Mr. Kevin Figgis:

I thank the Deputy for the question. I am responsible for nursing and midwifery staff but also the health and social care profession, including radiographers and radiation therapists. A number of these would have a role within this.

We described the emergency departments as the bottleneck of the health service. There is a bottleneck because there is so much on one side and such a little gap on the other. Filtering is also an issue. Clearly, the staff working in this area are working under major pressure. They are doing so all the time. Part of the difficulty is with getting the necessary resources and services to assist. It is really about being able to look after patients to "get them moved on" within the system, such that they are either being admitted or discharged. We all hear about the long delays faced by patients in being seen and in waiting for a bed. Many of these factors feed into one another.

We mentioned the difficulty in regard to general practitioner access. In this regard, we have mentioned the difficulty concerning diagnostics. Many people talk about accessing diagnostics. They do not talk about anything else in this regard other than the need to access diagnostics, as if it were just a matter of a button that just has not been pressed and as if it were easy to do so. The reality is that the services are under major pressure. We have given examples in our paper showing that the reality is that most diagnostics departments have not had a review of their staffing levels, possibly for decades. When people talk about the fact that the departments are fully staffed, they should note that they were possibly fully staffed when they were last examined, in the 1990s, but that does not mean they are fully staffed now. In addition, staff are trying to use equipment that is well beyond its sell-by date. Moreover, funding cannot be obtained for staffing. I recently dealt with a case in which people wanted to know why certain equipment was not being used. The equipment was funded but there was no funding for somebody to use it.

The difficulty faced by the nurses, doctors and support staff working in an emergency department is that they need to be able to work with and integrate with the other grades of staff in order to make the decisions ultimately necessary to determine the pathway for the patient. The problem in the emergency departments is that these difficulties extend well beyond their corridors, although it is clear that safe staffing is an issue. It is a national disgrace considering the pictures of people sitting on chairs and the like.