Ms Phil Ní Sheaghdha:

The staff increases, as my colleague from the IMO said, are largely reflected in the new services. There are many new services in which nurses and other healthcare professionals now work that were not there prior to Covid. The modest increase is staffing those services.

To answer the question in respect of acute-only hospitals, the TrolleyGAR, which is the HSE's trolley count figure, only reflects patients in EDs. Our count reflects and counts patients who are admitted on trolleys anywhere in the hospital. That is why the figure is usually higher. For example, today we have recorded over 500 patients on trolleys, 80 of whom are throughout the hospital in various units and corridors. The HSE does not count those whereas we do.

It is important to look at why theatre time is not provided, which was the question originally asked by the Deputy. That is usually because there is no bed available for the patient who requires a bed post surgery. Many patients return post procedure to a trolley in ED for emergencies. Surely that is not what we are advocating. We have surgeons who work in private and public hospitals so that goes back to the contract. I am not getting into that discussion but there are issues relating to public-only contracts and we support Sláintecare's position on that.

It is important if acute-only hospitals are concentrating on day cases that we state clearly that patients who require admission will have to be put in an ambulance and transferred to a hospital where they have an inpatient bed. If the day surgery hospital is the model and it closes at 5 o'clock on a Friday evening, there will be patients who will require care over the weekend in some instances. That again will put further pressure on the acute hospital. The model should be to provide inpatient beds on a 24-7 basis because that will reduce waiting lists and release the pressure on the acute emergency hospitals and the departments that are currently under such pressure.

In respect of bureaucracy, as we are saying, particularly in the reference to recruitment, it is so difficult to get through the red tape and recruit. Many hospitals still rely on agency staff because it is so difficult to replace staff and get through the bureaucracy that has become the machine of recruitment in the HSE in particular. The voluntary hospitals have a little bit more control. We need to get that cleared because if someone wants to work and is willing to come to work, bureaucratic obstacles should not be placed in his or her way. I hope I have answered the Deputy's question.