THE MID-WEST Hospital Campaign Group has said it is “horrified” at the timeframe for HIQA’s inquiry into overcrowding at University Hospital Limerick.
The terms of reference for the health watchdog’s statutory inquiry into overcrowding at UHL were published today.
The terms were developed by the authority following a request by the Minister for Health Stephen Donnelly.
Donnelly has said conditions were improving in almost every hospital in Ireland, but that UHL is “on its own in terms of the increase in patients on trolleys”.
Reforms recommended at UHL have not been implemented in full yet, the minister said, but added that there is “no reason why there shouldn’t be” improvement at the hospital by the winter.
Scheduled care across five hospitals and injury units in the Mid-West has been cancelled indefinitely since the second week in August in order to “de-escalate the UHL site”.
HIQA said its review will include whether there should be a second emergency department in the mid-west region.
There are currently four injury units in the region, but only one ED at UHL.
The HIQA review is expected to be completed in the summer of next year, when a report of the findings and recommendations will be provided to the Health Minister and published on the HIQA website.
“We are seriously concerned about the apparent lack of urgency here,” said Conor Reidy of the Mid-West Hospital Group Campaign.
“People are potentially dying on UHL trolleys right now and that is not hyperbole or trying to be sensationalist.”
By way of example, Reidy noted that on New Year’s Eve 2022, the campaign group held a candlelight vigil of outside the gates of UHL to “remember all those who had suffered and died in the year previous”.
“We had no idea that Aoife Johnston had died in that hospital just 12 days earlier,” Reidy told The Journal.
There has been a particular focus on emergency services at UHL since 16-year-old Aoife Johnston died at the hospital in 2022 after waiting for 12 hours to be assessed for suspected sepsis.
In its terms of reference document, HIQA said there has been “significant overcrowding” at UHL’s emergency department in recent years.
It said that population increases in the mid-west region had partly contributed to overcrowding, but added that the scale of it had “consistently been greater” than that at other hospitals.
Reidy noted that the review won’t be published until at least next summer and added: “We never believe that these deadlines will be met, so it could go beyond next summer before they actually produce their report.
“And when they produce their report, how long does that take for the government to negotiate?
“We’ve seen the chaos with the Children’s Hospital, so we’re very concerned about this.
“To put it bluntly, when our campaign team heard this afternoon that this review would not be produced for at least a year, we were horrified, there’s no other way to put it.”
The terms of reference also notes that HIQA will “consult and engage with key stakeholders in the region and nationally”.
Reidy said the Mid-West Hospital Group Campaign “absolutely consider ourselves part of the key stakeholders as a result of its work over the past five years.
“We’ve been before the Oireachtas petitions committee, we have met with Leo Varadkar when he was Taoiseach and with HSE Chief Executive Bernard Gloster,” said Reidy.
“We are people who have had loved ones suffer or die on UHL trolleys so we would be asking very strongly to speak with the HIQA inquiry and we as a campaign have a full expectation that we will.”
“Gloster is a Limerick man and has been saying the right things,” said Reidy.
He added that Gloster is “very much aware of the UHL situation and that his comments this past week are welcome.
“What we would be urging him very strongly now is to put his foot on the accelerator because the situation is not getting better, it’s worsening all the time and has veered out of control,” said Reidy.
And while Reidy said it is a “good thing this review is happening, it is very seriously overdue, 15 years overdue frankly.”
“The review needs to happen much sooner than the timeframe which is being set out, this needs to be accelerated because of the daily threat to life in this region.
“Once HIQA puts out the results and recommendations of that review, and we expect it will recommend something, it surely won’t recommend the status quo.”
Reidy said it will then become a “political matter for the government of the day” and that the government “must not sit on this or wait for another review”.
“Taoiseach Simon Harris said the government will act without fear or favour on the recommendations of this review,” said Reidy.
“We don’t know who will be in government, but they will really need to act very quickly to save lives, because people are suffering and dying.
“We’re happy with the existence and promises of the review, but not the timeline.”
HIQA’s statutory inquiry aims to identify what capacity would be needed above what has already been delivered.
Since 2019, there has been a 30% increase in staff at UHL, or an extra 1,200 healthcare workers, which includes emergency consultants, non-consultant hospital doctors and emergency department nurses.
“This review will aim to identify what additional capacity, if any, above that which has been delivered or which is in train, would be required,” HIQA said.
Among its eight terms of reference are the establishment of an Expert Advisory Group to inform Hiqa’s approach; to establish a Clinical Advisory Forum with relevant clinical and nursing representatives; and to review health service capacity in the HSE mid-west region.
On this last point, Hiqa said: “The outputs from this work will be considered along with the other work streams to inform key considerations and assumptions around best practice in the design and delivery of population needs relating to urgent and emergency care, aligned to current and project population numbers.”
-With additional reporting from Press Association
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