8. Deputy Dara Calleary asked the Minister for Health the status of the extension of the emergency department in Mayo University Hospital; and if he will make a statement on the matter. (Question 17028/18 asked on 19 Apr 2018)

Deputy Dara Calleary: Mayo University Hospital’s emergency department was designed for 20,000 patients. In 2016 it catered for 40,000 patients. This is placing the fantastic staff and patients under intolerable stress. The Saolta University Health Care Group has made a number of funding applications with regard to transforming the emergency department, but those applications are delayed at either HSE or Department level. There must be action on this and there must be progress on building a modular unit before next winter. Can the Minister give an update on this matter?

(Deputy Simon Harris): I thank Deputy Calleary for raising this issue. I had an opportunity to visit Mayo University Hospital a number of months ago and to meet the management and staff there. I am aware of the issues with the physical size of the emergency department. Despite the best efforts of the management and staff, which the Deputy rightly acknowledged, the emergency department is not large enough for the number of people who come through its doors. We are aware that the demographics in terms of the population and particularly the ageing population in many counties have resulted in increased attendances, and Mayo is experiencing that as well. I am pleased that through the national development plan I have a significant capital budget to expand the size of our health service to deliver 2,600 additional hospital beds and 4,500 community beds. I expect that Mayo and Saolta University Health Care Group will get their fair share of them. I will shortly ask the hospital groups to submit their proposals on how to increase bed capacity in their groups and Mayo will be examined in that context.

However, the Deputy’s particular question is about how we can physically extend the size of the emergency department, an issue that was also raised with me by of members of staff and management when I visited the hospital. I was apprised of the requirement for a new emergency department and also of the fact that the hospital and the group have come up with an interim solution in terms of a modular unit alongside the existing emergency department, which they believe would significantly benefit patient flow through the hospital. I am advised that the hospital and the group have advanced work on that proposal since my visit. Indeed, only last week officials from the HSE national estates were on site at the hospital to review and discuss the proposal and, following this meeting, further work will be undertaken on the scope of the design so the proposal can advance to the next stage.

I am actively considering a number of locations where we could provide modular units and modular builds, and Mayo is one such site. We are awaiting a number of proposals from the HSE in that regard. I do not wish to say to the people of the country that we have plenty of capital to increase the size of their hospitals but that it will take a number of years to build the extensions and wings. Bricks and mortar take time so I am looking favourably at modular units in that context, and Mayo is certainly under consideration. I look forward to the next iteration of its proposal following the visit by the officials from the HSE national estates.

Deputy Dara Calleary: I thank the Minister for his update. I, too, was in the emergency department over the Christmas period and spent time watching the staff and the patients trying to work and be treated under intolerable conditions. It is a tribute to the staff that they are managing to deal with in excess of 40,000 patients. We need progress on this. It has been delayed, with site visits and site inspections taking place for years. We need to see some type of ground works proceeding and action happening before next winter. A modular extension is a temporary solution, but the longer it is delayed the less temporary it will become. Mayo University Hospital has also had to cope with a larger influx of patients as a consequence of the closure of the emergency department in Roscommon and due to the pressure on University Hospital Galway. People in the north of Galway find it quicker to go to Castlebar than to go their city hospital. The management, medical staff in the emergency department and the Saolta University Health Care Group are doing everything they can and treating the issue with the urgency that is required. We need similar urgency from the HSE and the Department.

Deputy Simon Harris: The Deputy’s analysis of the situation is correct. The current emergency department was designed to meet a capacity flow of approximately 25,000 patients per annum but the figure for attendances last year reached over 37,000, according to the figures available. As is the case in much of our health service, the infrastructure was built for a much smaller population. That is why I unapologetically believe that we must embark on a construction and capacity building programme in the acute hospital setting. It frustrates me when I hear people in the national media say it can all be done in primary care. Much more could be done in primary care and we need to have more done in that area and to shift more services to the community, but despite all that we will still need more physical capacity and Mayo University Hospital is an example.

There is a long-term proposal to provide a new emergency department in the hospital and we can look at how to progress that, but we need an interim solution and to see how we can extend the existing emergency department. The only interim solution I see is modular build. The HSE estates office is working with Mayo University Hospital to review and discuss the proposal. There is some follow-up work required on the scope of the design and the hospital management is familiar with that. However, I accept the point that we need to see if we can do something quite quickly on it. I will examine it in that context and I will keep in touch with the Deputy.

Deputy Dara Calleary: I welcome the Minister’s commitment to review it. It is incredibly urgent. There was trolley pressure in the hospital this year. There are many pressures on the hospital and on bed management in the hospital because of delays in the emergency department, so there must be action in the coming weeks. It would be fantastic if there was some type of movement on this over the summer ahead of the winter season.

Deputy Simon Harris: With regard to modular build in general, the Department and I will have to make a number of decisions quite shortly on two things. The first is assessing what sites are appropriate for modular builds, that is, can physically contain modular builds, and where they can work from an engineering and layout point of view, which lay people such as myself are not familiar with. A body of work is ongoing there. The second is which sites could be delivered quickly and in advance of the pressures that tend to peak in December and January, although there are year round pressures in hospitals such as Mayo University Hospital. We will be examining those two issues quite shortly and Mayo will be considered in that context.