HIQA OFFICIALS said that building a new model 3 hospital in the Mid-west, which is one option they are proposing to solve the region’s bed capacity crisis – would cost billions. 

It’s one of the options that the Health Information and Quality Authority (HIQA) has laid out before politicians to address the crisis of bed capacity in the region.

CEO Angela Fitzgerald outlined to politicians on the Oireachtas Health Committee that even if the Government does invest in building a new hospital, other recommended measures need to considered to meet the urgent short-term healthcare needs. 

“We don’t know what it will cost to build a model three hospital but the only benchmarks we have are the Children’s Hospital and the New Maternity Hospital… you are talking about billions, and you are talking about a 10 year timeframe. We arent saying that that isn’t something the Government needs to consider, we are saying that if you do that option you still have to invest now.

“And the investment that’s planned, which is coming on stream, which is the 95 beds by 2029, needs to be augmented by another 100 at least to allow you to stay ahead,” Fitzgerald said. 

She said that there is an ever growing demand for services which is only going to continue.

This gap in capacity vs growing need presents a real risk to patient safety, Fitzgerald added.

The three options that HIQA has put forward for remedying the situation are:

1. Expand UHL’s capacity at the existing Dooradoyle site.
2. Extend the UHL campus and introduce another site that will support the delivery of healthcare services.
3. Develop a Model 3 hospital in the HSE Mid-west, which would introduce a second emergency department to the region.

Building a brand new hospital would go further to address long-term need, but it will have a longer lead in time, and even if it is the option the Government pursues, measures need to be taken in the short-term to bring more beds on stream, she said.

“What’s required in the first instance is a decision in relation to exactly how services will be set out… there’s a policy decision that’s required here, around how it’s intended to configure services now and into the future,” she said. 

Angela Fi

Fitzgerald said that building a hospital requires significant capital investment from Government not just in terms of building it, but also in order to develop the necessary clinical services. 

Politicians on the committee despaired at the current state of healthcare delivery in the region. 

It was noted that there doesn’t seem to be “a massive push on option C [building a hospital] for the people of the Mid-west,”. 

Fine Gael TD Peter Roche said we’re in a situation where “a lot of people fell asleep, and all of a sudden, we’ve woken up, and we have a situation where there’s 5.5 million people living in this country, as a result of that, the demands are extraordinary.”

He said he finds it “bewildering” that it is still the case that UHL has the highest emergency department attendance while having the lowest beds per capita. 

He asked what capacity would be needed right now “to make the situation better”. 

Fitzgerald said: “There’s a lot of numbers floating around but to break it down, the ESRI has projected that out to 2040, that somewhere between 299 and 599 beds are required. Why is that range there? Because there are uncertainties in the way the ageing and the profile of the population is changing. 

“If you take the 299 figure, the investment that’s planned now, and the next 100 beds that are coming… it leaves us about 90 beds short of the overall need that’s there. 

Fitzgerald said a strategic plan now needs to be developed and implemented that will see the Government make a commitment to taking action on the back of these recommendations.

Health Minister Jennifer Carroll MacNeill has said that building a new hospital is not off the table, and that her department is looking at all of the recommendations put forward by HIQA. 

HIQA’s review found that UHL has the busiest emergency department in Ireland and that patients are frequently forced to wait on trolleys, sometimes for days at a time, during their hospital stays. 

Some staff working at the hospital who spoke to the authority for the review said that they felt the hospital was “embarrassingly unsafe for patients”. 

The public has also learned a lot about how overcrowding issues are affecting operations at the hospital from the inquest into the death of teenager Aoife Johnston in 2022.