University Hospital Limerick (UHL) has emerged as the country’s worst performing hospital in a stark new study that lays bare the disparity of resources in the country’s biggest hospitals.
And the patient advocacy group behind the analysis of existing Health Service Executive data warned trolley numbers at UHL are set to ‘skyrocket’ before a proposed new hospital is built on the site.
The study of the country’s nine Model 4 hospitals – which provide 24/7 emergency care, critical care, highly specialised services, and serve a large region – was carried out by the Friend of Ennis Hospital (FEH) advocacy group.
UHL, the only Model 4 hospital in the Mid-West – where 16-year-old Aoife Johnson died in 2022 after waiting over 12 hours to be treated for sepsis – finished last in most metrics included in the analysis.
The hospital had the highest number of emergency department (ED) attendances and admissions last year, with 94,590 and 29,526 patients respectively.
But it had by far the fewest number of consultants per admitted patients.
UHL had 204 patients admitted for every one consultant, while the next highest, Tallaght University Hospital (TUH), had 96.
FEH chair, Anglela Coll, who led the analysis, told the Irish Mail on Sunday: ‘If you’re sick, you’re far better off in Dublin than if you were outside of the Pale.’
Her analysis shows St James’s Hospital and Beaumont Hospital in the capital are ranked one and two respectively when all the metrics are aggregated.
St Vincent’s University Hospital (SVUH) in south-east Dublin ranked eighth overall. Scroll down for the full table including how each hospital was graded across 19 key metrics
FEH chair, Anglela Coll, who led the analysis, told the Irish Mail on Sunday: ‘If you’re sick, you’re far better off in Dublin than if you were outside of the Pale’
FEH received assurances from Health Minister Jennifer Carroll MacNeill that a development board would be set up by the Dáil summer recess next month
These had 63 and 68 admitted patients per consultant, respectively.
But not every Dublin hospital scored as highly, with the Mater and Tallaght University Hospital ranking fifth and sixth out of nine Model 4 locations, while St Vincent’s University Hospital (SVUH) ranked eighth.
University Hospital Galway (UHG) and Cork University Hospital (CUH) ranked third and fourth respectively in the analysis.
They had 72 and 89 admitted patients per consultant respectively.
But UHL – which serves more than 400,000 people across counties Clare, Limerick, and North Tipperary – came dead last in 11 of 19 metrics compared, and second last in two more.
This is despite a 42 per cent increase in staffing levels since December 2020, according to figures provided by the Department of Health.
Ireland’s 9 Model 4 hospitals league table – Part One: How each institution ranked on the first of seven 19 key metrics used, beginning with ‘ED attendances’ and ending with ‘Attendances per Bed’. *WTE = Full time equivalent . Grading within each table ranges from worst performing (9) to best performing (1).
Ireland’s 9 Model 4 hospitals league table – Part Two: How each performed in the second set of key metrics, from ‘Admissions per Bed’ to ‘Admissions per NCHD’ (*Non-Consultant Hospital Doctor). Grading within each table ranges from worst performing (9) to best performing (1).
Ireland’s 9 Model 4 hospitals league table – Part Three: Grading the final five of 19 key metrics, beginning with ‘Filled Consultants per 100 beds’, and ending with ‘Consultant Vacancy Rates’. Grading within each table ranges from worst performing (9) to best performing (1).
The Government purchased a site for the construction of a new hospital in Raheen, Limerick, earlier this year, but a development board has yet to be established.
FEH received assurances from Health Minister Jennifer Carroll MacNeill that a development board would be set up by the Dáil summer recess next month.
The department this weekend said that the Minister is currently ‘working to establish a project board to develop a comprehensive strategic plan for the organisation of services and investment in the Mid-West to ensure a sustainable, region‑wide model of care’.
Ms Coll, an accountant who has been analysing HSE data since Ennis Hospital lost its emergency department in 2009, told the MoS: ‘They’re putting investment into Cork. They’re building this new hospital in Galway.
‘We have a site in Raheen, and literally you might as well have cows sitting in the fields because they’re doing nothing with it.
‘There is no hospital development board set up. There’s no planning submissions. There’s nothing happening with that site.’
UHL is set to get 96 new beds by 2029 in a separate extension of the existing hospital, while another 96 were opened last year on the campus.
But Ms Coll said: ‘We’re now in 2026, so the trolley numbers are going to skyrocket over the next three years [before the new beds come on stream].’
The 96 beds added last year were expected to be ‘a magic solution’, Ms Coll added, but trolley numbers in Limerick are still by far the highest in the country.
The HSE’s latest urgent and emergency care report, for the week ending 31 May, shows UHL’s year-to-date 8am average trolley count is 47.
The hospital with the second and third highest counts are Cork with 30 and St Vincents with 27.
The data shows the new beds in UHL have had some impact – the average daily trolley count is down six from the same period last year.
Extra beds do not necessarily translate into a major drop in trolley numbers as, depending on the age profile of patients being admitted to hospital, their average length of stay can vary significantly.
After the Mid-West, FEH predicts the South West will be ‘under the most pressure for acute beds in the next five to 10 years’.
Ms Coll noted: ‘From looking at population projections, looking at admissions, looking at population profiles, the Mid West is obviously the worst at the moment. But the South West, which is Cork and Kerry, is the next worst region in terms of need of investment.’
Stephen McMahon, who is co-founder and director of the Irish Patients’ Association (IPA), called the FEH analysis ‘a useful contribution from a patient perspective’ and said it ‘should be taken seriously’.
Mr McMahon told the MoS: ‘It brings together indicators that point in the same direction as official reviews, including HIQA’s work on urgent and emergency care in the Mid-West.’
But he added the caveat that policy makers should ‘interpret the precise scoring [of the FEH analysis] with care, because hospital comparisons involve complex issues of demand, capacity, staffing, patient flow and case mix’.
The patient advocate said: ‘Some indicators are closely related so the final ranking should not be treated as a definitive technical league table.
‘Its real value is that it highlights a clear and recurring pattern of pressure that requires urgent action.’
He added: ‘What is clear, however, is that patients in the Mid-West have experienced sustained pressure at UHL for years.
‘Emergency demand must be matched by safe bed capacity, consultant capacity, staffing, and timely patient flow.
UHL is set to get 96 new beds by 2029 in a separate extension of the existing hospital, while another 96 were opened last year on the campus
Beaumont Hospital in north Dublin
The Mater Hospital in north inner city Dublin ranked fifth out of nine Model 4 locations
‘The issue now is not simply the ranking of hospitals on a spreadsheet, but whether the Government and the HSE move quickly enough to turn acknowledged risk into safe, practical capacity for patients.’
The Department of Health said that Minister Carroll MacNeill received Government support last December to ‘progress with a blend’ of options proposed by health watchdog HIQA ‘to the challenges in the Mid-West’.
This includes 114 new beds across Ennis, St John’s and Nenagh Model 2 Hospitals, by 2031.
A spokesman said Minister Carroll MacNeill ‘has already asked the HSE to strategically assess the improvement and expansion of local services at Nenagh and Ennis Model 2 hospitals’.
He added: ‘This will enable patients to access some treatments and services closer to home where it is safe and appropriate to do so.
‘The Minister remains focused on ensuring that the recommendations arising from HIQA’s assessment are implemented in a timely and coordinated manner, and that people in the Mid-West have access to safe, high‑quality, and reliable care.’
