ESTABLISHING A SURGICAL HUB in Ennis can play a part in reducing waiting times and the trolley crisis in the Mid-West, a Clare TD has argued.

Last month, reported crowds of 11,000 attended a demonstration in Limerick organised by the Mid-West Hospital Campaign. It follows continued frustration with the standard of healthcare in the region and that the Mid-West is only served by one emergency department.

Clare TD, Joe Carey (FG) said Oireachtas members have had โ€œvery constructive, robust engagementโ€ with both the Minister for Health, Stephen Donnelly (FF) and the Taoiseach, Leo Varadkar (FG) on the matter since the protest.

In December, it was reported that Minister Donnelly was to bring a โ‚ฌ100 million plan to Cabinet for five surgical hubs designed to slash waiting lists for day procedures by providing more operating theatres. They are based on the Reeves Centre in Tallaght University Hospital, which saw a retail unit separate to the hospital converted into a hub for day surgeries. This is understood to have reduced waiting lists for certain procedures by 90 per cent. The hubs are to be built in addition to three major elective care centres which are being planned for Dublin, Cork and Galway, which will take longer to deliver and must be administered through the public spending code. The hubs will focus on high volume surgeries like urology, vascular surgery, orthopaedics, gynaecology and ophthalmology.

Deputy Carey is adamant Ennis could be one of the five hubs. โ€œWe could do the very same in Ennis, youโ€™d be giving an enhanced role to Ennis. I think we also need to extend the hours for the medical assessment unit, we need to upgrade it in the physical terms to make it bigger and more comfortable for patients, the minor injuries unit has been upgraded in a โ‚ฌ2m investment, we could also increase the hours there and get more people in. I welcome the new protocol for ambulances where the paramedic in conjunction with the MAU in Ennis can receive people who they feel can be dealt with adequately in Ennisโ€.

Referring to the major internal incident declared by University Hospital Limerick (UHL) management on January 2nd, Deputy Carey said, โ€œto see all these people discharged from hospital that it could suddenly be done, the chaos with the people on trolleys reduced dramatically, the numbers are far too high, a lot of work needs to be done, fundamentally there is an issue about capacity in Limerick and ironically the sod was turned on a 96 bed unit last October, granted it will only provide 48 additional beds. During the course of the meeting, the Taoiseach and the Minister for Health said there was two other proposals for two 96 bed units, they committed to trying fast-track those developments through the systemโ€.

Itโ€™s now seven years since the first 96 bed unit was mooted. Deputy Carey lamented the amount of time it took to get it to the construction stage. โ€œAll these developments we need to cut the planning process, move ahead and get the units built. I think there should be an enhanced role for Ennis, Nenagh and St Johnโ€™s, this whole issue gives us an opportunity to do that. I met a group of nurses from Ennis who explained the potential that is there to capitalise on the surgical theatres, it is not busy enough at the moment and we can ramp that up, there is a proposal to provide a surgical hub in the Mid-West. Limerick is mentioned but I donโ€™t believe there is any reason why Ennis couldnโ€™t be considered for that, โ‚ฌ10m has been earmarked for two new surgical theatres in Ennis, there will be money committed to thatโ€.

He felt โ€œone of the major issuesโ€ impacting UHL was โ€œthat 50 percent of the people are self-referrals, they walk in themselves, I met with consultants over Christmasโ€. To counteract this, Carey has said persons presenting should be met by a doctor and then assessed initially. โ€œA decision is made with regards to the care and whether they should be admitted or not. It is too congested, the emergency department was built for 190 people but weโ€™ve something like 140 people at its height presenting, it is really not good enough and the capacity promised in reconfiguration in 2009 hasnโ€™t materialised. There are proposals, construction is underway for the first 96 bed unit, we also need to see those other 192 beds fast-tracked through the development stages and construction started as soon as possibleโ€.

Speaking to The Clare Echo, Deputy Carey didnโ€™t believe the absence of strong voices from the Mid-West at Cabinet has been a factor in the slow progress of developments like the 96 bed block. โ€œIt is the way the thing is set up in terms of development stages that the HSE have in place, to bring it through every phase for capital development works is archaic and takes far too long. Some genius objected to the development of the 60 bed modular unit and it held it up for a year, who would object to the provision of those much needed beds. It has to be said, there has been serious investment in Limerick, you have a new critical care block, a new A&E, ED facility, 100 additional beds

โ€œIf you can get into the system it is great, there is wonderful cardiac care in Limerick, top class cancer care but where we are falling down really badly is through our emergency department and getting people into the system. I strongly believe there is a need for greater enhanced roles and investment in Ennis, Nenagh and St Johnโ€™s to take the pressure off of Limerick and to maximise the assets that they are, the skills of the people and give them enough work so that we could maybe establish the surgical hub in Ennis for the region and get those people to work in reducing the waiting periods for elective procedures. If you put those procedures off ultimately people will get sick and present at the emergency department, if you are cancelling those procedures, you are inviting more trouble on you, if you established the surgical hub in Ennis you will get the enhanced role, you will get more people through and move away the activity from Limerick, it would be a positive development for Ennisโ€.

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