Jimmy Devins (Sligo-Leitrim, Fianna Fail)

I am delighted to have an opportunity to speak on this Private Members' motion. It is opportune that the first Private Members' business after the Christmas recess should relate to the important issue of accident and emergency services. It is interesting to note that the Tánaiste has stated publicly and in this House that she is determined to solve these problems, which are the cause of a perennial crisis point in the health service.

All Deputies have an interest in the health service. Every year we hear of patients who have to spend many hours in accident and emergency departments while they wait to be seen. In some cases, people who are awaiting admission to hospital have to spend time on trolleys, which is unacceptable. Despite the great increases in spending on the health service by the Government, which will be in excess of €10 billion this year, the spectre of patients and staff in accident and emergency units having to put up with unacceptable conditions is still present. I warmly welcome the commitment made by the Minister to solve this problem. Her publication of a ten-point action plan serves to recognise that this recurring crisis must and will be dealt with. As the motion indicates, Deputy Harney has been Minister for Health and Children for 100 days, yet her decision to move decisively on this issue is very welcome. There is no doubt that the problems surrounding accident and emergency services are multifactorial and the solutions should be wide-ranging and need to take into account many different issues.

Let me consider a few of what I believe to be the underlying problems. Accident and emergency units are just that, i.e. places where accidents and emergencies can be dealt with. I believe strongly that some patients who have problems that do not fall within the definition of accidents and emergencies are attending accident and emergency units. They do so for a variety of reasons, some of which are very serious but which do not require attendance at such units. Patients who have been seen by their family doctors, who have taken a decision that those patients require admission to hospital, should not have to wait in accident and emergency units because there are no beds available in the relevant surgical or medical wards.

Some hospitals have acute assessment units and these have proved to be extremely useful. The Minister's decision to provide three acute medical assessment units in three Dublin hospitals, namely St. Vincent's, Beaumont and Tallaght, is very positive and should have a beneficial effect on the easing of the crisis in the accident and emergency units in these hospitals. The hospitals have been among the worst affected by the crisis.

The provision of extra step-down beds for patients who no longer need acute hospital care but still need some care before going home and the contracting of long-term nursing care beds for those who need higher level care than that available at home but do not need the level of care available in an acute hospital will have the effect of increasing the number of beds available for patients who need to be admitted to hospital after attending accident and emergency departments. This will have a very obvious beneficial effect in that it will reduce the number of people forced to spend time lying on trolleys in accident and emergency units while awaiting admission.

Time does not permit me to refer to the other aspects of the ten-point plan, but I must state that the implementation of the action in question will finally deal with this unacceptable issue. Will the Minister consider one further recommendation which I believe will also help? There is no doubt that some who attend accident and emergency units do so inappropriately. A nationwide publicity campaign to inform the public on the purpose of accident and emergency units would help to relieve some of the current overcrowding. In recent years, such a campaign has been running in the United Kingdom. I have been told that this campaign has helped patients to obtain quick access to the most appropriate care within the NHS. I commend the amendment to the House.

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