Dr. Colm Henry:

On the logjams, you need to look at the profile of our population and how it is expanding. It is clear that people with chronic disease and those who are ageing, as well as how we improve their experience and access to healthcare, represent the greatest challenge for our healthcare system. Reference was made to long waits of more than 24 hours in our emergency departments. A substantial proportion of the approximately 67,000 people who waited more than 24 hours were over 75 years of age. Much of the work being done in the service plan, and what we are trying to link up, is on broadening points of access, particularly for older people and those with chronic diseases so they do not have to access emergency departments. We are attempting to capture them earlier in their illness journey, so we can make interventions in the community before they become ill enough to need to attend an emergency department.

That said, when we look at the profile of older people, the proportion of over 65s is expected to double by 2041. People will still come to emergency departments. People with chronic disease will still come, as will people who are ageing. We need to have a more adaptive response than the one we are providing now. The single biggest logjam or challenge is how we deal with the challenge of this generation. Fortunately, it has a higher life expectancy than any country in Europe but they do not always survive that long in good health.