Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I looked into what it appears to be doing differently. What it appears to be doing differently is its admission from emergency department to the ward is substantially lower than the national average. That may be because it is case mix adjusted but it appears to have figured out in a focused manner the people who really do need to be admitted and those who can be sent home or back to community-based care and that puts less strain on the system.

One of the other things the group tells me it is doing is pushing the approach that when a patient is discharged, he or she is discharged to a care package in order that the patient does not arrive back with pneumonia again, for example, in the emergency department three weeks later and off we go again. In doing that, it is taking the strain off the system. It is interesting in that I have spoken to some of the clinicians working in some of the RCSI hospitals and some of them are telling a different story. They are saying that things have got a lot better around here; things have got a lot calmer, that they have more capacity, and they are being facilitated in working as doctors and nurses because of these things that have happened.

I do not know what the answer is. I am asking the question because obviously this is Dr. Gilligan's life, but there is an argument when one looks at the figures and when one looks at what the RCSI hospital group has done and how it has done it that says perhaps the solution is not 1,400 or 1,500 new beds, perhaps it is really good admittance practice from emergency departments and more beds in emergency departments. There are obviously choke points such as resuscitation beds or intensive care unit, ICU, beds in terms of patient flow where that is a clear blockage. More home care packages are also required. What is Dr. Gilligan's sense on that? Since I have come into this brief what I hear all the time is that we need more beds. I am not talking about for population growth. That is taken as a given that we do for the future but I have heard two different views from clinicians and managers. Some say we need more beds and others say we may not need more beds, we may need to provide very targeted emergency department beds, ICU beds and resuscitation beds, admissions practices and step-down beds or home care packages. What is Dr. Gilligan's sense on that?