MacNeill not ruling out additional hospital or reopening A&Es to ease overcrowding

David Raleigh

Jennifer Carroll MacNeill said on Monday that she had not ruled out sanctioning the construction of an additional hospital or reopening former accident and emergency departments to increase bed capacity in the mid-west region.

As the Minister for Health visited University Hospital Limerick (UHL) to launch the new €105 million, 96-bed block, the hospital was again the most overcrowded nationally.

There were 100 patients waiting on trolleys for beds, including 40 in the Emergency Department and 60 on wards, according to figures published by the Irish Nurses and Midwives Organisation, which has previously stated UHL overcrowding has reached dangerous levels.

Ms MacNeill told reporters that “all of the options are on the table”.

She said she had until “before Christmas” to decide which of the three options, as outlined in a HIQA report, were her preferred choice.

The health watchdog’s review of emergency healthcare in the mid-west recommended the construction of an additional hospital; extending the UHL site; and/or providing additional capacity off the UHL site.

The HIQA report said the “core issue is that there are not enough inpatient beds” in the region, and that “immediate action” was required to add capacity “to address current risks to patient safety in the shortest timeframe and safest way possible”.

Ms MacNeill said while she was “open to all three options that HIQA have identified”, her “priority” was to provide capacity in the short term.

Works have already begun on a second 96-bed block on the UHL site, with a third proposed.

The Minister said the current plan to add capacity at the UHL site will transition the region from having the “lowest per capita in-bed ratio” in 2020, to having “the second highest in the country” by 2028.

The 96 additional beds provided at UHL today was a “significant step towards addressing the bed capacity deficits in the mid west”, she said.

Ms MacNeill pledged to discuss with all stakeholders in the region, including patient groups, their ideas to build bed capacity, and added, “I’m thinking about twenty years ahead about what this region is going to need”.

The Mid West Regional Hospital Campaign Group, which includes families of loved ones who have died on trolleys at UHL during severe overcrowding conditions, has repeatedly called for the reopening of A&E departments in Ennis, Co Clare and Nenagh, North Tipperary, and St John’s Hospital, Limerick, which was closed in 2009 and reconfigured to UHL.

When asked if she was open to reopening the A&E units, as a means of relieving pressure on the overcrowded emergency department at UHL, she said the A&Es would require additional support services, but she repeated, “all of the options are on the table at the moment”.

Ms MacNeill added that several other measures have already been implemented to ease pressure on the Limerick ED, including placing more beds into Model 2 hospitals that provide step-down supports to the Model 4 UHL; increasing Medical Assessment Units; and providing virtual wards, “because we don’t want people coming to the emergency department unless they really need to”.

However, she acknowledged that a “twenty-year vision is not going to be enough” and additional capacity plan strategies would be required.

An estimated 400 staff are required for the 96-bed block that opened today. It’s understood that 300 staff were recruited and the remaining 100 staff were being provided by agency staff as well as a complement of staff already within the hospital.

When asked if the unit was fully staffed, HSE Chief Executive Bernard Gloster replied: “We’re not in the habit of opening facilities that are not safely and properly staffed.

“All of the beds are open, the unit is staffed. This unit would not be open if the beds were not properly staffed and the patients being able to be cared for.”