Government.

The Tánaiste: Information on Simon Coveney Zoom on Simon Coveney I will deal with the specific issues relating to Limerick in a minute, but it is important to give a broader picture nationally of what is happening with regard to trolley figures. The trolley numbers for the first quarter of this year are the best for five years, so it is important we deal with the numbers and the facts. I know there are some hospitals under severe pressure and staff under pressure, and no one wants to minimise or belittle that strain. It is there. It was there earlier this week in Cork and yesterday in Limerick and Galway, which are under pressure. The hospitals are responding to this, but the overall trolley numbers are down and are lower than at any point in the past five years. It is important to recognise progress. This reduction in the numbers is due to our investing in more capacity. We are trying to streamline management systems in hospitals in order to ensure that we can deal, in particular, with capacity at this pressurised time of year as we come through the winter and see outbreaks of influenza and so on and in the aftermath of a strike action, which also caused some pressures. I am not apportioning any blame in this regard; I am just outlining the reality. That said, there are and have been particular issues in the past 24 hours in Limerick.

The Deputy specifically mentioned ward 1A. The HSE has informed me that the closure of a 17-bed medical short-stay unit, ward 1A, at University Hospital Limerick will facilitate the completion of works on a new fracture unit there. The closure is in accordance with the plans to redesignate the space occupied by the old emergency department at the hospital. University Limerick hospital group has advised that staff were fully involved in this process, with the various teams presenting business cases on optional use of the old emergency department. The hospital group has advised that the new fracture clinic will have a specific benefit for patients in reducing waiting times and improving patient experience. We are trying to invest in new facilities at the same time as trying to manage current pressures, and we must do both. We cannot simply abandon plans to invest in increasing capacity and improved efficiency in an effort to try to deal with the immediacy of what is a very pressurised situation at University Hospital Limerick. The hospital group advises that the closure of these 17 beds has been offset by the opening of 22 beds elsewhere in the hospital in recent weeks, including a 12-bed surgical short-stay unit and three additional cardiology beds. It is widely agreed, however, that a key part of the solution for Limerick is additional beds. The capital allocation for 2019 of €2 million has been granted in recent weeks to facilitate the completion of enabling works for the 60-bed modular ward, to which I also referred on Tuesday.

Deputy Pearse Doherty: Information on Pearse Doherty Zoom on Pearse Doherty No matter what way the Tánaiste wants to spin it, we were sent pictures yesterday from individuals who were in University Hospital Limerick as 92 patients were lying on trolleys in corridors, wards and the accident and emergency department. The pictures are of ward 1A with padlocks and a chain around the gate. There are 17 beds behind those doors that could be accommodating these patients. However, Limerick is not the only hospital that has wards that are closed. In my local hospital in Letterkenny, there is a 20-bed ward in respect of which the Government has given sanction to open only ten of the beds, despite the fact that every day, every week, we see patients on trolleys. While the Tánaiste tries to claim that the Government is doing so much better, the reality is that there are 531 patients on trolleys today, hospitals are being deemed unsafe and his own local hospital in Cork had to invoke status black, which means it is unsafe to admit a patient into the hospital regardless of the circumstances. There is complete and utter chaos in our health service. This is not just about the discomfort of not having a hospital bed; it is about the treatment and the health outcomes. Those on the front line are telling us-----

An Ceann Comhairle: Information on Seán Ó Fearghaíl Zoom on Seán Ó Fearghaíl The Deputy is way over time.

Deputy Pearse Doherty: Information on Pearse Doherty Zoom on Pearse Doherty -----that people are dying as a result of this crisis, and the Government is failing to address it after eight years in office.

The Tánaiste: Information on Simon Coveney Zoom on Simon Coveney The Government is addressing this but it is taking time. Let us look at Cork University Hospital. This morning, according to the HSE count, the number of patients waiting on trolleys in Cork was 25, down 31 from yesterday and 55 from Tuesday morning.

Deputy Pearse Doherty: Information on Pearse Doherty Zoom on Pearse Doherty According to the INMO, it is 43.

The Tánaiste: Information on Simon Coveney Zoom on Simon Coveney The hospital has got on top of what was an unacceptable situation at the start of the week. Let us look at what the Government is doing in the medium term in order to increase capacity. What is required is a combination of increased capacity and improved efficiency and management systems. Increased capacity is a priority for the Government, as we have stated. An additional 241 beds were opened under the winter initiative of 2017-2018, and the national service plan for 2019 provides for a comprehensive capacity programme. Elements of this programme include 75 acute beds and 70 community beds scheduled to come on stream in early 2019 as part of the winter plan. The HSE has confirmed that 46 acute beds have been opened to date. I could go on and list a series of other capital expenditure programmes that are being invested in, including in Limerick, which is a major focus in terms of extra bed capacity. One of the issues-----

An Ceann Comhairle: Information on Seán Ó Fearghaíl Zoom on Seán Ó Fearghaíl The time is up.

The Tánaiste: Information on Simon Coveney Zoom on Simon Coveney -----to which I referred earlier involves upgrading of the Limerick facilities in order that we will have more efficiency in the not-too-distant future, when we get through the pressures we face today.

Deputy Clare Daly: Information on Clare Daly Zoom on Clare Daly In December 2017, I raised with the Tánaiste the case of Anthony Cole, the first person to bring an action concerning Lariam. That action had just been settled after the State sparing no expense in assembling a major legal team, with ten days of hearings over five months, before the Government threw in the towel.

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