Chronic overcrowding and a series of tragic deaths of patients means University Hospital Limerick (UHL) is seldom out of the public eye.
It is in light of this that the announcement of two new hospital buildings – one an extension of UHL, the other a private facility – for the midwest region cannot be anything other than welcome.
A report on the untimely death of 16-year-old Aoife Johnston in December 2022 at the hospital highlighted, in particular, the 2009 decision to reconfigure hospitals in the region, leading to increased pressure on UHL.
This move saw the closure of emergency departments in Ennis, Nenagh and St John’s in Limerick city, and their replacement by minor injury units.
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That left the midwest – which has a population of just over 500,000 – with only one model four hospital. This is the biggest type of hospital that has a 24/7 emergency department, an intensive care unit (ICU) and speciality services.
By way of comparison, according to the 2022 Census the West and Northwest region has a population of more than 900,000. To cater for that demand, it has one model four hospital, four model three hospitals and two model two hospitals.
The Health Information and Quality Authority (Hiqa) reviewed health services in the midwest at the request of Government and, in a report published late last year, outlined three ways to increase capacity in the area.
On Tuesday, Minister for Health Jennifer Carroll MacNeill announced progress on one of those options – extending the UHL hospital campus to comprise the existing Dooradoyle site and another site – by acquiring a new site in Raheen, Co Limerick.
The 17.8-hectare site, which cost €14 million, is located around 2km away from the campus, and a 30-minute drive from Clare and Nenagh.
This comes in addition to the opening of the Bon Secours private hospital in Co Limerick on Monday, a €213 million investment and the first new acute hospital to open in Ireland in two decades.
But this does not solve all of the woes of the health services in the region.
Many steps have been taken in the past to alleviate pressure in this area. A new 96-bed block opened at UHL in October, which resulted in some improvements in overcrowding but not enough to appease patients and staff.
Planning was recently granted for a second block, expected to open in 2029, which will further alleviate these concerns.
Staffing levels at the hospital have grown by 56 per cent since December 2019, while the UHL budget increased from €265 million to €507 million between 2019 and 2024.
But a distinct concern with this health region is the fact deprivation in the midwest is more acute than in many other areas across Ireland. It also has an above-average number of older people.
There are clear links between these two issues and increased health needs as well as poorer health outcomes.
So while these announcements are positive, they are only steps in the right direction and not a solution in and of itself.
As the State infamously witnessed with the new national children’s hospital, construction takes time, though any taxpayer would hope lessons have been learned from the debacle that continues to rumble on many years after it was due for completion.
Furthermore, it is not yet known where the money for the development of the Raheen site will come from or how quickly it will be delivered.
It remains to be seen whether it will contain an emergency department, or whether the maternity hospital will also be relocated, with the Minister stating all options are on the table.
In accepting Hiqa’s recommendations for the regions, the Minister said she and her department will develop a “strategic plan for the incremental reconfiguration and expansion” for healthcare services in the area.
This is a longer term aspiration, and while things may improve with each step taken, it is likely to be some time before the crisis is completely resolved.
