I attended a briefing on the recently published Deloitte report commissioned by University Hospital Limerick, UHL. Deloitte fulfilled the task it was given. It set out figures and predictions on patient flow and the requirement for 300 new and replacement beds up to 2036. I wholeheartedly welcome today's event, with the turning of the sod for a new 96-bed block in Limerick. This is long overdue but will take time to install and commission. In the meantime, University Hospital Limerick is in crisis. The chaos must be brought under control. Patient safety is already undermined. This serious and dangerous situation must be addressed as a matter of urgency. The emergency department in Limerick is dysfunctional. We have delayed admission followed by delayed action and intervention, a lack of co-ordination within the hospital, a lack of internal communication and a lack of information for worried family members. There is a general air of confusion. This is leading to demonstrable neglect of patients.

To leave patients in pain, waiting for hours on end on chairs and trolleys, is degrading, insulting and, obviously, dangerous. I have received numerous accounts of sick people from north Tipperary not being treated with dignity and respect. I hear disturbing stories about patients who have not received proper care and attention. It is inevitable that litigation against the hospital is increasing. Staff at the hospital are committed and diligent. They have become overwhelmed in this chaos. They are helpless.

UHL has a serious problem with bed capacity, staffing levels and management structures. Some months ago, I informed the Taoiseach in this House that these problems would not be resolved unless a dedicated team of professionals was deployed to Limerick. The Taoiseach agreed to my request. I understand their work is completed. Will their recommendations be made public? That group must have the freedom to insist on and implement organisational changes. Further special funding must be allocated to the hospital for a sufficient bed complement with enhanced staffing levels.

The immediate crisis cannot be ignored. UHL serves a population of 400,000 people from across north Tipperary, Limerick and Clare. The hospital cannot cope with the numbers depending on the emergency department or the hospital itself. Admissions are restricted. Ambulances are left idling outside the hospital as paramedics have nowhere to take their patients when they arrive. Staff at UHL are under unbearable pressure. They are stressed, careworn and exhausted. Ambulance personnel have told me that patients are telling them that there are aware of the serious problems and delays in Limerick and are asking to be taken to an alternative hospital. This is an appalling indictment of the service currently being delivered at that hospital.

I thank Deputy Lowry for raising this important issue. I appreciate that University Hospital Limerick is not just a hospital for Limerick, but for a whole region, including north Tipperary, Clare and the wider County Limerick. This morning, there were 21 patients on trolleys in Limerick. Eleven had been on trolleys for more than nine hours. That is a bad situation and is not acceptable at all. However, it is not the worst that it has been. We do see some evidence of some improvement in Limerick in the last few weeks. I acknowledge that and recognise the staff and management who have made some changes to make that happen over the last few weeks. I know that is no consolation to anyone who has had to wait on a hospital trolley for a bed.

As the Deputy mentioned, the HSE's performance management and improvement unit led an intensive engagement with the UHL team throughout the summer in response to concerns about conditions in the hospital and the findings of the HIQA report following its unannounced inspection of the emergency department in March. We accept that additional beds must be part of the solution. Some 150 additional beds have been provided in UHL since 2020, over the last two years, with 24 in the dedicated haematology and oncology unit, 14 single beds in a single-bed block, and an additional 60-bed block which opened in 2021. As Deputy Lowry mentioned, work has begun on an additional 96 beds in a new inpatient block at University Hospital Limerick. I believe the Minister, Deputy Donnelly, is breaking ground on that development today. The extra 96 beds for the hospital is a lot. It is a small hospital and will have an additional 96 beds in four storeys over the emergency department and renal dialysis unit. It will cost about €90 million. It will take two years to build and three months after that to commission.

We have to work with the hospital to do everything we can to improve the situation in the meantime. That is what the engagement with the performance management unit is all about. It does not just involve work with UHL but with other hospitals in the group and with community services to make sure that we avoid admissions and improve patient flow, so that people get through the hospital quicker and do not have to wait days to get a scan, when that scan might be enough to get them discharged. Regular, frequent assessment of patients reduces the number of long-stay patients waiting for a nursing home.

I thank the Tánaiste. At present, 58,000 people in the mid-west region are on waiting lists. UHL does not have the capacity or capability to complete these assessments. The option to upgrade and increase the services provided at Nenagh and Ennis hospitals is an obvious way to ease this pressure. I wish to acknowledge, in this House, and compliment the management and staff at Nenagh General Hospital for its workload, throughput and efficiency. Further investment, expansion and development of services on this site is a realistic solution and should be looked at. It is also obvious that the mid-west region needs an elective hospital to serve the needs of its huge population. Will the Tánaiste please inform me whether the Government or Department has made a decision on the need for such a new hospital in the mid-west region? Has a location or site been identified? What is the timescale for the delivery of such a project?

No decision at this stage has been made by the Government in relation to an elective hospital in the mid-west. It is open for consideration. I do not think it is a bad idea at all. I am realistic about it because I know how long it takes, believe me, to get a hospital through design and planning and then built. Realistically, it would take six years. In the meantime, the mid-west region has a new private hospital that will be under construction quite soon. That might be useful to us for public patients to access through the National Treatment Purchase Fund. We also have Nenagh General Hospital, St. John's Hospital, Ennis General Hospital and Croom Orthopaedic Hospital. As Deputy Lowry knows, there has been investment in Croom to provide 24 more beds. The solution for the mid-west might be extended and better use of the existing hospitals in Ennis, Nenagh and Croom, and the use of the private hospital, rather than putting everything into an elective hospital which we might not see until the end of this decade.