Mr. Paul Reid:

What has been put in place pre the winter plan is a €10 million additional injection across the system, of which the mid-west is part. This funding is, largely, funding directed by the Department and the HSE in terms of current expenditure, to try to address, pre the winter plan, some of the issues in terms of transitional care beds and to relieve pressure under the community support scheme, the nursing home support scheme and in respect of home help provision. There has been some improvement in the last few weeks in terms of delayed discharges, which we would expect, in turn, to impact on trolley numbers.

I want to assure members that in terms of delivery all of these matters are urgent and a matter of priority everyday for our managers. In terms of trolley count, including in the mid-west, over a three week period in September there was an increase of approximately 6.5% in people into our emergency departments, which is very significant. I visited University Hospital Limerick and many of the acute hospitals throughout the country. What we are seeing, particularly in the past few weeks, is an additional requirement for older persons coming through our emergency departments. As members will be aware, in our acute settings the rate of admission generally is one in four or 25%. In the case of older persons, it is one in two. As I said, we are seeing a significant surge of older persons into emergency departments and, thus, a significant increase in terms of admissions. The additional investment made ahead of the winter plan will have some benefit over the next few weeks as well as it starts to work back through the system.

On recruitment, in the period from July 2018 to July 2019 we recruited 2,895 staff. Since the start of January this year, 1,138 staff were recruited into the health system. The latter is a mix of nursing, midwifery, consultants, management and administrative staff. On management and administrative staff recruitment, which I have examined in detail, 85% of these staff are front-line support staff. We do have an issue and we will be reviewing the centre of the HSE in terms of management overhead. However, I would like to reassure members that much of the recruitment is primarily targeted towards front-line services.