Kate O'Connell (Dublin Bay South, Fine Gael)
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Following the comments on haemochromatosis, Warfarin pilot testing was done in the community. In other countries, that is done in the community. Generally the people on Warfarin are older and are more susceptible to illness. According to the latest figures, people aged over 70 were the main unscheduled presentations in emergency departments. If older people who are susceptible to illness are constantly exposed to the hazards of an acute hospital, it is only natural that they are they will be sicker. There can be efficiencies built in with Warfarin as for haemochromotosis. Giving the flu vaccine in pharmacies worked well. I was among the first tranche of pharmacists doing that eight or nine years ago. The morning after pill has worked and any interventions the Chairman and the Minister of State have made to make it available at the weekend have worked. We have evidence that when initiatives are moved into the community, they can be more efficient in themselves but also reduce burden of disease as well.

A major reason for admissions to nursing homes and hospitals is polypharmacy, incorrect prescriptions and errors. There is an incentive for pharmacists in the UK whereby if they make an intervention in a prescription, for example, bringing 12 meds down to six without interfering with doctor's orders, they get something like £5.

It is not very much, but there is an amount available to make it worth one's while to do the paperwork. That kind of approach has to be considered. Sláintecare is all about moving from acute care to primary care. However, looking at the big picture, what is being done? The money will run out and services will be cut in the future if they are not bedded down into the community with other people taking responsibility for them.

I am particularly concerned about those aged over 70 in the winter months. I do not see any major interventions to try and prevent them from requiring accident and emergency services. There have been proposals, but perhaps the Minister of State could outline the interventions that have been taken. Accident and emergency services are not necessarily the right services for those elderly people.