Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

In any accident and emergency department in any hospital there will be staff working to the absolute top of their capability. People are giving way more than their contracted hours and going way beyond the call of duty. As well as looking at the successes - sometimes when we note the rate of increase has slowed, it is classed as a success - we have to look at what those hospitals that are struggling need because it is not for want of effort on the part of the staff who are working hard. As part of the review, the Minister cannot simply look at one hospital that is doing well or a group of hospitals that may be performing better. That is just one measurement. There could be other areas to be considered. The Minister will also have to look at the hospitals that are struggling and look at what specific supports they may need because they are operating in the same environment as the other hospitals and additional beds were not added. If it is not for want of effort on the part of the staff, and we can all agree that is the case, then we must look at what is working in one hospital and what is not working in another hospital and try to examine if the hospital needs support. Very often the supports may not be hugely expensive but they may make a big difference. In this regard I suggest that the Minister should talk to front-line staff. I know the Minister does, and I do not suggest he does not, but I urge him to listen to the suggestions of front-line staff. I welcome the winter initiative being a bottom-up rather than a top-down approach because very often the people who are on the front line have some of the answers and can provide a valuable resource if they have the headspace to think.