Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)

The Senator will be aware that I set the policy direction and the HSE CEO is responsible for the management and accountability. It is fair to say that Mr. Gloster and I have had a shared focus on increasing productivity, in particular emergency care presentations and the management of those. Part of it is that the symposium, conference or whatever we call it on 11 September had an important element about real visibility among peers, including clinical directors from the regions, regional executive officers and hospital managers, to give everybody a positive opportunity to showcase the steps that they had taken, enabled by the POCC, five over seven and Mr. Gloster's direction that they would implement Saturday clinics and evening clinics, and have at least one example of that by the time they came to meet me in September.

That was an interesting conference because it was one of the first times that group of people had come together. They saw examples both from model 3 and model 4 hospitals of things that were exciting and different, like the Naas toolkit or the Mercy hospital toolkit. They are queueing up to get that outpatient toolkit. That was an additional 5,000 appointments in Naas through different outpatient department management. They were also able to see one another's challenges. It was also clear to see on that day that different approaches were being taken to the implementation of the POCC and Saturday working. We see those different approaches in our Saturday and Monday discharge figures. To be fair, a couple of different things are happening. I will bring them back on an individual basis in January and we will bring the group back together in April. That gives a continual peer visibility mechanism of accountability, which is as important as any other mechanism of accountability.

It is fair to say that I have written directly to Mr. Gloster regarding my deep concerns about the west and north west and the hospital-specific and regional issues that persist there. I have written a similar letter about St. Vincent's hospital on the east coast and will shortly write a similar letter about the south west, where there are not, in any of those cases, any regional or demographic explanatory factors for why hospital trolleys are so much worse at the weekend and there has been such comparative slowness to implement the reforms that we have insisted on. I might ask Mr. Gloster to speak on that.