HIGH levels of overcrowding at University Hospital Limerick (UHL), the cancellation of outpatients appointments, and spiralling waiting lists have been described as akin to watching a “car crash in slow motion”.
As UHL struggles to deal with an increase in Covid-19 patients and a dramatic increase in ED admissions, a senior government minister has admitted the pandemic record of 91 patients on trolleys in the hospital on October 12 was unacceptable.
UHL had the highest number of confirmed Covid-19 cases in the country on Tuesday with 47, and had the second highest number of suspected cases of the virus with 42.
Seven confirmed cases were in ICU, while there was only one available ICU bed on Tuesday.
In an interview with The Clare Champion, Foreign Affairs Minister Simon Coveney said the health service is dealing with an extraordinary global pandemic, which has put a lot of pressure and strain on hospitals.
“This is going to have a knock-on impact on other important work hospitals are doing. Of course, it is not acceptable to have 91 patients on trolleys. This is why we are investing in more beds, and why we will spend €22 billion on health care next year.
“I can remember a time when that figure was €14 billion in the last decade. We will spend a lot more money on more staff, more beds, increased resources across the hospital sector and the primary care sector to keep people out of hospital.
“The Budget provides for an extra 14,000 people working in the Irish healthcare system. We are driving a reform programme and are learning lessons from the pandemic.
“Nobody is accepting the kind of numbers we see on trolleys in Limerick, Cork or Galway.”
His visit coincides with growing concern over the impact the three-day cancellation of non-urgent outpatient appointments and some surgery will have on waiting lists for public patients in the region.
The number of people on out-patients list has jumped by
13.4% from 47,134 in January 2020 to 53,463, while the in-patient has grown by 21.25% from 4,798 to 5,818.
UHL is still recording the highest number of patients on trolleys in the country, with 65 waiting for a bed on October 15 and 55 on October 19.
Deputy Michael McNamara said when procedures are cancelled patients get sicker, are forced to present to the ED, which becomes even more overcrowded and this in turn results in a higher risk of Covid-19 infection.
The Independent Deputy has been reliably informed that a high number of people in UHL are contracting the virus.
He claimed there is no point in asking the HSE questions, as he is still waiting for an answer to queries submitted last February about a breakdown of the number of patients who died from Covid-19 where the virus was the primary cause of death.
He alleged the HSE is selective about the information it provides that creates a certain narrative that hospitals were previously overwhelmed with the virus whereas they are overrun with “incompetent management”.
“I appreciate Covid-19 has placed significant pressure on hospitals, but their underlying problems are far greater than the virus. It would be better if some of the doctors spent more time concentrating on running services in hospitals rather then pontificating to the public.
“If there is one infectious patient in an overcrowded hospital this patient will spread it to others. Even Simon Harris acknowledged this was the case when he was health minister in the spring of 2020. He promised significant measures would be taken to address overcrowding in UHL.
“I was raising this issue back then because it was obvious what was going to happen. What is happening now is like watching a car crash in slow motion.”
Deputy Violet-Anne Wynne has called for the proposed expansion of services in the Medical Assessment Unit (MAU) in Ennis Hospital to be in place in time for the fast-approaching Winter season.
Having welcomed the additional €286,000 allocated by the National Treatment Purchase Fund (NTPF) for an expansion of services in Ennis last December, she expressed frustration this expansion is in a theoretical stage a year later.
“It’s nonsensical that the people of Clare are expected to travel to Limerick Emergency Department where they know they will have to wait on trolley, for medical attention that could and should be available locally.
“The staff are working under exceptionally difficult circumstances and are doing their best, but even the escalation plan put in place to resolve these issues is not enough. There’s simply not enough staff.”
UL Hospitals’ Group cancelled all but the most time-critical outpatient appointments at UHL, and some elective surgery at St John’s Hospital and UHL, from Monday to Wednesday.
Patients who were directly affected by these cancellations were contacted with a view to rescheduling them at the earliest opportunity.
Outpatient appointments at Ennis, Nenagh, Croom and University Maternity Hospital Limerick were unaffected by the decision. Emergency care continued through the Emergency Department (ED) in UHL, and the Injury Units in Ennis, Nenagh and St John’s Hospitals remained open.
Unaffected services that continued included cancer clinics, rapid access lung, prostate and breast clinics, nurse-led heart failure and cardiac rehab, day case angiograms, acute fracture clinic, eye clinic, endoscopy, ENT, dermatology, endocrinology, dermatology and vascular laboratory clinics.
Patients can still attend these clinics.
The site-wide visiting restrictions introduced on October 5th in response to an outbreak of Covid-19 at the hospital, remain in place for now.
Cancelling elective activity is an option of last resort, and the group is profoundly sorry for the impact these cancellations will have on patients who had expected to attend for clinics or procedures on Monday, many of whom will have been waiting a long time for appointments.
In this context, the decision to cancel electives and outpatient clinics has been taken in the interests of the safety of all patients and staff in UHL.
The situation is being reviewed daily, in the hope of resuming the cancelled services as soon as possible.
UHL continues to manage an extraordinarily high level of emergency presentations, and increasing numbers of Covid-19 positive patients, which prompted the cancellation of some services to assist with patient flow.
There has been an average of 243 attendances at ED on weekdays, and 190 on weekends. The daily average attendance at ED in 2019, the last full year pre-pandemic, was 195.

by Dan Danaher