2025-12-09

Before I speak to this Topical Issue, I wish to commend Deputy Ó Muirí on raising a really important issue in the House. I fully agree with his sentiments, having been a youth worker for so long. I will be the first to stand here and critique, but on this issue I can attest to the improvements the previous couple of Governments have made in this regard. I know the app the Minister of State mentioned has a very place in her heart in terms of the impact it might have. I wish her continued success with the roll-out of that mental health app. When you live in Kildare you begin to plan for certain things at a very early stage. You try to get a crèche place for your child before they are born because they are often full. People try to enrol their children in local schools before they are born because the chances are they are full. People who are lucky enough to have a GP place need to give two weeks' notice to let the practice know they are going to be sick because capacity is a real issue. When it comes to Naas General Hospital, people pray to whoever it is that they pray to that they or their family will not have to darken the door of the hospital over the coming weeks and months. That is not because of the level of care provided, but the issue of capacity. The toll it takes on people's health outcomes is monumental. I hope it goes without saying that a critique of the hospital is no reflection on the majority of staff who conduct themselves with the utmost professionalism and dedication to their occupation as is humanly possible. Inpatients have told me how thankful they are for the care and medical expertise they experience from a beautifully diverse and wonderfully talented staff team in Naas General Hospital, but to get to that point people must often traverse an excessive wait in the emergency department. Some 255 people were cared for on trolleys in November this year and why I raise this with the Minister of State-----

How many?

There were 255. I raise this issue because it appears that this has become an acceptable norm in Naas General Hospital. Year after year, the same number of patients receiving care on trolleys. The numbers may fall or rise slightly, but it has become something of a predictable crisis. In the same way that young families have to plan early for basics like crèche and school places in Kildare, I ask the Minister of State, the HSE and hospital management team in Naas to plan better for this predictable crisis. Kildare has a population of 250,000 people. The county has experienced exponential growth in 30 years, more than doubling from the 1990s. In truth, we have been failed by successive Governments who rightly want housing delivered, but have utterly failed in their duty to deliver the necessary social infrastructure required in tandem with housing. This week the CEO of the HSE spoke on radio about emergency departments being about life threatening situations. I understand the point he was trying to make, but he also said if he was given 220 people being cared for on trolleys every day when he started in the role he would nearly have taken that. We cannot allow that to become the norm and that is what worries me. The 250 people in November 2025 in Naas were deemed suitable for care and admission and needed the level of care that only the hospital could provide, as did the 350 people in November 2024 and the 260 in November 2023. We do not have other options in Kildare. The out-of-hours services are not there to meet the capacity constraints in our county. I call on the Minister of State to raise this issue with the Minister for Health and ask for a meeting to be convened between the HSE, management and representatives in Kildare North and Kildare South to talk about the issues of fundamental importance when it comes to reducing the number from the mid 200s as much as we can over the next number of years.

