My colleague, Deputy Jan O'Sullivan, and I come from the mid-west. Those of us across the House, both in government and opposition, who come from counties Limerick, Clare and Tipperary, as well as from north Cork, depend on the University of Limerick Hospital Group. On Monday, 23 September, 81 patients were on trolleys in University Hospital Limerick. Can the Minister imagine what it will be like on 23 January? This is the highest the figure has ever been and we are only in September. That is despite the best efforts of management and staff. I plead with the Government to make a direct intervention. I was on the telephone to Mr. Paul Reid this morning. He knows that it cannot continue, but he needs the Government's support to do what needs to be done.

The constant high number of trolleys, the lack of bed capacity and the outrageous spending on agency staff all contribute to a situation which is the worst I have seen in my political career. Since I stood here last week, the INMO has highlighted that there are over 100 nursing posts unfilled. Behind the bluster and spin on the capital plan which was buried by the Minister for Health during the summer, there has been no real progress in building the necessary 96-bed block. Amazingly, University Hospital Limerick, unlike other model four hospitals, has only one MRI scanner. It is 14 years old and was donated by a local philanthropist. It constantly breaks down. The hospital cannot afford to buy a new one - it would cost €6.5 million - because of the overrun on the national children's hospital. It would cost €1.2 million to rent one, something it cannot afford to do.

Sláintecare funding was announced with further fanfare last week. The mid-west got nothing. Patients' well-being is suffering greatly. Staff are going on sick leave at record levels because they cannot cope. Compared to other groups across Ireland, University Hospital Limerick needs 130 more doctors, 200 more health and social care professionals, 150 more nurses, 160 more beds and about an extra 50 transitional care packages, in addition to a new MRI scanner. Its spending is €40 million below that of other groups. The people of the mid-west who are represented by me and others in this House are being discriminated against at a level not seen before. They are suffering. People in their 90s are on trolleys in University Hospital Limerick. Their families are crying on the telephone to me. I am not talking about one or two calls, but calls made every single day of the week. The issue takes up more time than any other on my political calendar.

I have three questions for the Government. When will it remove the recruitment ban which is stopping over 100 nurses from being recruited in the UHL group? Will it, please, bring forward work on the 96-bed block and include it in the capital plan? Will the Minister commit to bringing a new MRI scanner into the hospital? Of the 81 patients on trolleys, at least 30 would not be there if the hospital had a scanner that worked.

Nobody wants to see anyone on a trolley. It is acknowledged that the numbers on trolleys in University Hospital Limerick are unacceptably high. The HSE is working actively with the UHL group to ease congestion in the hospital, with the focus on facilitating transfers to level 2 hospitals, providing assistance at rehabilitation units and primary care services and the prioritisation of diagnostics to aid patient discharges. In addition to the new emergency department at University Hospital Limerick, a further 25 beds have been opened since 2017, including eight as part of the winter plan in 2018-19. A capital budget of €19.5 million has been approved for the provision of a modular 60-bed inpatient ward block at University Hospital Limerick, with funding of €10 million allocated in 2019. The new modular block will include three wards, comprising 20 single rooms with en suite facilities, two of which will have full isolation facilities and provide care and treatment for patients, from admission to discharge. The HSE has advised that the enabling works are complete and that the main contractor is commencing work.

The HSE has advised that while there is no recruitment embargo or moratorium, there is a priority requirement for all HSE services to get to and maintain an affordable staffing level that will be sustainable through 2019 and 2020, while also prioritising the delivery of safe services. In the light of this, the HSE advises that it has introduced control measures related to staffing and recruitment to ensure it will live within the resources provided. This means that in some hospital groups and community health organisations the filling of non-critical replacement posts will be paused. The preference is for the controls to remain in place for as short a period as is necessary, with an ongoing review, until there is satisfactory evidence of traction and delivery of balanced financial plans from hospital groups and CHOs.

The UHL group reports that it has recruited 68 staff in the past five weeks, 48 of whom are graduate nurses and midwives.

I thank the Minister for her generic response. I remember the Hanley report and the Teamwork report. They were the reports that were put in place to justify creating the model 4 hospital in Limerick. The issue was the resources and the capital required were never put into it. The amount of funding for staff such as doctors, nurses and health professionals was never in tandem with what was required. It has now come to a crisis.

Will the Government publish the report on the inequity in the funding of acute hospital groups in Ireland by Dr. Anne Dee, which has been buried by the HSE? It shows the discrimination that is happening to all of us in the mid-west. It is a couple of years old but it still stands. It was buried. If the Government does not publish it, I will publish it and put it out there. Will the Government please publish it? It statistically shows how we are being discriminated against.

The situation in the mid-west needs direct intervention now. Can the Minister imagine what we are facing into over the winter? We need more staff. The recruitment embargo exists; it is real. I could name tonnes of people who have been offered jobs but cannot take them up. Will the Government please make a direct intervention to ensure those staff can take up their jobs? Will the Government please ensure we can get the capital resources needed, such as the scanner I outlined? Will the Government please ensure that in the budgetary process that is coming forward, the mid-west hospital group will not be discriminated against as it has been?

I will ensure the Minister for Health hears the concerns the Deputy has raised.

He has heard already.

It is also important to put trolley figures in context. The hospital system is operating at close to full capacity. The number of patients attending emergency departments continues to increase year on year. Attendances in 2018 were up 3.5% on 2017 and this reflects increasing demand for unscheduled care, especially by patients in the 75 and over age group. Planning for winter 2019 to 2020 is under way. Although trolley numbers were lower over the 2018 and 2019 winter periods than the previous winter, attendances and admissions were higher than expected. Consequently, the HSE has commissioned an independent expert review group to identify the factors that contributed to performance over the winter period.

Another review. It is not about processes. It is about resources.

This group will carry out a comparative analysis of unscheduled care performance across the nine hospital sites and the relevant community healthcare organisations that were the subject of specific, focused support through winter 2018 and 2019. I will bring the concerns the Deputy has to the attention of the Minister for Health.

He knows.

He knows.