Mr. Bernard Gloster:

Yes. I believe I dealt with many of the comments in the past week with Deputy Durkan, but in answer to the question as to whether we are more prepared to respond more quickly to the challenge, the point I made to the Deputy in the past week was that we have 15 key people across the country who manage both acute hospitals and community services. From next week those 15 people will be in one place as part of the key decision-making processes of the HSE. They are in no doubt as to what is required. They are under pressure and there is no doubting that being the case also.

I completely agree with the Secretary General, where I made the point in the past week that we are long past the benefit of winter plans. We have to focus now on all-year round capacity. We have to balance the need to make changes, reform and progress, and to give time to that. We, however, have to respond to the needs of people today. That means there are certain things we may not be able to do that we would like to do, and we will have to concentrate on things like emergency department, ED, presentations and how we can avoid them; ED process flow and how people get in and out of the hospital system; and delayed transfers of care. If we did not have delayed transfers of care in Irish hospitals this morning, we would not have anybody on a trolley. That is as much a process issue as it is a resourcing one and there are two sides to that coin.

The focus, therefore, is very much on that and on the learning from the recent very extensive demands over the winter period. That learning is there and there is nothing new in it. To be clear, all that was known previously, but ED presentations are increasing. I will not go back over the analysis as to why that is as I am sure the Deputy has heard that many times. They are increasing and we have to accept the reality that they are increasing. We have to respond to them in a more consistent way than we have been doing previously, despite the fact that everybody is working exceptionally hard.