Tim O'Malley (Limerick East, Progressive Democrats)

An important element of acute hospital services is the delivery of emergency services. Comhairle na nOspidéal published a report on accident and emergency services in February 2002, which noted that a hospital-wide response was needed to meet the requirements of the emergency service. Delivery of the emergency service at hospital level is interdependent on the inpatient elective service and day and outpatient care. The effective delivery of emergency services, therefore, cannot be dealt with in isolation from the delivery of all hospital-based services.

Many of the difficulties and delays experienced in emergency medicine or accident and emergency departments reflect system-wide issues such as the demand experienced by each hospital, the resources available to it, as well as the structure, organisation and staffing profile of the hospital. It is necessary, therefore, to take a whole-system approach involving primary care, acute care and sub-acute and community care to tackle the problems in emergency medicine departments.

A number of initiatives are under way to address pressures in emergency medicine departments. Improved and expanded emergency medicine departments are being provided through national development plan funding in many acute hospitals. For example, new departments have been provided at Cork University Hospital, James Connolly Memorial Hospital, Naas General Hospital, South Tipperary General Hospital, and Clonmel and Roscommon General Hospitals. New departments are also under construction at St. James's Hospital and Tullamore General Hospital. The establishment of minor injuries units, chest pain clinics and medical assessment units will also improve the operation of emergency medicine departments.

The Department has approved Eastern Regional Health Authority proposals for a range of short and medium-term solutions to the problems associated with emergency departments in the Dublin academic teaching hospitals. The cost of these new initiatives is €2.4 million in a full year. Areas covered include the appointment of specialist nurses, the establishment of rapid assessment clinics and the provision of multidisciplinary teams to assess patients.

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