Séamus Healy (Tipperary South, Workers and Unemployed Action Group) | Oireachtas source

I welcome the HSE officials and thank Mr. O'Brien for his presentation. There are chronic circumstances in emergency departments that date back a long time, certainly to when the former Minister for Health and Children, Ms Mary Harney, announced an emergency in the early 2000s. While there have been peaks and valleys since, the situation has effectively been chronic since that period and one wonders when and if it will be resolved. There were 18 patients on trolleys in South Tipperary General Hospital this morning, three of whom had been on trolleys for over 24 hours. That is not unusual in the hospital or in others across the country.

Surely at this stage, we need to accept that a significant number of acute and step-down beds need to be put into the system if we are to attempt to solve the problem. This must be done, together with various community-based initiatives. I welcome the community intervention teams. Specific initiatives that are required involve the reinstatement in the system of home help hours which have been cut in recent years. Where exactly will the 440 additional beds be provided? In what parts in the country are the community intervention teams to be provided? The teams were announced in Tipperary last year, but they have not arrived. Will they be in the system this year?

There was also a proposal last year, which I note was supported by local and regional management, for a 12-bed step-down facility in south Tipperary. I wonder where that proposal currently stands.

I have two general questions on attendances at emergency departments. One concerns the possibility of direct admissions. A considerable number of patients attend emergency departments who have previously been in hospital not just once but on a number of occasions. They are referred by their GP to the hospital. Such patients are chronically ill, require admission and are going to be admitted even if it does take 24 hours. Has the emergency department team examined the possibility of allowing direct admissions so that patients do not have to go through the emergency department? There is also the question of elderly patients, which crosses over with the issue of direct admissions. How can we deal with very elderly patients to ensure they are not on trolleys for 24 hours? Even being on a trolley for six or nine hours is not acceptable for very elderly patients.