Mary Harney (Dublin Mid West, Progressive Democrats)

Deputy McManus acknowledged that I am present in the Chamber. She might also have been gracious enough to acknowledge that I was here on time. When a Deputy is delayed, it is customary to acknowledge the fact that the relevant Minister was present on time.

The difficulties being experienced in accident and emergency facilities throughout the country are not acceptable to me, to the Government or to the average person who cannot understand how, at a time when we have trebled spending on health care to €10.5 billion, these things can happen. Many patients are experiencing long delays and difficulties, notwithstanding the enormous efforts made by the dedicated and caring staff who look after them.

The problems of the accident and emergency services are not unique to them. They also affect the health service as a whole. When seeking solutions, we must consider those that are sensible, sustainable and which fit into the overall strategy of reform. Everyone in the House acknowledges — as those who have reviewed the health services have already acknowledged — that there are no quick fix solutions or magic wands that can be waved. If it were easy, it would have been done a long time ago.

I intend to bring forward a package of measures to improve the experience of all patients who enter our hospitals via accident and emergency departments. As Members are aware, 78% of patients who enter accident and emergency departments in the six hospitals in the Dublin area do not require to be admitted. The 22% of patients who require admission are experiencing particular difficulties. When I met the chief executive officers of the six Dublin hospitals, I asked them to provide patient data. I received that data this evening from the Mater Hospital. If we are to make sensible decisions, we must do so on the basis of the best possible information. We do not need to know who the individuals are but we need to know their circumstances.

Among the issues we will have to address in the context of the package I will bring forward will be those relating to step-down facilities. As Deputy McManus has acknowledged, some of the patients in our hospitals at present do not require an acute hospital bed, provision of which can cost up to €5,000 per week. Other patients require different medical facilities. In some cases, they may require access to rehabilitation facilities. Cancer patients may require hospice related facilities. I need to have that data if we are to come forward with an appropriate package of measures to address the difficulties being experienced.

I will, however, give this commitment. There will be no grandstanding on my part. I will not build up any false expectations and I will not play politics with seriously ill people. However, I will work as hard as I possibly can with the resources available to me to bring forward radical, sensible and sustainable solutions that will form part of the package not only of the accident and emergency reforms I want to bring forward but the overall reforms I wish to introduce in respect of the health services.

From 1 January, the Health Services Executive will assume operational responsibility for the work currently done by the health boards. I intend to take the legislation through the Oireachtas before Christmas to ensure this becomes a reality. I am delighted to inform the House that the chief executive officer designate of the Health Services Executive has agreed to bring forward the start-up date of his contract from 1 April to the end of January. This will mean he will be in place to ensure that the new systems of administration, accountability and responsibility will work more efficiently and effectively for all patients.

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