Is Hiqa's UHL review another overcrowding report to be left on a shelf until the next tragedy?

The long-awaited review of what needs to change for patients in Limerick was never going to please everyone, writes Niamh Griffin

Some of the patient overcrowding scenes at the Emergency Department and surrounding corridors at University Hospital Limerick on Monday. On Tuesday, 133 patients could not get a bed at UHL. Picture: David Raleigh

The Health Information and Quality Authority's (Hiqa) long-awaited review of what needs to change for patients in Limerick was never going to please everyone.

Given the headache that the overcrowding has caused, though, it has been greeted with relief by many who have been involved in the campaign to improve services. It could certainly cause a financial headache for the health minister.

The “core problem”, Hiqa said, is a lack of beds across Limerick, Clare and north Tipperary. That is not news to the nurses and doctors trying to shoehorn patients into University Hospital Limerick every day.

On Tuesday, 133 patients could not get a bed at UHL, the busiest by far of all the hospitals assessed by the Irish Nurses and Midwives Organisation. 

Solutions?

Campaigners had called for a single clear solution — build a new hospital with an emergency department.

This would give the area two EDs and, if it was built somewhere like Nenagh or Ennis, it would take a lot of people off the road to Dooradoyle in Limerick.

Hiqa offered this as one option without naming potential sites. It warned of a “long lead-in time”, making a not-so-mysterious reference to previous experiences of building public hospitals in Ireland.

It was more explicit cautioning about the budget, reminding that the high cost of the new children’s hospital has to be taken into account in any plans.

It is perhaps worth noting that the Bon Secours hospital group just opened a hospital in Limerick, having started construction two and a half years ago. Perhaps a public-private partnership could be considered instead of the approach taken to the children’s hospital?

Hiqa also advised expanding capacity at UHL in Dooradoyle. If this is the only solution accepted by Government, it is unlikely to make it popular.

The health watchdog pointed out a second 96-bed block — in addition to one due to open shortly — has already hit planning delays. Even both together will not be enough, the report adds, based on new ESRI data.

Is there even physical space in Dooradoyle for more expansion? Cork University Hospital is trying to answer a similar question with construction soaring upwards from existing buildings in some cases. Is that what Hiqa has in mind?

Some of the patient overcrowding scenes at the Emergency Department and surrounding corridors at University Hospital Limerick on Monday. Picture: David Raleigh

The middle option offered is to expand UHL and build a support hospital without an emergency department. You could say an elective hospital.

Cork, Galway and Waterford are already set to get elective hospitals. It is expected that the planning stages will only be complete by 2030.

So this Option B from Hiqa begs the question — why was the Midwest not simply included in those Government plans from the start?

What's your view on this issue?

You can tell us here

Sinn Féin and Labour have already suggested all three options are needed.

Marie McMahon from the Midwest Hospital Campaign points out that this review followed years of campaigning, pain and even tragedies at the hospital. She described the findings as a relief.

All eyes are now on Jennifer Carroll MacNeill. Will she listen to Hiqa or will this be another report about overcrowding left on a shelf until the next tragedy?