CO CLARE is to remain without an emergency department with HIQA not proposing to build a model three hospital in the county.
HIQA’s review into emergency services in the Mid-West region will not recommend the construction of a model three hospital in Co Clare while it is feared no new hospital will even be built in the region.
Last May, then Minister for Health, Stephen Donnelly (FF) requested that HIQA, conduct a review of urgent and emergency care in the Mid-West with the primary objective of ensuring safe quality acute care in the region. Terms of reference were published in August with the final report to be published this summer.
On Monday, the HSE held a briefing with elected representatives in the region, on the same day 98 of the 293 patients on trolleys nationwide were in University Hospital Limerick (UHL), over one third of the national average.
In March, a comprehensive submission was formally made to HIQA by the HSE Mid-West, overseen by Dr Terence Hennessy, Regional Clinical Lead for Strategy & Development. It followed an extensive regional consultation involving 25 structured focus groups across UHL, and engagement with around 350 stakeholders from every corner of the Mid-West health system. The groups had come to a consensus on the urgent need to shift away from fragmented and under-resourced models.
The submission proposes a more integrated and sustainable approach to Unscheduled Emergency Care (UEC) delivery, built around a fully functional acute floor and UEC capability at UHL, strengthening Model 2 hospitals like Ennis and Nenagh to maximise their role in Injury Units and Medical Assessment Units, and investing in community services to reduce avoidable hospital admissions and improve discharge flow.
Ireland South MEP, Michael McNamara (IND) said any plans recommending not to construct a new hospital in the region were “very difficult to reconcile with the persistent crisis in unscheduled emergency care at University Hospital Limerick (UHL)”. He rejected logic that a new hospital would be difficult to staff which prompt an expansion of UHL or the creation of a second linked site. “I don’t understand how it would be more difficult to attract staff to a newly built Model 3 hospital than to an already overstretched and under-resourced UHL, which has long had a reputation for more patients per bed and per staff member than any other hospital in Ireland. Staffing allocations are based on beds, not patients, and UHL’s patient load is uniquely high. That’s why it has such a difficult reputation and why it struggles to recruit”.
While acknowledging that the HSE made the recommendation in good faith, McNamara warned that the Mid-West has been misled before. “So too was the reconfiguration recommendation made in good faith – the one that consigned an entire generation in the Mid-West to a lower standard of healthcare than those living elsewhere in the Republic. Fool me once, shame on you. Fool me twice… In the Mid-West, we bought a pup with reconfiguration. We shouldn’t make the same mistake again.”
“We can’t keep treating UHL like it can absorb the entire region without serious structural reform,” McNamara said. “This is no longer about local management. It’s about national planning, political will, and system-wide responsibility. If we want to future-proof emergency care, we need more than meetings. We need a system capable of acting on its own evidence,” Scariff native McNamara said.
Concern has been expressed by Friends of Ennis Hospital that the lack of Mid-West voices around the Cabinet table will hurt the cause for a new hospital in Clare. Chairperson of Friends of Ennis Hospital, Angela Coll flagged, “There are 36 emergency departments across the country only four of which are located west of the Shannon, serving over one million people. The other four million of our population have 32 EDs. Who knew, that when British Colonisers drove our population “To hell or to Connacht” in 1652, that almost 300 years later and 100 years on from our Independence as a nation, the population of the west of Ireland would be still looked on as the poor relations! FEH believe that the HIQA report whether it comes next week or next month will not make a specific recommendation as to the location of an additional emergency department in the Mid-West”.
Existing sites at Ennis, St John’s, Nenagh or UHL are not suitable for a new ED, she said. “We need a hospital in Clare for Clare. While there are rumblings amongst some people including certain politicians about Coonagh being the favoured site – It should be remembered that Coonagh is in fact in County Limerick near the Clare border and that no matter how you twist it – it is not in County Clare. That particular rumbling needs to be stopped in favour of an actual site in County Clare that will benefit every Clare person from North, South, East and West of the County”.
