Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

First, the 60-bed unit was critical but not enough. That is part of the issue. We launched an ambitious winter plan last year. There was only around a 12% reduction in attendances, but there was a 60% reduction in the number of those on trolleys. The trolley numbers were the lowest since the records were first collected, I believe, in 2013. Therefore, it worked well. There were some things going in our favour, such as the absence of seasonal flu, but we had other things going against us such as the global pandemic.

The reason it worked was we implemented solutions for the whole patient flow. First, we kept people out of the emergency department wherever possible. Second, if they did need to come to emergency departments, they were streamed into minor injuries, medical assessment or surgical assessment units or what we would all understand as the normal emergency department. Third, if they could be discharged quickly and supported at home, we did that; and, fourth, if they did need to be admitted, for example, to be stabilised for 24 hours, we ensured a home care package was available to get them out of the hospital and supported at home as quickly as possible. This approach worked. We are looking at a similar approach this year.

The good news is that last year's plan was a €600 million winter plan and we locked the vast majority money into the base. The staff, home care hours, diagnostics and beds that we added for the winter plan are still there for this winter. That said, I share the Senator's concerns, because this is going to be a tough winter.