Ms Angela Fitzgerald:

It is fair to say we do not have enough emergency department physicians. The point was made around 24-7 cover. We have 12 sites with fewer than two whole-time equivalent staff members and, as such, their capacity to provide out-of-hours cover is very compromised. In 2015, we put in five additional consultants. It was a very small number. We had hoped to do more of that this year but we are not in a position to do it. Alongside that, we have been trying to build capability around the acute medical assessment units in order that they can support emergency physicians. By any objective comparison, we do not have the numbers to provide 24-7 cover across the current number of emergency departments we have. Dr. Henry is involved in looking at the trauma review which will allow us to think about emergency networks. I am sure Dr. Emily O'Conor spoke a bit about that.

The way forward in organising and configuring services is probably hub centres supported by emergency centres providing some but not all of the services. In the short term the impact of austerity has hit us most significantly in consultant numbers. Mr. Woods mentioned the OECD's Health at a Glance report. We do quite well in comparisons on nursing numbers. Liam Doran would not be very happy with me for saying that. We do very badly in the comparisons on consultant numbers. There is work to be done. The establishment of the groups allows for more logical thinking on how to prioritise emergency physicians and this is the work we must do in 2017.

I will answer Deputy O'Reilly's question on nursing. There were several strands to her question but as part of the emergency department agreement we had with the INMO, there was recognition that at the time there were 144 vacant posts. We have a commitment and funding to put these in place. At our most recent review with the INMO, it emerged that between 80% and 90% of the posts were in place. As the Deputy quite rightly stated, the challenge is attracting people into an unattractive environment. There is a bit of chicken-and-egg situation. If we get the staff in, we will make it more attractive. The second piece is with regard to the norms we use.