Health campaigners in three counties are eagerly awaiting news on whether the midwest region requires a second hospital emergency department (ED) as the deadline approaches for a year-long review.
Over 1,100 public submissions have been made to the Health Information and Quality Authority (HIQA) as part of the process which was announced by the last government in light of population growth in the region - as well as ongoing pressures and controversy at University Hospital Limerick (UHL).
The review was announced by former minister for health Stephen Donnelly in May last year, just weeks after an inquest into the death of 16-year-old Aoife Johnston, from Shannon Co Clare.
The inquest was told she waited over 12 hours to be seen by a doctor and treated for sepsis when she attended the overcrowded ED at UHL in December 2022.
A subsequent report by the former chief justice Frank Clarke found her death was "almost certainly avoidable" and warned of the risk of a "reoccurrence" despite improvements at the hospital since 2022.
The HSE apologised for failing Aoife, which resulted in "the most catastrophic consequences for her and her family".
Aoife's parents have repeatedly called for a second ED for the midwest, telling RTÉ’s Drivetime recently that "Ennis would be the obvious choice" of location.
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16 years ago facilities there and in Nenagh, Co Tipperary, and St John’s Hospital in Limerick city were closed down as part of the reconfiguration of health services in the midwest in 2009, leaving just one ED at UHL to serve a population of over 450,000 people.
With HIQA tasked with delivering a final report by the end of May, campaigners in Clare are among those who made 1,100 public submissions into their review of emergency healthcare in the midwest.
Angela Coll led a delegation of the Friends of Ennis Hospital to a meeting where she told HIQA that it was not fair that the midwest was the only region in the country relying on one ED.
She called for a new hospital in Clare, as reopening the former A&E department at the model 2 Ennis General Hospital "would not be safe" without cardiac care, ICU, minor surgery and a high dependency Unit in the 1940s building.
Based on delays in the building of the National Children’s Hospital in Dublin, she also expressed hope that a new hospital could be built in Clare, "using modular building".
She added that her view was that Britain’s NHS would be able to do this in "under two years". "So I don't see why the HSE can't," she added.
The Friends of Ennis Hospital Group also outlined research citing how "24.7% of the patients who go through the ED in Limerick are from Clare", how the midwest has "the oldest population of any health region in the country", and how "UHL had the highest ED attendance of any emergency department in the country" in 2024 as evidence to support the need for a new hospital and ED.
Limerick mother Melanie Cleary is part of the midwest hospital campaign and she believes a "whole new hospital" is needed. However, she expects it is going to be in Limerick.
Her 21-year-old daughter Eve died from a blood clot hours after being discharged from UHL in July 2019.
The HSE subsequently expressed condolences and "deep regret" to her family in a court settlement made without admission of liability.
Melanie told RTÉ’s Drivetime that with "half a million people" in the midwest, it was "never going to work" closing three ED facilities, referring to the downgrading of hospitals in Tipperary, Clare and Limerick city 16 years ago.
"Everybody knew they made a mistake," she said, adding: "We're not expecting them to come out publicly and say this is a mistake, we just want to correct it now."
Asked about the new 95-bed block currently under construction to address capacity at the UHL site in Dooradoyle, Ms Cleary said that would not be sufficient though she expects building a new hospital in Limerick would take up to seven years.
In Tipperary, Tanya McMahon chairs a group called "Nenagh needs its A&E" and she said she and her family "avoid going to the ED in Limerick".
Instead, they try to go to Portlaoise, Portiuncula or Tullamore, preferring to "travel longer and go to hospital where I'm going to be seen" rather than "waiting on beds, on trolleys or chairs".
While she believes the former ED at Nenagh General Hospital could be reopened, Tanya said campaigners in north Tipperary are "desperately clinging on and hoping that when this HIQA review finally comes out" another ED will be rebuilt or reopened in the midwest.
"It doesn't matter where it is" she added, "as long as we get another emergency department" in Clare or Nenagh, because "something has to be done" to ease what she called a "healthcare crisis" in the midwest.
While Minister for Health Jennifer Carroll McNeill said previously that she expects HIQA to deliver its final report into emergency healthcare in the midwest in May, HIQA has not confirmed a date for publication.
It said in a statement that work on the report is progressing in line with the terms of reference for the review.
When completed, the final report will be issued to the Minister of Health and published thereafter.
