Mr. Tony O'Brien:

The Deputy is correct. There is significant room for improvement in the performance of emergency departments. The targets are set based on where, from a quality point of view, we need to get to. It would be wrong to set a target which, if achieved, would not get one to where one needs to be. Based on experience in other countries and what the evidence shows us, in terms of what would be a good-appropriate experience, in an ideal world we would be moving towards a target of 100% within six hours. For example, up until recently in the United Kingdom there was a four hour target.

What we have seen is the impact of the targets, including the intermediate targets for trolley numbers and so on three times a day. The work of the special delivery unit has been to bring a slightly different focus to the urgency attached to improving patient experience time in emergency departments. While these targets have not been met throughout the year, there was a significant improvement in terms of the number of patients recorded on trolleys and so on. In recent weeks, owing to the matters we discussed earlier, the situation has disimproved and we have had to take particular actions to try to improve it. Nonetheless, it remains appropriate to set as a target what would in truth be the acceptable level of performance and seek to move incrementally towards it. Clearly, 67.5% is not an acceptable outcome. What it tends to hide is the extent to which there have been improvements in processes and flows in individual emergency departments.