Mr. Stephen Mulvany:

I have a couple of points to make. First, the hospital system is a 24-7 system. It works seven days of the week. The issue is that it does most of its diagnostic and discharge-related work Monday to Friday. It is not built to do other than emergency work at the weekend. Our senior decision makers and other staff are in hospitals at weekends and have been before we made any change. Typically, however, the focus of consulting staff is on the unwell patients, keeping an eye on them and making sure there are no difficulties with them, and less so on discharge. In fairness to consultants, discharge, particularly any complex type of discharge, is not just about the consultant making a decision. It may be that a scan is required or some capacity in the community needs to be assessed, etc.

Yes, we have senior decision makers onsite at the weekend. Yes, we now have more of them and more of other staff, both in hospitals and in the community, at the weekend. It is too early to say what the impact of that has been. This measure was part of the overall steps that made an impact. Our key issue will be to determine which of the various actions, including that extra weekend working, made the biggest impact and which of them should be sustained. Most of them will have to be stood down for a period and we will have to make a change, including investing in more staff or whatever it is, if there are some elements of the changes that were both impactful and make sense in the longer term. It is not as simple as saying the impact was because there were a few more doctors around. Doctors are often in hospitals, and certainly are on call, over weekends.