Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

I will read to the committee from an e-mail I received some days ago on foot of the debate about overcrowding in our accident and emergency departments. It states:

My 76-year-old father was sent by our GP to an accident and emergency department in St. Vincent's Hospital on New Year's Eve. He spent over 50 hours there on a trolley and we had to supply him with pillows and blankets. He did not receive any hot food for the period endured. There was bread and yoghurt for breakfast, a sandwich for lunch and another sandwich for tea every day. Try to survive on that when you are well. I sat on the floor by his trolley. Barely able to breathe, he had to queue for the one available toilet and there were no washing facilities or privacy. There were insufficient numbers of doctors and nurses as we continue to export our expensively trained Irish doctors and nurses to Australia. Meanwhile, seriously ill people are scattered all over our inadequate emergency departments.

The e-mail also highlights difficulties with parking, etc., but this is an indication of what is happening with our accident and emergency departments. I should not need to tell Mr. O'Brien and the Minister about that, but I must reiterate it because that is unacceptable. The accident and emergency task force is to deal with a potential impending crisis but, in effect, we knew for some time that this would happen. The Minister was informed there would be difficulties when he took up his post and he was forewarned about this in November. He was notified of cuts to the fair deal scheme and the difficulties in moving people from the acute hospital setting to step-down facilities, residential care and home care packages. It is not Fianna Fáil, me as Deputy Kelleher or any other Member that gave such a warning; it came from the HSE in its request for over €100 million to deal with the delayed discharge element in our hospitals. It is a critical matter. We have spoken about other issues to be addressed, but the fundamental problem is that 650 to 800 people in our hospitals should not be there and do not want to be there. They should be somewhere else. If it is beyond our capability to shift people from an inappropriate setting to something more appropriate that will benefit them and others, I fear the worst.

I assume the task force relates to accident and emergency departments rather than being an "emergency" task force; if it is an emergency task force, it has not been very energetic in its responses. I do not mean to criticise individuals but I would like to know how often it met to deal with the evident difficulties. Had it planned to meet early in January? Did it meet when we hit the magic number of 601 people on trolleys in accident and emergency departments?

I listened to a long lecture last night from the Minister, which was fine as we were in a political forum in the Dáil Chamber. We have now come to almost accept that 200 or 300 people lying around these departments is okay, but it is not. Nobody should be lying around on trolleys and 76-year-old men should not be looking for sandwiches for sustenance. That is not okay at all. The number is one element, and as this went over the magic figure of 600 people have become outraged, leading to a response. The response did not happen in December, when the event was being planned for; if we are honest, we know the response came after 601 people arrived in the accident and emergency departments. It came on foot of headlines, and that is why numbers have decreased today. As sure as night follows day, if 601 people were not in those hospital departments, we would not be having this discussion. We would plod along if it was only the usual 300 or 400 people on trolleys. There was no planned response whatever and instead there was an emergency action to try to reduce numbers. Nevertheless, that demonstrates that when commitment, effort and minds come together, the number can be reduced without a problem. If it is easy to get it down now, why could it not have been reduced three, four or six weeks ago?

Our level of acceptance of appalling standards for the sickest people is a problem. We do not mind the worried people who are well waiting around, but the people who present at our accident and emergency departments, by and large, are not there for the craic. They are certainly not there for food. They have been sent or referred to the hospital because they are sick and need attention. There are inappropriate and unacceptable standards now built into the system as the norm, but they are far from normal. I am not trying to absolve the role of my political party over the years; there is almost a societal acceptance in this regard. People are almost expected to lie on a trolley in an accident and emergency department for two or three days. That is completely unacceptable.

It comes down to resourcing and priorities. It is wrong to have 700 or 800 people in our hospitals who should not be there. It makes no economic sense. Some hospitals do not want sick patients when budgets run out, as sick patients cost money. If hospitals come under pressure and their budgets are stopped, they cannot carry out procedures but they may keep beds full anyway. This relates to the transfer policy for the fair deal nursing home scheme.

We know what the problem is: we cannot get people who should not be in hospitals out of them. These people should be in step-down facilities, but there is a level of acceptance that 300 or 400 people will at any time be in accident and emergency departments. This is where people must scrounge for pillows and a 76-year-old man must queue outside a single toilet in the morning hours. His daughter had to lie on a corridor next to him for 50 hours.

Then there is a response when there are 601 people waiting. I assure Mr. O'Brien, the Minister, the committee and everybody else that if there were 547 or 552, there would not have been the same outrage. However, when the number went over 600, suddenly people accepted that it is a major problem. Whether it was 601 or 301 on Monday week last, it was still a problem for every person who was lying on a trolley and for those who were trying to provide them with care.

I do not want to be pointing fingers at any individual. This has been going on for years. The Minister came in and lectured me last night for the first ten minutes of his speech about the historical aspect of it, but the norm now is 300 or 400, where we all are happy. However, the number hit 601 and then the system clicked into gear. My point is that, when it clicks into gear, the Minister can come in here and tell me that we have made significant progress. Why could we not do that in November last when we all knew about it? Why could we not do it the previous year, the three previous years, the previous 15 years? Is it beyond our capability to deal with this in a planned, sustained manner and accept that it is an issue of resourcing as well?