I thank Deputy Kelly for the opportunity to address the House on the discussion around the need for a new model 4 hospital in the mid-west region. I also thank him for his ongoing advocacy in relation to University Hospital Limerick. I have stood across the floor from him many times over the past five and half years discussing health matters, and he has been very consistent. I want to put that on the record. In May 2024, HIQA was requested to conduct a review of urgent and emergency care in the mid-west region, with the primary objective of ensuring safe, quality, acute care. As part of this review, HIQA was requested to consider the case for a second emergency department in the context of the population changes in the region and with the ongoing pressures at UHL. HIQA submitted its final report to the Minister, and it was published on 30 September this year. As the Deputy will appreciate, the reports and analysis supporting this review are extensive. There was substantial stakeholder engagement, regulatory inspections, a national policy review, data analysis review and international evidence reviews. The Minister and I acknowledge the substantial work undertaken by all those who both conducted and took part in this review, including the expert advisory group which included a wide representation of relevant experience. In summary, HIQA’s analysis found the inpatient bed capacity in the region needed to be increased to meet current and projected demand for patients requiring more complex or specialist healthcare. I acknowledge UHL is still the busiest hospital, with a 10% increase in attendance this year compared to the last year. I had a conversation with senior management this morning and they are on track to receive 100,000 attendees to the emergency department this year. Mitigation pieces are in place regarding senior clinician decision-making and de-escalation of the emergency department, with a good length of stay averaging at four and half days. Thankfully, mortality is static and currently in line with every other hospital. I recently visited the mid-west region to discuss mental health and I compliment the mental health teams. The CAMHS teams there have turned around the complete waiting list and are now operating much better. I also visited University Hospital Limerick and met with the regional executive officer, Sandra Broderick, and senior management. I visited the new 96-bed block and I am delighted to say it is open, which the Deputy has welcomed publicly. The second one will be up and running as soon as possible. However, this does not solve the short-term issues. This morning there are 32 people on trolleys in UHL - three in the emergency department and 29 moved to wards. This is similar to other areas. In Galway, there are 51, in Cork, there are 39, and in the Mater, there are 27. Certainly, every focus has been put in place to try to reduce that. Going back to the HIQA report, it presents three options, as the Deputy knows, with the expansion of capacity at UHL on the Dooradoyle site, which is option A; the extension of the UHL hospital campus to include a second site in close proximity, which is option B; and option C, which is the development of a model 3 hospital in HSE Mid West. The Minister has accepted the report and the advice from HIQA. Along with her officials, she is considering the comprehensive and detailed reports and advice provided by HIQA and will report back to Government before the end of the year. The ESRI has projected the number of inpatient beds to meet the projected 2040 demand will need to increase from between 299 and 593 beds compared with 2023 capacity levels.

Sentiment score: 0.19

I thank the Deputy for that. The Minister will update her Cabinet colleagues before Christmas on her considered response. I acknowledge the fact the Deputy appreciates there is work going on to increase capacity and additional funding has been provided. UHL's budget has increased from €265 million in 2019 to €507 million in 2024. I will also touch on the two rapid build 16-bed units opened in December 2024 and June 2025, respectively, and the 96-bed block that was opened in October 2025, which the Deputy spoke about, to provide an additional 128 beds in the region, since the ESRI assessment of capacity in 2023. This has already helped reduce the number of people waiting on trolleys, notwithstanding the pressures all hospitals are currently facing due to the increased presentations by people sick with the flu. A second new 96-bed block is in progress at UHL and a third 16-bed block is planned for 2026. Bed capacity has been further expanded throughout the region, through the acute hospital inpatient bed capacity expansion plan, including 24 new beds at Nenagh Hospital, 48 new beds at Ennis Hospital and 42 new beds at St. John's Hospital. It is expected that there will be at least an additional 420 beds in the region by 2031. Other initiatives for the region include the acute virtual ward for 25 patients, which went live in UHL in July 2024. I will also touch on the staff, especially those working in the emergency department with the constantly increasing presentations every day. They are the front line and do a phenomenal job. However, I take on board every word the Deputy said. I know people are waiting in anticipation for the Minister's response. She has said she will bring it to the Cabinet before Christmas and I will speak to her after this debate to let her know about the Deputy's strength of feeling. Everyone accepts and acknowledges that there is not enough capacity of acute hospital beds in the region at the moment. I thank the Deputy again for his advocacy.

Sentiment score: 0.06