Minister for Health Stephen Donnelly has told an Oireachtas committee he believes that the reconfiguration of hospital services in the mid-west region in 2009 was not done properly at the time and the resources that are being put in there now should have happened then.
The minister was addressing an Oireachtas petitions committee on a petition put to it by the Mid West Hospital campaign group about re-opening emergency department's (EDs) at Ennis, Nenagh and St John's hospitals, all of which were closed as part of that reorganisation of services 15 years ago.
Committee Chair, Martin Browne TD, said: "The Mid-west Hospital Campaign Group is seeking the reopening of the emergency departments at Ennis, Nenagh and St John's hospitals, which were closed in 2009 and replaced with minor injuries clinics as part of a reorganisation of the emergency services centred at University Hospital Limerick.
"The petitioners believe the loss of the EDs at Ennis, Nenagh and St John’s has significantly increased pressure on the ED at UHL which is overcrowded on a daily basis as it treats patients from across Clare, north Tipperary and Co Limerick, as well Limerick city.
"The campaign group is seeking the reopening of the closed EDs and the development of level three trauma facilities as a part of an expansion of emergency hospital services in the mid-west."
Minister Donnelly recently ordered a review of urgent and emergency care in the mid-west region and tasked the Health Information and Quality Authority (HIQA) with inquiring into whether a second emergency department would be appropriate.
He said the clinical advise backed up by clinicians and by HIQA at the time was that emergency services at these hospital were withdrawn because they were unsafe and that patient safety was compromised.
His recent announcement was prompted, he said, by a rise of 40% in trolley figures at UHL in the first four months of this year.
He told the committee there had been considerable investment at UHL over the lifetime of this government in terms of extra medical staff and bed capacity - up to 300 beds will have been provided by early next year, bed capacity which he accepted should have happened at the time of reconfiguration.
The HSE’s Chief Clinical Officer Dr Colm Henry said the addition of a second emergency department in the region cannot be considered in isolation from the myriad of other specialist teams and services that must accompany it, such as an intensive care unit, critical care beds, diagnostics, anaesthesiology, CAT scans and laboratory services.
He stressed it cannot be considered outside a model three hospital and there is a considerable gap between the level of expert services required and the current services at the model two hospitals in Ennis, Nenagh and St John's.
Róisín Shortall TD pointed out that UHL was an "outlier" in that it was the only hospital group in the country with only one model four hospital and no back up model three hospital.
She said all other hospital groups had two model fours and sometimes three model threes.
Ms Shortall said it was "blindingly obvious" that an error was made in reconfiguring services in the region and that people are paying a high price since and that there had been resistance at Government level to address the shortfall ever since.
She challenged the minister on the level of investment when she said UHL had begun at a very low base and that it was still behind other hospitals in the number of consultants employed there.
Minister Donnelly said the terms of reference for the HIQA review will be tabled once Justice Frank Clarke’s report into the tragic death of Clare teenager Aoife Johnston is completed.
But he said even if HIQA do recommend a second emergency department for the region it will take several years before it’s a reality and his focus was on improving conditions for patients in the UHL emergency department today and that was being addressed by investment in capacity and reforms in how UHL is managed.
He also confirmed to Tipperary TD Michael Lowry that the decision to use a new community nursing facility at Nenagh as a step down facility to relieve congestion at UHL will not be overturned or reviewed.
The minister said he knows there is disappointment by patients from St Conlon's nursing home who were due to move there, but he had to use whatever extra bed capacity there was to reduce risks to patient safety.
