Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

May I just answer that in part? There was money in the last budget but the Supplementary Estimate figure for the period to date this year is approximately €84 million. It would be incorrect to characterise that as all having gone towards dealing with emergency department overcrowding. The largest proportion of the funding was for the fair deal scheme. Most of the people who benefited from that went from their home into a nursing home. That was good because, had they not gone to a nursing home, they could have ended up in a hospital before going to a nursing home. It would not be correct to characterise the expenditure as having been entirely devoted to this particular issue.

Emergency department overcrowding is different in every emergency department, but it is predominantly caused by factors that are not actually in the emergency department. In some hospitals, it is evident that there just are not enough beds. That is probably not true in most hospitals. In some, the problem is associated with the average length of stay. There are various factors. One can even find that when additional beds are provided in a hospital, that hospital, having been relieved by the additional beds, slows down a bit and the patients that were staying for four days end up staying for five. That is what eats up all the additional beds, leaving one back where one started. It is almost like one of those machines with 11 or 12 different dials that almost all need to be in the right place. It is extremely difficult. At least with surgical waiting lists, one can sign a cheque, if needs be, and have the operations done. With the emergency departments, there are so many different moving parts and they are all different in different places, making it very difficult.

We should acknowledge a point I have not had a chance to make to the media, but I will make it if I get a chance. If one compares the nurses' figures for this month with those of last month, one notes there are actually improvers.

St. James's is one example of where, in conjunction with the fair deal scheme, the hospital was able to reduce the number of late discharges and then use the additional capacity to ensure things ticked over. Connolly Hospital Blanchardstown was also able to reduce the number of late discharges for similar reasons. The Midland Regional Hospital at Tullamore, even though it can be very overcrowded, is substantially less so than this time last year. Even though the situation is worse nationally, some hospitals have shown significant improvement but other hospitals, where there were never trolleys, have become unbelievably worse. That is what makes it so difficult.