Irish Examiner View:  Permanent crisis at Limerick hospital

Why is Hiqa bothering to continue with surprise visits when the level of results is uniformly and consistently unsatisfactory?

Patients on trolleys at the Emergency Department at University Hospital Limerick hospital.

Another week, and another set of damning statistics emerges for patient treatment at University Hospital Limerick (UHL).

A Hiqa report identifies one patient who waited on a trolley for 116 hours. A second took more than 85 hours, and the delay for a third was 71 hours. One patient who required an angiogram, a relatively straightforward process, waited for 45 hours. It should normally be carried out within six hours.

The figures emerged from an unannounced inspection on March 15 by three Hiqa officials. But the question to be asked is why Hiqa is bothering to continue with surprise visits when the level of results is uniformly and consistently
unsatisfactory and a horrible denial of patient dignity and confidentiality. It may as well have someone permanently in situ with voice recorder, computer, and stopwatch to ensure that the rate of progress, or otherwise, is properly recorded.

Last month we commented that the long shadow cast by the Covid pandemic upon health service provision pointed daily to systems which, if not yet totally broken, are seriously
ruptured. We were too generous in this conclusion. All the evidence from Limerick indicates that the systems are fully broken, whatever the best endeavours of staff locally.

UHL was provided with Government investment for a
modern emergency department in 2017, while at the same time the workload of previously functional emergency departments at Clare and Tipperary was redirected to the new facility. Patient overcrowding has increased. Over 100 new beds were opened in 2021, but most had to be allocated to Covid. Limerick is awaiting the construction of a new 98-bed unit in its grounds but capital projects with escalating costs, supply-chain problems, and skill shortages are a bed of nails.

The decision to close outlying departments before new
capacity was on stream appears to be an unmitigated disaster and one which is not amenable to any form of quick fix. 

Limerick provides the only emergency department in the region, and the Hiqa report states this caters for a population of 385,172 people.

The hospital has nine emergency medicine consultants, eight of them specialists. Despite having recruited almost 300 nurses last year, the inspectors found the hospital struggling to provide enough nurses to satisfy demand and meet safety and care standards.

Health Minister Stephen Donnelly sent a task force into Limerick in April to tackle the emerging crisis and the first rough drafts of what it is proposing should be available now. It is time to publish the action plan as it currently stands.

But we would be foolish to imagine that this is somehow solely a Limerick problem. Three days ago it was identified that 84,038 people are waiting for outpatient and inpatient treatment across Cork hospitals.

Irish Hospital Consultants’ Association president Alan Irvine said that public hospitals are unable to cope with acute demands and that at least 1.3m people across the Republic are on waiting lists for public health services.

The cost of living. Housing. Public health. While four horsemen are required for the apocalypse, three are more than enough to preoccupy our domestic politicians for now.