Other Members’ Questions

This is a question for the Taoiseach or the Minister for Health. I attended a briefing on Monday delivered by the HSE mid-west management team. The briefing outlined the challenges facing University Hospital Limerick, UHL, this winter, the progress made and the support required to ensure patient safety. The message was forthright, clear and disturbing. However, it is important to acknowledge that progress has been achieved. There have been a 10% increase in emergency department attendances and 2,000 additional admissions to UHL compared with the same period last year. Department of Health figures also show that UHL's overall activity and output has increased by 36% in recent years. With the encouragement of the Minister, Deputy Carroll MacNeill, governance and oversight have improved, with stronger executive accountability and enhanced clinical management structures. Output and delivery across care services have increased and improved. This reflects the commitment and professionalism of staff and management. However, I want to be equally clear about the stark reality facing us this winter. Improved performance cannot compensate for inadequate hospital capacity and a specialist workforce that remains below what is required to meet demand. Demand has escalated sharply. Emergency department attendance records have again broken records. There is an extraordinary level of demand on a hospital under sustained pressure and in crisis. The regional executive has identified measures required this winter and sought the funding and support to implement them. Given the exceptional circumstances facing the mid-west region, I ask that this funding and support be made available. The response must match the urgency of the situation. We were also briefed that to provide resilience within the hospital system over the winter, day surgery and scheduled care at Nenagh, Ennis and Croom hospitals will be severely curtailed. Currently, management’s only solution is to reallocate existing resources at the expense of selected services. The availability of consulting staff is a critical issue. The mid-west has 80 fewer consultants compared with the average across other regions. I welcome the establishment of the Mid West Health Planning Board and the acknowledgement that the region’s healthcare capacity deficit has to be addressed. However, we need to be clear about what the board has been tasked with delivering. A regional healthcare map is not the same as a specific mandate to plan a new hospital. Following HIQA’s review and its recommendations, the people of north Tipperary and the mid-west are entitled to clarity about the intended outcome. Are we going to get a model 4 hospital on the new site at Raheen? Is the Government committed to delivering that hospital and the additional capacity and staffing to address the deficit identified by HIQA? Our health staff are doing extraordinary work and the progress achieved is tangible. However, staff cannot compensate for inadequate infrastructure and insufficient specialist staffing.

I thank the Deputy for raising a very serious and important issue, particularly for those in the mid-west in terms of health services at University Hospital Limerick. I commend all the staff and all who work at all hospitals in the mid-west, including UHL, on the work they do. It is true that UHL is one of the busiest emergency departments in the country, with presentations totalling 95,000-plus in 2025, which was the busiest year to date. Demand remains exceptionally high, with attendances increasing by 8.4% between January and September. A lot of good work has been done to deal with those increasing pressures. Parallel with that, the Government has prioritised investment in the mid-west, and the Deputy has acknowledged the progress. We recognise that more is required. The Deputy knows about the completion of the first 96-bed block and that the contract has been signed for a second 96-bed block. That is happening right now. There is also the delivery of two 16-bed rapid-build units. Innovative alternative care pathways are reducing pressure on UHL, including a 40-bed virtual ward, the phased opening of the Limerick surgical hub and over 53,000 attendances at injury units at St. John’s in Ennis and Nenagh Hospital during 2025. It is interesting. Funding for the hospitals has more than doubled from about €370 million in 2019 to €763 million in 2025. We then add to that the €317 million in capital investment between 2020 and 2025 so, by any yardstick, the increased investment has been very significant. Equally, there has been a significant expansion in the workforce. The number of staff at University Hospital Limerick has gone up by 46% since 2020, growing by thousands up to 4,568 now, with more doctors, nurses, midwives and so on. Therefore, both on the human resource side and the capital side, there have been significant investments. We had the HIQA review of safety and the design and delivery of urgent and emergency healthcare services in the mid-west, and we now have the board. That is important. A site has been bought. What is that saying? I think the board has had two meetings. What I would advise, and I think it is important, is that the integrity of the board needs to be maintained. If a board is established, that board should get on with its job in terms of its remit and a proper blueprint for the region into the future, based on the recommendations and the options in that HIQA report, which the Government has agreed with. I am not comfortable with details being articulated after two minutes. The board needs to get on with its work and have the capacity to do that.

We have been promised the new hospital, and it is essential that it happens. I want to ask the Taoiseach and the Minister about the winter surge and the package of support. Have we got a package and is the staffing ready? In the context of the winter surge, can the Department revisit the proposal to take control of the Raheen Lodge care unit in Mungret for the duration of the winter? This unit is operated by Bartra Healthcare and it is a state-of-the-art facility. It provides step-down and convalescent beds for 80 single-occupancy ensuite rooms. It is a brand-new facility. It is fully staffed but it is currently unoccupied. It is available to the HSE. Negotiations should start immediately to get this centre up and running within the HSE. I consider it to be a necessary and logical step to alleviate the pressure on UHL. The people of the mid-west need to know that regional service planning will proceed in parallel with the development of a new hospital at Raheen.

A winter plan has been developed with the region. I understand there was a recent conference in the royal college with all the regions to work through a winter plan to deal with the winter surge. On the procurement of additional beds, in order to develop a greater sense of efficiency and value for money for the State, a national tender competition was entered into recently, and a bespoke national panel arrangement has been established for the provision of short-stay therapeutic beds. My understanding is that the HSE has confirmed that the beds referred to by the Deputy are included in the new tender process. It is on the new panel of providers as a result of this tender. The allocation to the mid-west will, in the first instance, increase to 55 beds on a phased basis, with an opportunity to increase that again in early 2027 to support the region to deal with demand over the winter period. A national tendering process was entered into for procurement for these short-term therapeutic beds. That is probably a more structured way to deal with issues as opposed to-----