Leaders' Questions

Chaith níos mó ná 12,000 duine de 75 bliain d’aois nó níos mó breis agus 24 uair an chloig i rannóga éigeandála inár n-ospidéil. Is iad seo ár dtuismitheoirí agus seantuismitheoirí, agus is daoine iad atá tinn, scanraithe agus traochta. Cá bhfuil an dínit? Cá bhfuil an meas? Níl sé seo ceart ar chor ar bith. Tá sé cruálach. Tá srianta earcaíochta ag cur cosc ar choinní riachtanacha agus ag cur othair i mbaol, fad is atá altraí traenáilte ag fanacht ar thairiscintí fostaíochta buana. Cad sa diabhal atá ar siúl? Is faoin Aire Sláinte atá an fhreagracht fáil réidh leis na bacanna, baill foirne a earcú agus othair a chosaint. Some 12,106 people aged 75 years and over spent more than 24 hours in emergency departments in the first half of this year. That is an increase of almost 21%. These are already sick people. They are our parents and grandparents. They are left waiting through the day, into the night and into the day again. They are exhausted, frightened and in pain. These are people who have worked hard all their lives. They have raised their families. They are the people who built this country, and it is shameful that an elderly person has to go through this. When you are ill at that age, spending more than 24 hours in an accident and emergency unit is an ordeal. Where is the dignity? Where is the compassion? Does the Minister know what this is? It is cruelty. It is absolutely cruel what is happening to our elderly people. Older patients accounted for over 81% of the national increase in waits exceeding 24 hours. Almost two thirds of patients aged 75 years and over spent more than six hours in our emergency departments across the State, and according to the Irish Nurses and Midwives Organisation, INMO, last month was the worst September on record for hospital overcrowding. Hospital managers are now telling us very clearly that recruitment restrictions are preventing them from filling essential posts, and this is putting patients' safety at risk. In the mid-west alone, there are 350 vacant posts. Management is reporting that it has been unable to recruit since last June because of the HSE's employment restrictions. The people who are responsible for safe services are warning of daily risks while being denied the authority to recruit. What we are seeing now is unprecedented. Senior managers speaking out in the way they are speaking out is unprecedented, and they are doing so because they are telling us that they have no other choice. They are very worried. These are priority posts that hospitals have been asked to identify. They have identified them, and they are still not being allowed to fill them. What in God's name is going on? Back in April 2024, the Minister's predecessor and the HSE appointed a support team to tackle overcrowding in the mid-west. Two and half years on, the occupancy rate there is 122%. Managers are telling us that the situation is going to get worse, and are warning that planned procedures will inevitably be cancelled if this continues. That means more patients left in pain. It means more families getting the call to tell them that the operation they have been waiting months for is cancelled. The Minister's winter plan depends on seven-day services, extended diagnostics and safe staffing, but who is going to deliver that if hospitals cannot recruit? Newly qualified nurses and midwives cannot get permanent positions, yet hospitals have vacancies.

Hear, hear.

Is the Minister going to immediately fund and empower health regions to fill urgent posts, clinically prioritise vacancies and remove the barriers blocking recruitment? Will she ensure that permanent offers are issued to newly qualified nurses and midwives where the vacancies exist? What additional staffed hospital beds and rehabilitation places will she open? These are our parents and grandparents. They deserve dignity and safe care. They also deserve answers from the Minister about what she plans to do today to make their care safe.

Hear, hear.

