'Something has to change'

Calls have been made for an independent review of the Emergency Department at University Hospital Limerick after record levels of overcrowding were recorded last week.

On Tuesday the Irish Nurses and Midwives Organisation’s ‘Trolley Watch’ reported that 97 patients were waiting admission to a hospital bed at UHL, the highest number since November 16 last (95). The following day the INMO said there were 111 patients on trolleys, one fifth of the national total.

Willie Keane of Nenagh said his wife was among those awaiting admission at the Limerick ED last week. He experienced overcrowding at the old A&E at the hospital several years ago and regretted that little has changed in the time since.

“The new one is worse,” Mr Keane exclaimed, outlining how his wife had to sit in a chair in a corridor for six hours in sub-standard conditions, with only one toilet available to those present. “It’s a disgrace. We’re in a civilised society; how have we still not copped what to do about this?”

He called for public representatives to adopt a united front in trying to resolve the persistent overcrowding problem at the ED once and for all. “Something has to change,” he said. “All politicians need to come together and see that this is wrong. It’s not just one party standing up. Something powerful has to happen and it has to start now. They have to act as a unit. Stop this point-scoring and stop blaming… this is too serious to be playing political football with.”

Mr Keane was particularly saddened to see elderly patients with dementia being brought from nursing homes into the overcrowded situation at UHL. He said the department is clearly lacking doctors and nursing staff, but he added that once a patient is admitted into the hospital, the standard of care is “first class” and he praised all of the staff involved.

He backed the INMO’s call for the Health Information & Quality Authority to immediately investigate the overcrowding issue at the Limerick hospital, as did Nenagh councillor Séamies Morris. “The independent review should include a look at all options in the Mid West region including reopening 24-hour A&Es in Nenagh, Ennis, and St John’s,” Cllr Morris stated.

He also wanted PAMs (emergency response ambulances for psychiatric patients, first deployed in Sweden), which could treat patients with mental health episodes at their home.

“The decentralisation of A&E and ICU services to just one site at UHL has not and will not work, and I am asking for a full independent review of this policy, which has had horrific consequences for people in the Mid West,” Cllr Morris said. “I am calling on all Tipperary politicians for their support on this.”

The matter was raised in the Dáil on Wednesday afternoon, after which An Taoiseach Mícheál Martin said he would ask the HSE and Minister for Health to looking into commissioning an independent inquiry into the overcrowding at UHL.

Nenagh-based TD Alan Kelly said he was “very concerned with the situation in UHL at the moment. Despite all the great efforts of management and staff in there, the situation is simply not sustainable,” he said. “There has to be a greater role for Nenagh, Ennis and St John's into the future.

“In the longer term, there needs to be a site developed for elective surgery. The Government have announced plans to build elective-only hospitals across Ireland. The Mid West needs to be the top priority for such a hospital.”

NENAGH HOSPITAL

In a statement, the HSE encouraged the public to consider all care options available, including the Local Injury Unit at Nenagh hospital and those of Ennis and St John’s. It said that in the 24 hours to 8am last Wednesday, 251 people presented at the ED in Limerick. The average daily attendance at the ED since the start of the year was 226.

“On all weekdays this month, attendances at the department have exceeded 200, with the highest attendances, 265, recorded this Monday and on January 18. This is far in excess of the 195 average daily presentation figure in the last full year pre-pandemic (2019), and continues a trend experienced in the Mid West over a number of months.”

The statement added that there were 61 Covid-positive patients in the Limerick hospital that Wednesday, five of whom were receiving critical care.

“We apologise to patients who are experiencing long waits for an inpatient bed at UHL as a result of the significant demands on our service.”

The overcrowding numbers began to stabilise towards the end of the week, with the IMNO recording 50 people awaiting admission (24 in the ED and 26 elsewhere) at UHL on Friday.

At a media briefing earlier in the week, CEO of UL Hospitals Group Colette Cowan said it had not been possible to utilise the hospital’s recently-built 60-bed block as it was “in effect a Covid unit”. However, Ms Cowan anticipated that with the subsidence of the virus, the block could be used to flow more patients from the ED.

Plans are at tender stage to build another new block of 96 beds in single rooms. The tenders are to be reviewed in February and the €50 development will take around 18 months to complete.

Ms Cowan said there is also a plan to enhance community care and set up community investment hubs and alternative pathways for patients so that they do not have to go to the ED. She hoped to have further information about this plan at the next briefing.