Bernard Durkan (Kildare North, Fine Gael) | Oireachtas source

My apologies for being late, which was caused by multiple issues. I welcome the Minister of State and his officials. On the income shortfall, while I understand the unpredictability of income, it is possible to identify issues based on trends over the past four or five years. To what extent has this been done? Are the same issues arising repeatedly? If so, how are they to be addressed because they are creating unease within the system, particularly for patients who need to access the system?

The issue of public hospitals versus private hospitals and the insurance shift was mentioned. Perhaps the Minister of State would elaborate on that issue. It was mentioned that a public hospital receives a fee of €80 per night up to a maximum of €800 but this can drag on and become a larger amount. While this can alleviate the burden on the private sector, it means the public sector is effectively subsidising the private wards. I have no ideological views on this issue but if it is creating a problem in the funding for the public hospitals, then we need to examine it. Now is as good a time as any to deal with this matter once and for all.

On the winter plan, much of what has been said today has been said before. Every winter will test our resources. I agree with the Minister of State's remark that the trolley count is becoming misleading and that the length of time one spends on a trolley is the critical issue. It is better if everybody gets a trolley when they enter the accident and emergency department rather than being left in ambulances or at the doors of the hospitals. The critical issue is the speed at which the patient is dealt with thereafter. This is what we should be seeking to identify in future counts. In the past, elderly people were left on trolleys for lengthy periods, which can cause considerable distress.

Perhaps the Minister of State will give us some idea of the extent to which we are keeping a tab on developments in that situation.

I may ask a further question in a minute. I must get my functions together first.