The Minister for Health, Stephen Donnelly, and the head of the HSE, Bernard Gloster, are expected to make a crisis visit at University Hospital Limerick (UHL) this Thursday, over their concerns about chronic patient overcrowding and patient deaths at the hospital.
It comes on the back of recent reporting of an unpublished investigation by an internal UHL Systems Analysis Review (SAR), which found that overcrowding in the Limerick Emergency Department was a fundamental factor in the death of UHL patient Martin Abbott (65) from Shannon, in December 2019.
Mr Abbot’s inquest, which took place at Limerick Coroner's Court last week, heard he fell off a trolley in a cubicle in the crowded emergency unit and was dead on the floor for up to and over an hour before he was found. Mr Abbott could not be ventilated by a doctor as rigor mortis had set in.
The SAR found that "severe crowding in the emergency department was the fundamental causal factor” in Mr Abbott's death, as first reported by the Sunday Independent.
The findings were given to UHL hospital management in late 2021, over a year before 16-year-old UHL patient, Aoife Johnston, died at the hospital for bacterial meningitis after languishing 12 hours on a trolley to be treated for sepsis.
Despite years of persistent overcrowding at UHL, a SAR on the circumstances of Ms Johnston’s death found that, systems at the Limerick hospital had “little apparent understanding of the risks and inefficiencies caused to patient care by an overcrowded environment, in terms of the impact on the emergency medicine doctors assessing and managing patients and the nursing staff’s ability to provide safe care”.
Retired Chief Justice Frank Clarke is presently conducting a review of the circumstances into Ms Johnston’s death.
The Shannon teenager’s inquest is scheduled at Limerick Coroner’s Court for April 22nd-25th, however this is expected to be postponed until Mr Clarke’s investigation is completed.
The HSE, and the UL Hospitals Group, which runs UHL and five other hospital sites in the mid west region, has apologised for its failings in both Mr Abbots and Ms Johnston’s care.
Mr Abbott’s daughter Anne Marie, said last week that her father’s death at UHL should “not be in vain” and it should be a catalyst for change at the Limerick hospital.
Many in the region say the 2009 reconfiguration of 24-hour Accident and Emergency services across North Tipperary, County Clare, Limerick City and County, into UHL, has fuelled patient overcrowding.
on Tuesday, A&E advocacy group, the Mid-West Hospital Campaign (MWHC) announced a “Drive to Save Lives” protest march in Limerick to highlight the region’s hospital crisis and mark the 15th anniversary of the closure of the region’s three A&Es.
It said a convoy of vehicles will set off on Saturday, April 13th from Ennis, Co Clare; Nenagh, north Tipperary; and from around Limerick, traveling through the Treaty City on its way past UHL and converge at the offices of Mr Golster and the UL Hospitals Group in the Raheen Industrial Estate.
MWHC spokesperson Mary Cahillane, said the A&E reconfiguration “has been an unmitigated disaster.
UHL is consistently the most overcrowded A&E in the country, we have one emergency department to cover 425,000 people, and under these circumstances ‘reconfiguration’ cannot be made to work”.
“When the new Fine Gael leader Simon Harris visited University Hospital Limerick in 2017, there were 47 people on trollies.
He said that something needed to be done about it. Today, there are consistently over 100 people left on trollies every day,” said Ms Cahillane.
“We want to say loud and clear for Mr. Harris that the time for action is way overdue, people are dying as a result of these conditions. We’re calling on him to reverse ‘reconfiguration’ and reopen the closed A&Es,” she added.
Fellow campaigner Charlotte Keane said: “Unfortunately, it feels like people in the Mid-West are not being heard. So we must make ourselves visible.
"We’re calling on Limerick people to come out in force on the 13th April to join the convoy through the city or line the route and cheer it on as it passes.”
Incoming Taoiseach Simon Harris officially opened the €24 million Emergency Department at UHL in 2017, which was officially touted then as “Ireland's largest and most advanced Emergency Department. Allowing for faster investigations and treatments for the sickest patients, improving outcomes”. However, patient overcrowding at the hospital has worsened.
A crack team of HSE experts sent to UHL in June 2022 by Minister for Health Stephen Donnelly has also failed to solve overcrowding.
The Irish Nurses and Midwives Organisation, on a number of occasions, has described conditions inside the overcrowded Limerick hospital as “dangerous” and a threat to patient safety.
The Health and Safety Equality Authority has also produced reports critical of overcrowding at the hospital.
The chief fire officer at Limerick City and County Fire Service has previously threatened the hospital with legal action following a number of breaches of a cap on the maximum number of patients and trolleys allowed in hospital.
The battle for bed space at UHL has also led to vulnerable elderly patients being woken from their beds late at night/ in the early hours of the morning to be moved to step down facilities, which the hospital has issued an apology.
The hospital has also been forced to routinely cancel scheduled surgeries to save beds for emergencies situations.
The UL Hospitals Group has sought hundreds of additional beds to meet patient demand.
A 96-bed unit is currently being built on the grounds of the hospital and due for completion next year, although it is now unclear as to how many of these beds will be additional beds or will replace existing not-fit-for-purpose nightingale wards. A second 96-bed unit at the hospital is approved for planning but does not have a start date.
