"I find myself more confused than ever"; Questions raised over HIQA review of Limerick hospital

MINISTER for Health, Jennifer Carroll MacNeill told the Dáil that 96 beds in University Hospital Limerick (UHL) will open by the end of next week and she will visit Limerick to formally open them later this month, while other beds are tangled in a planning appeal. 

Minister Carroll MacNeill was responding to questions in the Dáil on Tuesday afternoon, after the publication of a comprehensive HIQA review into urgent and emergency care in the Mid-West.

Speaking at Leinster House, she said:  “The most important thing is the inpatient acute bed deficit in Limerick hospital - that has to be our first priority.”

While these beds are to be delivered soon, the review states that another 96-bed block is currently being held up by an appeal with An Coimisiún Pleanála and it “likely won’t be operational until 2029 should it be approved.”

The Health Minister was responding to calls from Clare Fianna Fáil TD Cathal Crowe, for a Model 3 hospital to be located in County Clare. 

The review does state that “a determination would need to be made to establish if a Model 3 hospital could be commissioned at the site of an existing healthcare service in the Mid-West, or whether a new site and build is required.”

HIQA acknowledges that as part of the stakeholder engagement process in this review, Clare County Council pro-actively informed HIQA that it would be supportive of efforts to provide for an expanded or new hospital in Clare. It should be noted that HIQA did not actively seek such an assurance from other local authorities for development in their areas. 

Read more here.

The call for a hospital in Clare was re-iterated by Deputy Crowe in the Dáil.  

He said: “The evidence is there in abundance - of all counties of Ireland, of all regions, we are the most health disadvantaged in the country, we are geographically peripheral.

“For more than half our population, there is no golden hour, they live well beyond it,” and he concluded by saying that there are many sites that are accessible to all of the Mid-West within County Clare.

Mayor of Limerick, John Moran said that HIQA offering three options will inevitably lead to “more confusion, forcing more conversation and delaying action again.”

He asks the question of why a fourth option, that would be more ambitious, was not considered. 

“In terms of next steps, we can at least however dismiss option A, as I believe we will quickly run out of road again by 2030/2040 and be back with more capacity issues and no space in Dooradoyle to solve them. Is the answer a blend of option B and C?

“Two things however are clear to me from the report. We need more action and we need more land. I urge the Minister for Health, therefore, to give early funding approval to the HSE to buy that land. 

“I will push for that with the Minister when I see her in a week or two. Give us a green light and I will immediately put our planners together with officials from the HSE to come up with a single preferred option with excellent connectivity in the region.”

Mayor Moran added: “We cannot lose any more time or we will lose more lives.”

Fianna Fáil Senator Dee Ryan said there needs to be a short-term emergency plan.

"Whilst reflecting on and considering the long term advices in this report, I urge the Minister for Health to act quickly and put in place an emergency strategy to address the immediate short term need for more acute inpatient bed capacity at UHL."

In June, Senator Ryan called for the immediate development of a winter plan specifically for the emergency department at UHL citing continued overcrowding and record trolley numbers in the region.

She highlighted the need for immediate, targeted solutions for UHL this winter, saying the Mid-West region deserves equitable access to emergency care.

Labour TD Conor Sheehan said that the HIQA review doesn’t leave any room for complacency. 

“It is deeply worrying that it has taken a regulator’s intervention to make the Government face up to the reality of what patients and staff have been shouting about for years.

“Every person in Ireland has the right to safe and timely healthcare. Yet the reality at UHL is chronic overcrowding, repeated trolley crises, and an emergency department that simply cannot cope. 

“The strain on patients, families, and healthcare workers is intolerable, and it is getting worse, not better. 

“This report is a wake-up call that cannot be shelved or spun away. The Minister for Health must act now.”