Dr. Peadar Gilligan:

I wish to respond to Senator Burke on the issue of additional staff within the system and his concern that we are not getting the right staff in the right places. That comes back to the recruitment and the retention challenges and whether people feel valued within the system. We have highlighted the fact that the disparity in pay at consultant level is one of the main blocks in this respect. The failure to honour the contracts of NCHDs is certainly a block to recruitment at that level, and the failure to reverse the FEMPI provisions and engage properly on the GP contract is the challenge to recruitment and retention of general practitioners in our health system.

I refer to the issue of security in the emergency setting and in the hospital setting in general. If we want our emergency departments to be safe, we should not overcrowd them. We should not have them running at 200% and 300% of their available clinical space, occupied by people who should be on wards. People coming to emergency departments are distressed by the conditions they are coming with. They are often anxious and upset. The last thing they want to experience is an even more stressful environment. As a nation, we have to get that right. If we can get that right, we will make the patients' journey safer and we will make it safer for the staff working in hospitals, because we will make the environment in which patients undergo their initial assessment, and in the majority of cases all of their management, less stressful.

I acknowledge that the intent of what Deputy Kelly said was not to cause hurt, but I note that he described the two emergency departments in his constituency as the worst. I think what he meant to say was that they are the most challenged with regard to overcrowding.