Minister for Health Stephen Donnelly is to order a review into urgent and emergency care capacity in the midwest region to determine whether a second emergency department is required.
The announcement comes amid a big increase in the population of the area in recent years and ongoing ED pressures at University Hospital Limerick (UHL).
Mr Donnelly said that smaller emergency departments in the region closed 15 years ago - based on clinical advice at the time.
The units - at Ennis, Nenagh and St John's hospitals - were closed in 2009 as part of a government decision to concentrate all emergency services at UHL.
The population has increased considerably since then, the minister said, and is older than it is in most other regions.
The review, to be conducted by the Health Information and Quality Authority, will consider additional capacity as well as future reforms.
Terms of reference will be finalised and published once the upcoming review by former chief justice, Mr Justice Frank Clarke, has been considered so that its findings and recommendations can be incorporated.
He is conducting a formal investigation into the death of 16-year-old Aoife Johnston at UHL.
Ms Johnson, from Shannon, Co Clare, died from meningitis on 19 December 2022.
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Mr Donnelly said that what has happened at UHL in recent months is "at odds" with other hospitals around the country.
Speaking on RTÉ's News at One, the minister said that additional staffing, beds and community capacity elsewhere have helped to reduce the numbers of patients on trolleys.
"By contrast in UHL, it's had the biggest level of investment and biggest increase in staff, in spite of heroic efforts by many of those staff, not only are the trolley numbers in UHL not falling [but] in the last few months, they’ve actually gone up very considerably on this time last year. I want an answer for the people in the midwest."
Mr Donnelly said that he agreed with a HIQA assessment that reforms are happening, but they have a long way to go.
"It's one of the ongoing engagements that I have with the senior leadership in the hospital," he added.
Huge pressure on members in UHL - INMO
The Irish Nurses and Midwives Organisation (INMO) said it welcomed the review of urgent and emergency care capacity in the midwest.
In a statement, INMO Assistant Director of Industrial Relations for the Midwest Region Mary Fogarty said: "A HIQA-led review into the emergency care options in the Midwest is very welcome.
"We look forward to engaging with HIQA and the Minister on the terms of reference.
"The issues that have dogged the emergency department in University Hospital Limerick have been well flagged by the Irish Nurses and Midwives Organisation.
"So far this year, 8,798 patients have been admitted to University Hospital Limerick to be treated on a trolley, chair or in another inappropriate bed space.
"There is huge pressure on our members working in University Hospital Limerick due to capacity issues and staffing deficits coupled with changes in demographics in the Midwest region.
"Any review into providing additional urgent care capacity will be welcomed by the INMO and we want to have input into the drafting of the terms of reference.
"It is clear that at this point we will need a Model 3 hospital in the Midwest," Ms Fogarty added.
Speaking on RTÉ's Drivetime, Marie McMahon of the Midwest Hospital Campaign group said that people are afraid to attend UHL, but they have no other choice as it is the only hospital with an emergency department in the region.
She said that UHL was not safe now and had never been.
Ms McMahon said that questions had to be answered about the role of HIQA this time around in terms of the review.
She said that before the Government had "ignored" points made by the campaign group up to this point, but Mr Donnelly acknowledged the problems today.
"While we welcome the news today, we're questioning whether or not it's another election ploy," she said.
