Minister for Health Jennifer Carroll MacNeill has renewed her focus on what she called "better weekend systems" across emergency departments nationally.
The minister was speaking at University Hospital Limerick, where a 96-bed block is nearing completion as part of an overall investment in infrastructure for the HSE Mid-West region.
However, there are renewed calls for a second acute hospital in the region to provide for an ageing cohort.
The minister was on site to see the expansion of UHL first-hand, with the new unit due to open in September.
But the hospital has the worst overcrowding record in the country and there are ongoing calls for a second emergency department in the region.
The minister says she will await the final report on the matter from HIQA in May.
For now, she wants to focus on better weekend working systems in the existing emergency department and those across the country.
"If you think of [an emergency department] a bit like an airport with people arriving, they arrive all the time. Many people will be discharged from an emergency department. About 75% of people who come to an ED will be seen. And you know, they don't need to be admitted to hospital," the minister said.
"About 25% do. So, what we really need is a place for those 25% to go. We need additional beds for them, rather than them being stuck in the emergency department."
Achieving better workflow
The minister said there were two ways of achieving a better workflow.
"One, you have to have a flow of patients through the hospital naturally, so people have to be discharged, and where we've seen that they've not been discharged at weekends, where they're able to be discharged and they're staying in the hospital that causes a backlog, or where there aren't enough beds for them to be able to move, that too can cause a backlog.
"Here we are focusing on two things, as we are nationally, focusing on the processes to make sure that people are working at weekends, and that means that we're able to get people admitted and discharged. People can be admitted correctly, not too many admittances, and also enough discharges at the weekend to keep that patient flow."
The minister said she recognised that UHL has a need for significant additional capacity and that is why the first bed block is coming on stream in September and building will start on a second 96-bed facility straight away.
Despite the investment in infrastructure and bed capacity, hospital campaigners say all the data points to the need for a second acute hospital in the region.
Investment 'not going to solve population problem'
Angela Coll is Chairperson of Friends of Ennis Hospital.
"We welcome any investment and extra beds but it's not going to solve the problem of a population that's growing to half a million in the next five years and an ageing population who get sick and need to have access to an acute hospital that's not heaving with patients," said Ms Coll.
"We have looked at the data and presented it to Minister Carroll MacNeill. I'd be hopeful she'd appreciate the figures we've compiled.
"Also, we look forward to the final report from HIQA in May to hear what they are saying about a second acute hospital with an emergency department and the provision of critical services like radiography, surgery, intensive care and so forth."
Ennis and Nenagh reconfiguration criticism
Chief Executive of the HSE Bernard Gloster addressed criticism of the reconfiguration of Ennis and Nenagh hospitals in 2009 which saw 24-hour care services cancelled.
"I think the big thing that didn't happen back in 2009 was the investment in infrastructure and bed capacity, broadly in the region, and that is the huge gap that has taken a really long time to get on top since 2020," he said.
Mr Gloster said over the past four years, staffing has grown by over 1,000 in acute care at UHL.
"It's only in the last three to four years that you can start to see significant signs of the type of investment you might have expected to see back in 2009, but we all know what the economic straits of the time were. I hear every day about the pause that we had to introduce in 2023 nationally, and the new ‘pay and number’ strategy from last year.
"And still, this hospital, and every hospital in the country, has grown its staffing right throughout that period. The investment in additional staff, the new 96-bed block here at UHL this year illustrates the infrastructure and the staffing combined. And yes, everybody accepts we should have had them earlier, but we now have them, and I think we must build on that."
Meanwhile, the HSE has held meetings with representatives from the healthcare unions in a bid to avert industrial action over "pay and numbers" due to take place at the end of this month.
A meeting is scheduled for early next week to resolve the contentious issues which unions say are impacting patient safety and working conditions.
