*Ennis Hospital. 

A DETAILED submission has been made to HIQA outlining the case for an additional emergency department for the Mid-West region and the upgrade of Ennis Hospital to model three status.

Friends of Ennis Hospital made the submission to HIQA’s review team who are tasked with establishing whether or not the Midwest Region needs another Emergency Department for the Region.

On Wednesday night, Friends of Ennis Hospital officially launched the document in the Doonbeg suite of Hotel Woodstock. All Clare’s Oireachtas members and twenty eight county councillors received invitations to attend.

“Since the decision to downgrade the hospitals in Ennis, Nenagh and St. Johns in 2009, University Hospital Limerick has been somewhat of a case study for why hospital reconfiguration fails when adequate resources are not put in place. Headline grabbing stories with tales of loss and tragedy have become the byline for UHL,” the submission outlined.

UHL’s trolley count has grown from 2,422 in 2009 to 21,445 in 2023. From January 1st 2023 to June 19th 2024, the trolley count was more than 100 patients on 120 days or 33 percent of the days recorded. This number peaked at 150 patients on trolleys on the February 7th 2024. On only eleven occasions did the number of patients on trolleys fall to 49 or below, the recommended capacity at UHL ED is 49 per HIQA’s 2022 report meaning that the emergency department is operating above capacity 97 percent of the time.

In addition, on 40 percent of the days recorded (148) Ennis hospital had patients on trolleys with the highest number being 16 on January 5th 2023. In 2022, according to HIQA UHL operated at 105 percent occupancy that year.

From 2009 to 2023, data obtained through the Regional Health Forum has confirmed that 239 people died on trolleys or chairs in the emergency department of UHL.

As part of their submission, Friends of Ennis Hospital argue, “The facts support us. We have the oldest population of any hospital region. We have social deprivation higher than the national average. We have a self-perceived health status below the national average. The proportion of persons with disability are higher than other hospital regions. Our population density is higher than other counties with multiple emergency hospital facilities. We call therefore on HIQA to recommend to the Minister for Health that immediate steps be taken to provide a model 3 hospital to the ULHG to support the staff in UHL and the patients in the Midwest region”.

They added, “Now that we have established beyond any doubt the need for a second ED in the Midwest Region, we must look at the options available. The options as things stand are as follows, An Upgrade of Ennis from Model 2 to Model 3, An Upgrade of Nenagh from Model 2 to Model 3, An Upgrade of St Johns Hospital Limerick from Model 2 to Model 3, A Greenfield site construction of a new Model 3 or 4 hospital. It is our contention, and hardly surprising given that we are the “Friends of Ennis Hospital” Campaign group that the fastest, most cost efficient, logical, and efficient way to provide a second ED in the Midwest region is by upgrading Ennis from Model 2 to Model 3 status”.

“Of the three counties in the UL Hospital Group Clare is the only one without an existing ED. Tipperary has Clonmel, Limerick has UHL, Clare are the odd ones out. Clare has now the population and age profile to more than justify the investment in a Model 3 facility. A Greenfield site would be extra cost and extra delays in the provision of emergency services. Nenagh which does not have the population to sustain a safe ED. St Johns which might have the population but is not a HSE owned facility. The mere idea that the HSE would make the required investment in a hospital which is a registered charity and who’s property is vested in Trustees and not in public ownership would be appalling and show a scant regard for lessons which should have been learnt from the not-too-distant past,” the submission stated.

The submission concluded, “In 2008 the Hanly Report recommended investment in Ennis as it was deemed to be ‘unsafe’. Instead, the Minister of the day chose to close the A&E. It is our contention that this was a grievous error at the time. The consistent overcrowding in Limerick shows this to be the case. Millions have been poured into Limerick and the problem persists. The population is growing the problem is growing, at what point do we recognise that the ‘reconfiguration’ of services in the Midwest Region was a failure. We feel the time is now”.

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