At the start of this year, 76-year-old Mary Hughes was in Roscommon hospital and was transferred to Portiuncula after suffering a seizure. Mary passed away on 4 January at Portiuncula hospital after waiting more than seven hours for a bed before finally being admitted to a ward. Mary had been forced to leave a bed in Roscommon hospital to go onto a trolley in Portiuncula hospital. Her daughter, Edel, spoke to the Roscommon Herald and she said:

My poor mother went to Portiuncula unwell, and it is not so much a case that she died because of it, it is more her passing was not as peaceful as it could and should have been. The crisis increased her suffering and ours. The system is hurting people beyond belief.

Sadly, this is one of many personal stories emerging around this country.

If we delve down into the numbers of patients waiting on trolleys to date in 2023 and analyse this as a percentage of the number of beds in each hospital, which I believe is a far better reflection of the pressure that each hospital is under, Portiuncula hospital, with just 157 beds and an average of 22 patients on trolleys each day this year, has a 40% greater demand on its beds than the headline-grabbing university hospital in Limerick and a whopping 325% greater demand on beds than Galway university hospital. We should not be surprised because not one additional bed has been put into the hospital since the emergency department was closed at Roscommon hospital in 2011 even though Portiuncula has taken the bulk of the Roscommon referrals.

In June 2020, I wrote to the then Minister for Health, the chief executive of the HSE and the Secretary General of the Department of Health pointing out the desperate situation in Portiuncula, which at that point had lost one in ten of its beds due to the Covid reconfiguration at the hospital. At that stage, the hospital had put forward a proposal seeking two modular buildings, one of which was to provide the space needed in its emergency department to deal with the present demands that were being placed upon it. Thirty-one months later we are still awaiting a decision from HSE estates as an average of 42 patients a day lie on trolleys in that hospital. We need to see this project proceeded with - the modular emergency department - as a matter of urgency. I am asking for the Taoiseach's intervention and for his intervention in similar proposals in other hospitals that can ease the current crisis that we are facing.

I thank the Deputy. I want to say at the outset how very sorry I am to hear about Mary's experience of our health service. For most people, their experience of our health service is very good - that is what they tell us in patient experience surveys - but I know for some people it is very bad. Mary, sadly, is just one example of many others that all of us could recount to this House. It is not acceptable that she experienced that.

We know that overcrowding in emergency departments and delays in getting to a ward result in reduced patient outcomes. We know from international research from the UK, Western Australia and other parts of the world that it can result in higher mortality also. This is what makes it a very serious situation.

We are working on this as a Government. In less than three years the Minister for Health, Deputy Donnelly, has added more than 1,000 beds to our acute hospital system, including community beds. We have 6,000 more doctors and nurses working in our health service than we did three years ago. We are doing a lot to keep people out of hospital in the first place with, for example, more funding for general practice and community intervention teams. There are also record levels of funding for home care so that people can get out of hospital when they are well. That is still a work in progress and there is much more to be done in this regard. We are catching up on period when there was very little investment because the country could not afford it.

In the coming years I will work very closely with the Minister Deputy Donnelly, and with the Minister, Deputy Donohoe, and the whole Government, to see what we can do to speed up health capital projects. Too many of them are taking too long. Some happen pretty quickly, and I am impressed with what happened in Kilkenny and the Mater, but some are going on forever and it is not okay.

I accept the point the Deputy made that overcrowding in a small emergency department in a small hospital can be worse, and I have seen it. I have been to small emergency departments such as in Naas and Portiuncula where ten or 11 patients on trolleys block up the corridors and the whole space in a way that would not be the same in a large emergency department with a lot of floor space. The point the Deputy made is valid in this regard.

The budget allocation for the hospital has increased to €85.6 million from less than €70 million five years ago. The outpatient department will be relocated to a new modular build on-site. That will allow the existing outpatient area to be converted into a 12-bed ward with eight single rooms and two twin rooms en suite. This area will accommodate service users requiring isolation rooms and end-of-life care. I am told that could be ready for occupancy later this year.

The Deputy will also be aware that enabling works have started on a new 50-bed ward block. This will provide 50 en suite single rooms allowing for the relocation of two medical wards from existing buildings and general improvement in the services to patients. We believe that could be open next year. Saolta University Health Care Group has also advised us the ward block could accommodate additional development, and enabling works have been completed with that in mind.

What we need to see is pressure taken off the emergency department and we need that modular building. I am asking the Taoiseach for his intervention on this. He is correct that the second modular building at the hospital was to facilitate the relocation of the outpatient department and provide those ten additional single beds to replace some of the beds lost to Covid reconfiguration. This project was to be completed as part of the 2020-2021 winter initiative. These beds will not be available until this summer. As the Taoiseach said, a 50-bed ward block is being constructed at Portiuncula University Hospital. This is thanks to the intervention of the then Minister for Health, Deputy Harris, on my behalf. Sadly, these are only replacement beds. What we need to see at the hospital is more beds. Again at my instigation, provision has been made to facilitate a further 50-bed ward block at the hospital. I ask the Taoiseach that plans be expedited to proceed with this extension while the builders are on-site.

I thank the Deputy. As he knows, the Minister for Health is with us this afternoon and will certainly speak on it later. We will work together to do anything we can to speed up increasing capacity in Portiuncula University Hospital, which is all the more necessary since the reconfiguring of Roscommon University Hospital and given the fact that Galway University Hospital is so congested.

As I mentioned, the outpatient department is being relocated. This will provide a new 12-bed ward. Work is ongoing with the design team on a prefab extension to the emergency department to give it more space. We are awaiting an updated draft of the plan for the prefab so it can be expanded.

We mentioned the 50-bed block earlier. It will open next year. The development of a further 50-bed ward would involve significant reprovision and reconfiguration of the campus and, so far, no capital submission has been made on this. It is something we are open to.

The population of the region is only going to increase and get older, and it is unquestionable that we will need further capacity in addition to the 50-bed block that is being built now.

That concludes the first Leaders' Questions of 2023. Before proceeding to the Order of Business, I understand the Taoiseach has an announcement to make for the information of the House on the appointment of Ministers of State.