Mr. Robert Watt:

The Deputy has mentioned two broad issues - unscheduled care and scheduled care - in terms of the waiting lists. On unscheduled care, we had a very difficult situation at the beginning of the year, which reflected a large increase in attendance for a variety of reasons. For example, longer-term demographic changes and the incidence of significant respiratory viruses. Dr. Henry can give more detail on the numbers involved. It was a very challenging situation for the health system. A number of initiatives were put in quickly by our colleagues in the HSE under the direction of the Minister for Health. The initiatives stabilised the situation quickly. A variety of changes were made in terms of patient flow, discharges, accessing private beds, weekend working and so on.

Unfortunately, we are again back at a situation of having to deal with too many people at various stages. In particular, early in the week on Mondays and Tuesdays, there far too many people who must wait in accident and emergency units. Nobody is satisfied with that because we know that is a very difficult situation for people and their families, and it has an impact on patient outcomes. We have undertaken a review of lessons learned from that period, and both my Department and the HSE will act on those recommendations.

We need to get away from a notion of a winter plan and have, in effect, an overall capacity and reform plan, which deals with the reality of this situation because it is not winter. We are in spring now and this week, unfortunately, too many people are waiting on trolleys, particularly early in the week. There are a variety of different issues that we need to address around capacity, work reform, patient flow and particularly the question of the delayed discharge of patients. There are way too many people who have been treated in hospital and then need to be discharged back into the community or their home, or to an appropriate facility. Managing that integrated piece is challenging. I am sure that Mr. Gloster and his team will have further things to say on that.