Tim O'Malley (Limerick East, Progressive Democrats)

The delivery of accident and emergency services continues to receive attention at the highest political and official level. A new vigour has now been given to the issue by the Tánaiste. Her plan will be the focus of the highest level of political attention this year and I am confident it will deliver results.

Much publicity has been given to the number of patients waiting on trolleys in accident and emergency departments. I agree that everything must be done to resolve this problem. Much of the good work being done, however, in accident and emergency departments goes unreported. Is it not also news-worthy that hospitals deal with approximately 1.2 million attendances at accident and emergency departments each year? This is equivalent to 3,280 patients being seen in accident and emergency departments every day of the year.

Discharges from acute hospitals now run at over 1 million per annum as hospitals continue to treat more patients. While we do have problems in particular areas of service delivery, it is unfair to the dedicated medical, nursing and support staff that their tremendous commitment and achievements do not receive the recognition they deserve.

This Government has provided additional resources for accident and emergency services for some time. In June 2004, the Department of Health and Children approved proposals for short and medium-term actions to be taken to address the problems associated with accident and emergency departments in the Dublin academic teaching hospitals. These initiatives cost €2.4 million in a full year and include the appointment of a new consultant in emergency medicine, specialist nurses, the establishment of rapid assessment teams, a clinical decisions unit and the provision of multi-disciplinary teams to assess patients.

An independent review of security arrangements in the accident and emergency departments of all hospitals providing accident and emergency services was undertaken in 2002. The Department provided €2.35 million towards the cost associated with the enhancement of security arrangements.

There are now 52 emergency medicine consultant posts in acute hospitals, more than double the number in 1997. The availability of senior medical staff in accident and emergency departments facilitates rapid clinical decision making, enhanced management, diagnosis and treatment of patients.

Our capital investment programme for hospitals continues to be rolled out. Actions and investment programmes have been put in place in recent years which are contributing to and will continue to increase the hospital system's ability to meet increasing demand for services.

In September 2004, the previous Minister for Health and Children, Deputy Micheál Martin, approved the commissioning of a number of new units in acute hospitals which have been funded under the national development plan. These developments will provide modern health facilities particularly for cancer care, medical assessment units and accident and emergency departments. New day facilities, theatre and diagnostic capacity will result in improved patient flows through the hospital system and make better use of existing inpatient beds.

Pressures on the hospital system, especially in Dublin, arise from demands on emergency departments and on difficulties associated with patients who no longer require acute treatment but are still dependent. Funding of €16.8 million was made available to the former Eastern Regional Health Authority between 2003 and 2004, resulting in over 600 patients being discharged from acute hospitals to more appropriate settings. A total of €5 million is also being provided to the Southern Health Board under the delayed discharges initiative to facilitate the discharge of patients from the acute hospital system.

The Tánaiste has already spoken in detail about the ten point action plan she announced for accident and emergency services. She has secured €70 million in additional revenue funding and €10 million in capital funding to support these initiatives. The Department of Health and Children is liaising with the Health Service Executive to progress the implementation of the plan.

I look forward to continued improvements in the delivery of accident and emergency services so that patients' needs are met in a timely and appropriate manner.

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