I thank Deputy Doherty. It is an absolute priority for everybody in this House that we do not have people waiting on hospital trolleys. It is a key marker of patient safety, but it is also a key marker of dignity and how we treat our people. It has been an imperative for me the entire time that I have been Minister for Health. When I started, we had 617 people on hospital trolleys. This morning there are 340. Our safe threshold is 280. There are so many different hospitals that have improved and sustained that improvement. I will speak about Drogheda in particular. It was a particular flashpoint. Everyone is aware of how difficult it was in and around Christmas 2024 and January 2025. There was a particular problem with ambulances queueing up to try to get into Drogheda hospital. There are no patients on trolleys in Drogheda this morning, and they have sustained that improvement throughout the past 18 months. They have seriously improved. Similarly, Cavan was a hotspot for hospital trolleys over weekends and on Monday mornings. Again, it has improved and sustained that improvement. It is a credit to them, and everybody working there, that they have employed different processes. Demand has increased everywhere. Demand has increased in Beaumont Hospital, but they do not have an unsafe situation in relation to trolleys this morning. Demand has increased across the board. It has increased in Limerick and Cork. The Deputy is right. He has identified two hospitals where have been particular calls. However, may I point out a couple of things in relation to those hospitals? When I started, there were on average 90 to 100 people on trolleys in Limerick every day. There are now 36. Again, that is 36 too many, but there are 17 spaces available in the virtual ward. They are figures from this morning. There are 17 spaces in the virtual ward. Dr. Colm Henry and the senior clinical team visited Limerick hospital during the summer to test all of the safety parameters. While healthcare is always a risk, and we will never say that every day is safe, Limerick has the safe staffing framework in place. It is safe staffed. It will require, as every hospital will, more staff next year. It has the second highest recruitment of any hospital in this country. Some 139 people were recruited into this hospital just this year. That is higher than James's, the Mater and Beaumont. Cork is another place where there has been an articulation of patient safety and recruitment challenges. Some 233 people have been recruited into the hospital. That is the highest by some distance of any hospital in this country, and yet there are 40 to 44 people on trolleys today and yesterday, but there were 11 beds vacant in the South Infirmary. There are 15 beds vacant in the South Infirmary today. We opened a new community nursing unit there just last week with 35 new spaces. We have increased spaces in Mallow hospital from 37 to 90, and I am pleased to say that all of those spaces are now used. We have increased capacity not just to the individual hospitals but to the areas around them that support them. A crucial part of what we are trying to do is local injury units to try to keep people who do not need to be in hospitals, such as category 4 and 5 patients and even category 3 patients, out of them in the first instance. The local injury units have played a big part in relation to that. Roscommon provides enormous support with 20,000 people attending there in a year. A new local injury unit is opening in Ballina to support Mayo. Indeed, in the Deputy's constituency, a new community nursing unit opened this winter will provide support to Letterkenny hospital, which has 35 delayed discharges of care. I take this so seriously, as the Deputy does, and I thank him for raising it because it is important that we articulate this every day. I take it so seriously because when I go into a hospital emergency room, whether I go in on a scheduled or an unscheduled basis, which I often do, every person waiting there has their dignity. Every person there is important to all of us. Every person there is our family. It is because of patient safety and dignity that we have this focus on urgent and emergency care. It is so very important. This morning, I joined the trolley call at 11 a.m. to check in and see how things were going but crucially, what the preparations were for this weekend. In Galway when we started this week, there were 64 patients on trolleys. Today, there are only 14. Why do things change and why is it not consistent? It requires whole region integration and the full seven day focus on making sure patients are not left on trolleys.

I listened to the Minister's response. While listening to her, I was trying to think about me as the son or daughter of one of those elderly patients - one of the 12,106 people over the age of 75 who have their dignity stripped away from them because of what is happening. They are forced to wait in accident and emergency departments for over 24 hours while sick, worried and concerned. What the Minister has said today gives no reassurance to them. The situation has got worse under the Minister's leadership. There are 2,000 more people at this point in time who are waiting over 24 hours who are elderly than there were this time last year. The Minister talks about Limerick. The trolley count in Limerick is likely to exceed in October this year the figure it stood at last year. They are the realities. I am not talking about one individual hospital. I am talking about the facts right across the network. We have a serious, serious problem. Will the Minister lift the recruitment embargo and remove the restrictions that are there?

Hospitals that were asked to do so have identified priority posts and they are not being allowed to fill them. In my time in politics, we have never seen senior management-----

-----sit down with politicians and say I have to speak out because I am worried about the safety of my patients.

I ask the Deputy-----

What I hear from the Minister-----

-----is that everything is okay and it is far from it, I am sorry to tell the Minister.

Time is up.

Sit down.

Do not wave your finger at me when I am speaking on behalf of patients.

Sit down.

I am speaking on behalf of people in my constituency who are worried and I will take no lectures from people on the Government side telling me to sit down. The Leas-Cheann Comhairle will do his job and only the Leas-Cheann Comhairle.

Then listen to him.

It is disgraceful when I am raising a very serious matter and the Minister knows that, in fairness to her.

Well, let us take the facts seriously. The reality is that demand has increased in every area and every hospital. I look at it on a whole of hospital basis every single day. I look at it every single day so you tell me why Beaumont is different to Cork. Both of them have recruited. Both of them have the same demand pressures. Both have needs for the future into 2027, which is what this budget has delivered but Beaumont has nine people on trolleys whereas Cork has 44. They are using things differently. Tell me why St. James's, one of the biggest, busiest hospitals in this country in an area of particular socioeconomic disadvantage only has ten people on trolleys, notwithstanding the pressures it faces, but Cork has 44? Why does St. Vincent's, in such a strong area, consistently have 49 people on trolleys? The reality is that many hospitals have improved significantly over this year but there are about six or seven hospitals that have not. They are Cork, St. Vincent's in my own area and Limerick, which has improved enormously since I took over and there are only 36 on trolleys in comparison to 100.

That is not true.

That is 36 too many but the facts are here every single day. The reality is that there are some hospitals that have not improved that need to improve. Bizarrely, the ones that consistently do not improve, i.e. Cork, have had the highest recruitment. If there was a correlation between recruitment and performance I would agree with the Deputy but there is not.

Wow.