Mr. Damien McCallion:

I will make a couple of points. While the private sector has small departments it calls emergency departments, these are not comparable. If you have a real emergency, it is a question of using the public system. Sometimes, the private sector offers local injury units or other facilities. It is more about how we get it resolved for ourselves. None of us wants people to have to wait for as long as they do. At national level, we track what is called the patient experience time, be it six, nine, 12 or 24 hours, and we also focus on the over-75s because they comprise a particularly vulnerable group. We consider the data by hospital.

I visit emergency departments regularly. More important, however, we have a team that examines those sites that are under pressure to understand what can be done to help them and learn from where services may be working better. There is a major process around this. We recently launched what is called a patient flow academy, which is trying to share some of the lessons and insights on what works. No one who works in a hospital, or indeed a community service, wants patients to have to wait.

It is about trying to transfer the learning from places where things work well and apply it to the sites that are under the greatest pressure. The Deputy's point is well made. Locally, we are really pushing hard. The chief executives, clinical directors and directors of nursing are in the emergency departments every morning checking, managing and looking at the operations to see what can be done. Having sat in on some of the meetings they have to discuss flow within the hospitals, I know they are actively trying to manage every patient to keep the system moving and keep a good flow. That is essential. The reason people get delayed in emergency departments before admission is all to do with flow.