Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I welcome Mr. O'Brien and his colleagues. On the first page of Mr. O'Brien's presentation, there is a reference to the fact that there were almost 900,000 new patient attendances in the year to October 2015. It is stated 83% of patients are seen and either discharged or admitted in nine hours or less. The reference to the period of nine hours arises later in the document, on page 4, where Mr. O'Brien states efforts are focused on new procedures and processes to prevent patients from waiting any longer than nine hours for a bed following a decision to admit them. The period of nine hours arises in two sets of circumstances, but the reality is that the period is much longer. Mr. O'Brien talks about patients waiting nine hours for a bed following a decision to admit them. I have been dealing with the case of a person very close and dear to me who had to wait overnight for 16 hours in an emergency room before being seen this morning for a decision to be made on discharge or admission. The decision to admit was taken 16 hours after the patient presented by ambulance yesterday evening. The period of nine hours follows a significant waiting period for a decision to be made on discharge or admission. The case I am citing is not unusual; all too sadly, it is the norm. If a patient must wait the full nine hours after a decision is made, he or she could be waiting for in excess of 24 hours in total, which is not acceptable. This is an inordinate period for patients to have to wait. That 83% of patients are either discharged or admitted within nine hours still means that 17% are not discharged or admitted within that period, as in the case I have just cited. While I appreciate and acknowledge that significant efforts are being made, it is important that we recognise much more needs to be done to arrive at the necessary level of care.

Mr. O'Brien cited figures for the trolley count. Yesterday the number was 405. It has exceeded 400 again, having been relatively consistent between 300 and 400, yet we are not in the worst of weather conditions. We are experiencing mild weather; yesterday was a very mild day, as is today. The number on trolleys increased to 405 yesterday morning. I have not been able to check the figure for today. What is happening rings an alarm bell in that we are looking at the graph rising again. If the weather disimproves, it is likely that the number will increase further.

Will Mr. O'Brien confirm that the emergency department task force is temporary? If so, has the HSE considered its establishment on a permanent basis? I am not suggesting the reason for my proposal is we do not expect matters to improve.

I have covered the waiting period of nine hours following a decision to admit a patient. The opening hours of radiology departments, from 8 a.m. to 8 p.m., are without doubt very important. Will Mr. O'Brien confirm that these opening hours will apply seven days a week? Is that possible? Are the opening hours mentioned just for five days a week? Are the departments moving to opening for 12 hours straight, from 8 a.m. to 8 p.m., seven days a week? Would this apply across the board in the acute hospital network?

I welcome the inclusion of, and the reference to, the GP out-of-hours service. However, Mr. O'Brien has stated further development and expansion are required to provide complete cover nationwide. I know from the north-eastern experience that it has been very difficult to secure the participation of general practitioners and sustain the service. What particular investments is the HSE proposing to ensure a sustainable service across the board that can be developed and expanded? It was very clear on a number of occasions that the great difficulty concerned sustaining the service and access, even at the level initially envisaged.

On the 30-day moving average, why is St. Vincent's University Hospital - I do not want to invite a particular focus on it - absolutely against the trend for the eight focus sites, as mentioned on the final page of the presentation?