*Angela Coll, Chairperson of Friends of Ennis Hospital (FEH).
PLANNED bed blocks for University Hospital Limerick (UHL) will not alleviate overcrowding in the region and instead renewed Government focus must be placed on establishing an acute hospital in Clare with an emergency department, a local health activist group has argued.
In a pre-budget submission to the Government, Friends of Ennis Hospital (FEH) have called for the construction of a second acute hospital in the Mid-West, putting forward the case for Co Clare to be selected.
Ahead of Budget 2026, FEH have said they are keeping in mind the allocation of resources in the National Development Plan published this month and the ESRI national capacity review of the health service published in May.
Established in 2009, FEH are a non-political campaign group although some of its members have been in politics and are members of political parties. FEH are committed to lobbying and campaigning for better health services for the people of Clare and the wider Mid-West region. They say they believe in a campaign based on data analysis rather than soundbites, focused on future planning with all stakeholders.
Two distinct sites with two acute hospitals in the Mid-West under a single structure for governance would put patient safety and comfort at the core of healthcare in the region, FEH outlined in their submission.
Ongoing overcrowding in the Mid-West “is attributed to the 2009 downgrading of three accident and emergency departments in the Mid-West without adequate provision for additional capacity, leading to a significant increase in trolley counts at UHL from 2009 to 2024. The Midwest region, with the oldest population and highest rates of chronic illness and multimorbidity in the country, faces additional pressure on healthcare resources”.
Chairperson of FEH, Angela Coll stated, “The cause of the current trolley crisis in University Hospital Limerick is simple, the downgrading of three 24-hour accident and emergency departments in the Mid-West in 2009 without adequate
provision of additional acute capacity in the region. The lack of future planning and failure to consider the subsequent population growth in the country has left the Mid-West as the only hospital region in the country relying on one acute hospital and therefore only one Emergency Department for the entire region”.
Patients spending on trolleys for twenty four to forty eight hours cannot possibly be without risk, the submission stated while pointing to no privacy, no dignity, extended wait times for treatment, an unsafe working environment for staff and patients plus an increased risk of infection, misdiagnosis, mortality and morbidity from extended waits on a trolley.
Data from FEH indicates that an approximate one fifth of the population in the region passes through UHL’s ED annually. “Using the predicted population figures and the current conversion rate per region without a second acute hospital in the Mid-West we are looking at almost 100,000 presentations per year in Limerick by 2034 if not before it. The currently planned bed blocks for UHL will not eliminate the current overcrowding and cannot therefore realistically be expected to eliminate the overcrowding forecast due to population growth in the Mid-West region”.
UHL’s campus “does not have space available to build the capacity required to eliminate the use of inappropriate bed spaces in 2025 never mind into the future,” FEH stated.
For the first ninety days of 2025 over 8,800 patients waited on a bed in UHL. There are currently plans for two ninety six bed blocks on the campus in Dooradoyle, the first of which is due to open in the third quarter of this year, the second bed block has been stalled at the planning stage with FEH warning “which means in reality it will be three years before planning is granted if it is granted and another two years construction giving us a 2030 opening date at the very earliest”.
Trolley numbers exceeded 100 for fifty consecutive days last year at UHL, the overcrowding protocol was triggered every single day in 2023 and 2024 while elective surgeries have been cancelled on multiple days over the last three years. A HIQA report also found that a patient in UHL had to wait 116 hours before getting a diagnosis which they received in a public corridor.
Such statistics have prompted FEH to stress, “The only thing that will relieve the trolley crisis in UHL is the provision of an additional ED in the region. We understand, and have always understood, that ED services cannot be safely
provided in a Model 2 facility. We also understand that that it would not be cost effective to consider reopening all 3 of the EDs which were chosen for downgrading in 2009”.
900 beds are needed in the Mid-West to eliminate overcrowding, FEH calculate. “A new greenfield Model 4 hospital is preferred for its safety, quality standards, and better recruitment prospects. Clare, with over 130,000 residents and a significant influx of tourists, lacks any emergency department, forcing many to travel over an hour to UHL, thereby risking delays beyond the critical ‘golden hour’ for trauma care. Compared to other HSE areas with similar or smaller populations, the Mid-West has far fewer emergency departments, creating inequity in healthcare access. Adding a new hospital with an ED in Clare would decentralise services, strengthen the regional healthcare system, and provide resilience against seasonal tourist demands and demographic shifts”.
Locating such a facility close to the existing motorway network “could also assist in the recent overcrowding in Galway as well as being easily accessible for patients in North Tipperary should they wish to use the new facilities”.
Only Clare with a population of 131,000 as per the 2022 Census and Leitrim with 25,815 on the western seaboard have no emergency department, the submission highlighted.
On why Clare should be chosen, FEH stated, “Clare is home to the number one natural visitor attraction in the country with over 1.3 million visitors every year. Ennis is Munster’s largest town with a population of 28,000. It is the only county in Ireland with an International Airport without a hospital. Clare it should be noted is the only county in Munster without an ED. 40% of Clare’s population lives more than 45 minutes from an emergency department. Almost 25% of patients presenting at UHL have a home address in Co Clare”.
Reference to the 1916 Proclamation that “The Republic guarantees religious and civil liberty, equal rights and equal opportunities to all its citizens” is made in the submission and the Irish Constitution of 1937 of “seeking to promote the common good, with due observance of Prudence, Justice and Charity, so that the dignity and freedom of the individual may be assured, true social order attained” is made by FEH in the submission.
Concluding their case, FEH said, “In 2025, it is our contention that the people of the Midwest are not afforded ‘Equal Opportunities’ when it comes to healthcare. ‘True social order’ remains a lofty ideal which will never be achieved while an obvious regional imbalance exists in Ireland. FEH Believe that the standard of healthcare and access to healthcare in Ireland is currently determined not by need but by Eircode”.
