*Minister Stephen Donnelly during his visit to UHL.
HIQA have confirmed it is to undertake inspections of the emergency department at University Hospital Limerick (UHL) while the Minister for Health has said more emergency medical doctors are needed at the Dooradoyle facility.
Along with carrying out inspections, HIQA are to work with UL Hospitals Group to develop a strategic plan to address capacity issues at UHL, Minister Stephen Donnelly TD (FF) confirmed.
Clare TD, Michael McNamara (IND) earlier this month called for an independent inquiry into ongoing overcrowding at UHL. He stated, “UHL is the most consistently overcrowded hospital in the country with over 76,000 attendances in 2021, up 16% compared to 2020 and up 7% on 2019”. He added, “Hospital management and staff appear to be firefighting on the issue of overcrowding as opposed to identifying and rectifying the issues that are causing the problem”.
Overcrowding has worsened rather than improved since the delivery of the 60-bed modular ward block and the provision of an additional 38 inpatient beds, Deputy McNamara flagged. “A full review of operations within the UL Hospitals Group is required if we are to ultimately find lasting solutions to the overcrowding issues”. Admission and discharge policies at UHL need to be reviewed, the Scariff native maintained.
Speaking following a visit to UHL, Minister Donnelly outlined, “It’s very clear to me that in University Hospital Limerick, one of the things we need is more healthcare professionals, we need more nurses, we need more allied professionals, more junior doctors, more NCHDs, more specialists, one of the things I’ll be doing is having that conversation with the Department of Health, with the senior team in the HSE and looking to how we can build capacity in our public health service very quickly so that critically the public get access to the best possible care”.
Claims of a clean-up operation prior to the Minister’s visit were made by hospital staff and Senator Paul Gavan (SF) which Donnelly labelled “a very unfair allegation”. He continued, “I met the nurses and the hospital porters last night, they are under so much pressure that they didn’t have time to be finding places to put patients, I went in and spent a good bit of time there, I spoke to a lot of people, the reality is there was a lot of patients who had been admitted who didn’t have a bed and who were on trolleys, they shouldn’t be and they don’t want to be, it’s not fair on them and it’s not fair on the people working in the emergency departments either”.
During his visit to UHL, Minister Donnelly met with nurses, CHDs, specialists and doctors. “I got a clear picture of the extraordinary healthcare professionals we have, they are unbelievable but also the unacceptable pressure they are under, that is not to blame anyone, from hospital management right through they are all doing their best, they need more staff, they need more nurses, they need more allied health professionals and more doctors, that is the reality. As well, we need to put in more beds, I’d like to see the diagnostic suites open longer, there are good innovations they are putting in place, there is now MRI available on Saturdays, we need to do more. One of the things I can do is allocate funding for staff, beds and machinery, that is something we are doing and need to make sure the teams on the ground get to turn that into hiring great new people”.
On Deputy McNamara’s recent call for an independent review at UHL, Minister Donnelly said, “I know that question gets asked a lot, I wouldn’t be ruling anything in or out, I’m a great believer that most of the answers are known locally, I was talking to hospital porters who were showing me how to solve the issue they would be dealing with, I met NCHDs who said this is how we deal with our bits, I met nurses this morning and they had idea after idea after idea, the hospital managers have very ambitious plans, in my experience the local teams know what needs to be done, what Government has to do and what the HSE have to do is give them the freedom to do these things themselves.
“For example, University Hospital Limerick got a derogation to hire locally, it has gone really well, if you’re hiring a consultant nationally it can sometimes take a year and a half but they can do it in six months here. We need to give the local teams, not just the managers, we’ve got to listen to the workforce and give them the freedom they need to make the changes, that doesn’t mean we should always be open to external experts being able to say this is great but actually there is more opportunity in Ennis or Croom”.
Despite significant investment in UHL, the problem of overcrowding continues. When asked why this is the case, Minister Donnelly responded, “If we look back now versus five years ago, the budget for UHL has gone up quite a bit from a little over €200m to almost €400m, there has been a lot of investment and the workforce has gone up in the same period by about a half, has that translated for better care in Limerick it has, they showed me around the new oncology ward and the difference is incredible, single occupancy rooms, en-suites, they brought in allied healthcare professionals, occupational therapists, dietitians, all of which oncology units need, a lot of money has gone in, a lot of staff has been hired and really important advances are happening.
“Given all of that additional resource, why are we under so much pressure in the emergency department, why are the waiting lists not coming down, part of the reason is COVID, for example half of the nursing homes still have outbreaks so patients that would normally be discharged to nursing homes can’t be at the moment, the emergency department a new one was put in place a few years ago which was three times the size of the old one, there is a whole area of the emergency department being used for COVID patients, that will free up a certain amount, there are COVID patients in some of the wards so some beds have to be closed for infection prevention and control, part of the reason is COVID has stretched the resources in the hospitals and reduced the discharge options but it is not all of it, we still need more doctors and nurses, I know from talking to the emergency medical consultants that we do not have enough emergency medical doctors in UHL”.
