*Senator Martin Conway (FG). Photograph: Natasha Barton
MANAGEMENT of University Hospital Limerick (UHL) clashed with Clare Oireachtas members over ongoing overcrowding at the region’s main hospital.
On Wednesday morning, management of UL Hospitals Group appeared before the Joint Oireachtas Health Committee. Their appearance came on the back off a damning HIQA report published in June which detailed that a number of patients were waiting more than 70 hours plus in the emergency department for a bed and in one instance a patient was left on a trolley for 116 hours.
CEO of UL Hospitals Group, Colette Cowan issued an apology for the “distress and the lack of dignity and privacy” experienced by a high number of patients seeking treatment at UHL. She said it was not the kind of care environment they wished to provide.
A record 76,473 patients were in UHL’s experience department last year with a further increase in 2022. She flagged that their inpatient bed capacity of 530 fell “far short” of what was needed, 98 extra beds have been added since the pandemic with another 96 bed block to be built which includes 48 new beds and 48 replacement beds. Over 1,200 new staff have been recruited by UL Hospitals Group in 2021 with an additional 900 staff added to their books this year, she confirmed.
Prof Cowan was hopeful the publication of the HIQA report would be a “catalyst” for change within UHL. She said that UHL should have 642 inpatient beds, to manage the extra acute and emergency medical and surgical patients arising from the changes in Ennis, Nenagh and St John’s Hospitals.
Senator Martin Conway (FG) stated, “nobody wants to see the situation that has existed for years”. He questioned why management were not proactive in seeking help, “ye knew how bad the situation was on the ground” and why “did it take the Minister to send an expert group to look at flows resulting in incremental improvements we’re seeing, was it not of concern for ye to reach out and look for help”. He described UHL as the “eye in the eye of a storm”.
Consultant cover was queried by Senator Conway with Chief Clinical Director, Professor Brian Lenehan explaining that UHL has “historically had a low amount” of non-consultant doctors, “we’ve the busiest emergency department in the country with presentations, the Mater is the second busiest but it has 100% more non consultant doctors”.
Prof Lenehan when asked by the Ennistymon man if Ennis should become a tier three hospital, responded, “I don’t believe our existing model twos are in a position to be upgraded, there is a significant infrastructural and staffing requirement”.
Limerick TD, Maurice Quinlivan (SF) said the figures at UHL were “unacceptable” and were “going to be worse in October and November”.
Deputy Cathal Crowe (FF) pressed management on why HIQA were “incessantly pointing out UHL” and not other hospitals or hospital groups as being a risk. Prof Lenehan said this was due to “demand capacity, it’s arithmetic, it’s a higher demand than we are able to service, it is going to persist despite all efforts of everyone working on the ground”.
Meelick native Crowe said that whilst in UHL’s ED with a family member five weeks ago no privacy was evident for patients, he suggested staff have more regular check ups by giving patients tea and toast instead of leaving them “to wallow”. Prof Lenehan responded, “To deal with privacy and dignity is to not have trolleys, if we had attendances to match capacity and not have them boarded up, that issue wouldn’t exist”.
Criticism of management being located outside of the hospital was repeated by Deputy Crowe. “How can you have oversight of what happens when you’re based in office block 1km from where it’s happening, I was a school teacher before I was a TD, the principal was only a few doors down and in a Garda station the Superintendent is based there. There is no way you can have oversight when you’re based in an industrial estate, you cannot be based in an office block from where it’s happening, you surely have to be on site, HIQA report has identified that. Management have to come back to the hospital”.
Prof Cowan defended this working arrangement, “You’ve raised this before. We were on site in UHL when I first started 8 years ago, we moved out 4 years ago because clinical teams had no space to work out of, clinicians hadn’t space, that’s why we moved. I run six hospitals, we are on site all the time, we’re up and down three to four times a day, we hold meetings in the board room, staff know us by name. It is unfair to refer us to a principal, we are responsible for six hospitals. HIQA did not say CEO and management were off site”. Crowe responded, “But they found deficiencies. The captain of any ship should be on it and not working remotely”.
