For the seventh time in the past year and a half, I am raising the issue of the serious, chronic and worsening situation at Sligo University Hospital, SUH, regarding the numbers on trolleys and waiting for beds. There is no shortage of statistics thanks to Trolley Watch. While numbers fluctuate day on day, if we look at the trends, we will see what is happening. If we look at this year, from January to August, we see that compared with all other hospitals, SUH started off in January as the fifth worst. As the year progressed, it went from fourth to third. When we get to August, because that is the last full month, we see that it was in the fourth-worst position. The figures in September show a distinct disimprovement. The headline figures for the month of August, which show Sligo with 720 people waiting, do not tell the full story. One needs to look at the capacity of any hospital, such as the number of beds and staff, because that, to a large extent, determines how it can manage those waiting on beds. If we look at August of this year and compare bed capacity in Sligo and Limerick, for example, which is meant to be perhaps one of the worst hospitals from the perspective of those on trolleys and waiting for beds, we see that Sligo is the worst of all the hospitals in the country. That is measure of the real challenge that is facing SUH, not the headline figures that are screaming at us at this stage.

I am sure the Tánaiste is well familiar with this issue, not just from my interventions, but from his party's councillors and Government Deputies, some of whom described the situation recently as truly shocking. They are right; the situation is truly shocking and completely unacceptable. The situation, while it is worsening, has not crept up on us by stealth; rather, it has worsened year on year. If the Tánaiste looks at the figures back from 2006, he will see that those figures are getting worse year on year. All hospitals have experienced increases, but Sligo is the worst.

That is why I am asking the Tánaiste for an immediate, short-term response for the coming winter-spring period. I know there are longer-term plans for a 42-bed unit, and we are waiting on that. However, we need immediate action. The hospital is under severe pressure. Staff are under huge stress and suffering burnout. Covid tested all of us, but it tested healthcare staff more than others. As we face into uncertain winter and spring in the context of Covid and flu, what short-term messages can the Government put in place?

I thank Deputy Harkin for raising this important question and raising SUH again in the Dáil. She has raised this matter many times in the House and has spoken to me offline about it as well.

According to the HSE this morning, there are seven patients on trolleys in the emergency department in Sligo, but it has been much higher on other and, indeed, in recent days. I acknowledge the Deputy’s point that ten people on trolleys in a small department, such as Naas or Portiuncula, for example, is worse than ten in a very large department, such as, for example, St. James’s or St. Vincent’s.

The Deputy makes a valid point and I acknowledge it.

With regard to short-term actions, the HSE is currently preparing its comprehensive winter plan. That will include bespoke local plans for Sligo University Hospital and the community healthcare area of which it is part. It is being finalised and will be brought to the Government very shortly. In the meantime, funding has been provided for actions to take place this year. These include GP and out-of-hours support, the extension of the local injury unit operating hours, transition-care funding and short-stay respite services. Across the country, the HSE has been instructed to recruit an additional 51 emergency medicine consultants, including on a locum basis, if necessary.

Attendances in Sligo have been very high relative to the predicted range for September. The HSE is acting to alleviate congestion by prioritising diagnostics to get people discharged more quickly and also by using day services. Elective services have been pared back to six beds over recent months, unfortunately, but that was necessary.

In the past two years, additional capacity, including 41 public intermediate care beds, has been provided to Sligo. There has been an extension of the emergency department, which has provided a new reception area, a Covid assessment area, separate adult and child waiting rooms, a new nurse triage area and an ambulance arrival area, which opened back in January.

I thank the Tánaiste. On 28 September, the INMO branded Sligo University Hospital a safety hazard. That is not politics and it is not me saying it. The INMO does not do this lightly. That is where we are at the moment. The INMO has called for an urgent inspection by HIQA because of the increased overcrowding and safety issues for patients and staff. I hear what the Tánaiste says about diagnostics. That will work in two or three years; it will feed into the system. I also hear what the Tánaiste says about the 51 emergency consultants. How many of them will be coming to Sligo? I understand that there are four ICU beds in Sligo not opened because the HSE is not sanctioning the required staff. Did budget 2023 ensure the deployment of the 30 additional staff needed for Sligo University Hospital? This is what we want to hear. I do not expect the Tánaiste to wave a magic wand today such that the waiting list will disappear tomorrow but I want to see some kind of immediate action so the people attending the hospital and its staff will know some support will be in place for this winter and next spring.

I thank the Deputy. As I mentioned in my earlier reply, a winter plan is being developed. There will be a bespoke winter plan for Sligo, taking into account not only the hospital but also the community services in the wider area. Diagnostics can help quite soon. I know from bitter experience, both as a doctor and Minister for Health, that patients very often must wait a long time in hospitals, particularly over weekends, to get the scans or tests they need. Then they must wait for a senior decision-maker to decide whether they need to stay or can go home. Just having more diagnostics, particularly in the evenings and at weekends, and having senior decision-makers on site, can speed up services. Just reducing the average length of stay by half a day can be as good as providing dozens or hundreds of additional beds across the health service. You need to do all of these things to reduce the average length of stay, and also provide additional bed and staff capacity.

As the Deputy mentioned, there are plans for a new four-storey block for the hospital. That will include 42 new beds, as well as additional staffing for critical care. That is needed as soon as possible. The Minister of State, Deputy Feighan, is working very hard on this and I know Deputy Harkin is too. We need to get it under way as soon as possible but also to make the short-term changes.