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

As an aside, I have a question about an issue that is arising frequently. I mentioned demographics and the fact that we were all getting older. There is a further requirement for us to address the issues of nursing home support, geriatric teams in the community and retaining people in the home care setting. We conducted some research and I have now seen a great deal of evidence when it was just anecdotal until recently. Locum doctors or out-of-hours GPs are handling out-of-hours calls for many nursing homes. I am not saying it is happening in every case, but there is a high tendency for the elderly person to be referred to an emergency department. Can we be imaginative in any way in addressing this issue? When one speaks to the consultant in the hospital, he or she says the person should not have been there and that he or she needed to be on IV drip and antibiotics and should have been retained where he or she had been. There seems to be a lack of capacity in the out-of-hours service. It is fine when the GP calling knows the patient in the nursing home, but is there any way for us to be more imaginative in dealing with this issue? Being moved from a nursing home to an emergency department where there is a great deal of trundling, unnecessary agitation and so on, only to be kept for a number of days to receive low-level treatment before being sent back, places a major burden on the patient which is causing difficulties. Hospital managements state it is a significant issue. I do not know whether it is a significant issue in the delegates' areas, but if an area contains a large number of patients in nursing homes, there must be something more than an out-of-hours service.