Mr. Tony O'Brien:

Senator Thomas Byrne asked when we would be reporting on MRI waiting times. The information will be available from quarter one of 2016. It will be included in the performance reports relating to that period.

Deputy Ciara Conway made a number of important points about how accident and emergency pressures and other pressures are affecting the system. The relationship is the other way around from the one posited by the Deputy. It is the accident and emergency pressures that have had an adverse impact on the capacity of the system to provide a range of services. However, with regard to gastrointestinal endoscopy, as of 27 August, 16,311 people were awaiting routine scopes. Some 50% of them were waiting for no more than three months at that stage. The HSE has identified a requirement for a strict application of standardised referral criteria in addition to a review of demand capacity and a clinical review of need. With regard to urgent colonoscopies, there is a four-week access target, and a policy of zero tolerance applies to any breaches. There were some breaches in the earlier part of this year. The accountability framework has been successfully deployed to address those. While the pressures are significant and are continuing, and while it is true that the 8 a.m. trolley figures in July were of concern and remain so, there has been an increase in some other activity in acute hospitals. For example, the combined inpatient and day-case discharges for the period between January and August show an increase of 0.3% over the same period in the previous year. One thousand and ninety-three additional people have been provided with inpatient procedures, and 56,138 more people have been assessed by outpatient services than were planned to be assessed by this point, or by the end of 2015. None of that takes away from the centrality of the Deputy's point. The reason we are engaged in the process in which we are now engaged regarding emergency departments and all the contributing factors is that all the measures taken before, while they had an individual impact, did not have the collective impact we would have hoped for or expected in terms of emergency department trolley pressures. That is why we are stepping up a level at this stage.