I thank Deputy Farrelly for the manner in which he has raised the issue. While acknowledging the challenges in Naas General Hospital, he spoke about this issue being no reflection on the staff and that the level of care being provided is exceptional. I want to acknowledge his work in advocating for the people of Kildare. I did not realise 250,000 people live in Kildare. That is huge population growth. Naas General Hospital is a 202 inpatient and 18 day bed acute public hospital, providing healthcare to over 250,000 people in the growing catchment area of Kildare and west Wicklow. Naas General Hospital caters for patient activity through emergency, inpatient, outpatients and day services departments. The hospital is the sole provider of acute care in the integrated health area and serves a significantly larger population than many of its model 3 hospital counterparts. Naas General Hospital continues to experience sustained pressure across all service areas. From January to October 2025, emergency department attendances have risen by 9% compared to the same period in 2024. Emergency department attendances of patients aged 75 and over have also risen by 9% in this timeframe. The average length of stay for patients aged over 75 is more than twice that of patients aged under 75, compounding pressure on bed capacity and overall patient flow. I acknowledge the fact that the Deputy said 255 people were on trolleys through the month of November. The last thing any of us wants to see are people waiting on trolleys, especially elderly people and those aged over 75. We have invested hugely in home care, day care and meals on wheels to provide as much support as possible to support people in living well in their own communities, but there comes a time when people have to present to hospital and be looked after. The emergency department can be very difficult for an elderly person when it is extremely busy. I want to highlight some of the good work being carried out at Naas General Hospital during these challenging circumstances. From January to October 2025, the median waiting time for all emergency department patients was down 18% compared to the same period in 2024. I accept there is more to be done. The HSE capital plan sets out the planned health infrastructure investment within a given year. Capital investment plays a critical role in enabling and enhancing health service provision. Construction is underway to repurpose and refurbish existing HSE accommodation in St. Mary's at Naas General Hospital to provide short-term accommodation for enhanced community care, the integrated care programme for older people, ICPOP, and chronic disease management services. Naas General Hospital is currently at design feasibility stage for multiple projects, including the conversion of an existing operating theatre and ancillary rooms into two endoscopy procedure rooms, increasing the total number of rooms from one to three. Another project involves a 15-cubicle transition unit for patient admissions and discharges to alleviate emergency department admission pressure. In 2020, Naas General Hospital received a €74 million budget. In 2025, the budget allocation for the hospital rose to €130 million. This investment in recent years is fundamental to supporting the ongoing development of services and ensuring that Naas General Hospital will continue to play an invaluable role in the delivery of health services to the local community in the years ahead. Notwithstanding the almost doubling of the budget between 2020 and 2025, I take on board the points the Deputy has raised. I will be very happy to discuss them with the Minister for Health, Deputy Carroll MacNeill.

I thank the Minister of State for her considered response. It is really useful. I hope she can see I am not trying to play politics with this.

You are not.

It is an issue that has maintained over years and will continue, notwithstanding the matters of merit in the Minister of State's response in terms of capital works and an increased budget. The budgets are increasing in tandem with the population increase. I do not think that will address this meaningfully. I spoke with someone today who works in Naas General Hospital and their words are more important than mine. I will quote that person: The nursing staff are voting today via the INMO for work-to-rule. The management is adding services to an already understaffed hospital. No one is listening to the nurses on the ground, despite union meetings. Management wants to change hours without approval of the staff. There are 30 nursing vacancies at multiple levels that are unfilled and unadvertised. There is not enough staff to cover sick leave. They are using agency staff to run theatre lists and endoscopy lists are being filled without following [joint advisory group] JAG protocols. These are not my points. What matters at this point are the voices of those working on the ground. This has become an entirely predictable crisis. Irrespective of concerns over how the national treatment purchase fund, NTPF, is being used, the powerful words from someone working in the hospital are what we all need to hear. The majority of staff in Naas General Hospital will continue to work tirelessly, but they will work tirelessly in conditions that are simply unacceptable. I again thank the Minister of State for her time. I ask her to convey the importance of this to the Minister, and to consider convening a meeting of the stakeholders I mentioned to include the union representatives to make sure we hear the voices of staff, patients, ourselves and management so that we are not here this time next year talking about a predictable crisis.

I thank Deputy Farrelly for raising Naas General Hospital and the challenges we are seeing right across the country at the moment in terms of the surge in presentations, in particular older people, relating to flu. I heard Bernard Gloster, the chief executive of the HSE, say quite clearly on Sunday that if people are very unwell, they need to present to hospital. It is especially true for older people in relation to flu. I will also take this opportunity to encourage people to take the flu vaccine as well. That is really important because we are seeing a huge surge of presentations. I could talk about waiting list initiatives and that but that will not help the Deputy out at the moment. Under the 2025 plan, Naas General Hospital has completed works, including an 11-bed acute medical assessment unit and an emergency department admissions discharge lounge. They were some capital projects that have completed. I take on board what Deputy Farrelly is saying. With the size of the population in Kildare, the fact it is the only model three hospital in that area means there is a huge amount of demand. I will give the Deputy a commitment on the floor of the Dáil that I will speak to the Minister, Deputy Carroll MacNeill, to see what more supports can be provided for the hospital. I look forward to seeing the announcement in relation to where some of this national development plan health capital allocation of €1.56 billion for 2026 goes. I will certainly relay the Deputy's concerns to the Minister.