The Reality of Healthcare at UHL
University Hospital Limerick (UHL) has become a focal point in Ireland’s healthcare discourse, and not for the reasons anyone would hope for. Recent investigations and reports have uncovered serious shortcomings in consultant rostering practices and overcrowding in emergency departments (ED), particularly during weekends. The implications are grave, including jeopardised patient safety, allegations of medical negligence, and a growing erosion of public trust in the healthcare system.
This blog dives into the root of the consultant rostering crisis at UHL, its broader implications for Irish healthcare, and actionable recommendations to address these challenges.
Understanding the Crisis at UHL
Deficient Weekend Consultant Coverage
One of UHL’s biggest failings is its insufficient consultant coverage during weekends. A letter obtained under Freedom of Information laws from Robert Watt, the Department of Health’s secretary-general, brings this issue into stark focus. At present, an ED consultant is typically tasked with covering an entire 48-hour weekend shift, with minimal support.
This level of understaffing directly contravenes earlier recommendations from the Frank Clarke Report in 2022. The report highlighted that staff shortages contributed to avoidable tragedies such as the death of 16-year-old Aoife Johnston. The repercussions of such inadequate rostering extend well beyond delays in care—they result in entirely preventable medical outcomes that devastate patients and their families.
Persistent Overcrowding in Emergency Departments
Adding to the crisis is the alarming rate of overcrowding in UHL’s ED, which treated a record-breaking 23,203 patients on trolleys in 2024 alone. Patients are often forced to endure hours, if not days, of waiting before receiving the care they urgently need. UHL now leads the country in trolley counts, a worrying trend mirrored at other hospitals such as Cork University Hospital and University Hospital Galway.
These conditions are unsustainable and unsafe. Delayed treatment in overcrowded wards exacerbates illnesses and contributes to higher mortality rates, as demonstrated by the 239 patients who tragically died on trolleys at UHL between 2019 and 2023.
What This Means for Patients and the Healthcare System
Increased Risk to Patients
Failures in consultant rostering and overcrowded EDs significantly heighten the risk of adverse outcomes. The delayed treatment from understaffed units often results in complications, prolonged hospital stays, or worse. Tragically, cases like that of Aoife Johnston represent just the tip of the iceberg.
Decline in Public Confidence
The repeated reports of substandard care have shaken public trust in UHL and, by extension, the wider Irish healthcare system. For the public to regain confidence, hospitals must demonstrate that they can provide timely, high-quality care—not just during the working week, but on weekends too.
The Broader Picture Across Ireland
Ireland’s Trolley Crisis
The issues at UHL are hardly isolated. According to TrolleyWatch, 122,186 patients were treated on hospital trolleys nationwide in 2024, 2,000 of whom were children. This systemic overcrowding places an enormous strain not only on patients but also on healthcare staff, who work under relentless pressure.
Staffing Challenges
The root cause of these issues lies in chronic understaffing. Although Ireland’s Health Service Executive (HSE) has made moves to incentivise public-only consultant contracts, recruitment and retention remain significant hurdles. A HSE directive issued in 2025 proposed extended working hours for consultants and other healthcare professionals appointed since 2008, but unions argue that this ignores existing agreements and will create friction with staff.
Potential Reforms to Fix the System
Immediate Actions
To address the crisis at UHL and other hospitals nationwide, several immediate measures must be taken, including:
- Increasing Weekend Consultant Coverage: Sufficient consultant availability must be ensured during weekends to handle high patient volumes.
- Expanding Emergency Department Capacity: Additional ED facilities can alleviate overcrowding and reduce patient wait times.
- Implementing Training Programs: Frontline staff should be equipped with strategies to mitigate crises in high-pressure environments.
Long-Term Solutions
- Infrastructure Investment: Building additional emergency facilities and upgrading smaller regional hospitals—such as in Ennis—could ease the burden on major hubs like UHL.
- Recruitment and Retention Strategies: Offering competitive salaries, flexible schedules, and enhanced working conditions will attract and retain top healthcare talent.
- Data-Driven Decision-Making: Hospitals need robust metrics to monitor patient outcomes and adjust hospital protocols dynamically.
Legal and Ethical Accountability
The ongoing crisis also raises critical legal and ethical questions. Delayed treatment, overcrowded EDs, and poor staffing levels could constitute forms of medical negligence. Law firms specialising in medical negligence cases, such as HOMS Assist, highlight the growing need for affected patients to understand their rights and explore legal recourse when care standards fall below acceptable levels.
How You Can Help Advocate for Change
- Raise Awareness
Share articles, participate in discussions, and engage with policymakers. The more public attention the issue receives, the higher the chances of intervention and reform.
- Support Patient Advocacy
Donate to or volunteer with organisations focused on healthcare reform. They work tirelessly to ensure patients’ voices are heard at the governmental level.
- Understand Your Rights
If you or someone you know has experienced substandard care, consider seeking legal guidance to hold relevant institutions accountable. Trusted legal firms like HOMS Assist offer expert advice in navigating medical negligence claims.
A Healthier Future is Possible
The rostering crisis at University Hospital Limerick is a vivid reminder that systemic healthcare challenges cannot be ignored. Patient welfare and trust are at stake, and meaningful reform is desperately needed to fix overcrowding, understaffing, and operational inefficiencies—not just at UHL but across Ireland.
By taking both immediate actions and long-term measures, healthcare providers, policymakers, and advocates can work toward rebuilding a system that guarantees safe, timely, and equitable care for all.
If you or a loved one has been affected by medical negligence, HOMS Assist can guide you through your options. Contact us today for expert legal advice and compassionate support.
