Mary Harney (Dublin Mid West, Progressive Democrats)

I propose to take Questions Nos. 8, 16, 20, 22, 70 and 99 together.

The House is aware of my opinion on the problems being experienced in acute hospitals which provide accident and emergency services. I have announced a number of initiatives aimed at improving the delivery of such services. Progress is being made on each of the ten actions I announced earlier this year. The Health Service Executive has given the Department of Health and Children an update on each of the actions. I will outline to the House some of the progress that has been made.

The HSE has had positive discussions with public and private sector providers about the development of additional minor injury facilities in Dublin. It is expected that the second MRI for Beaumont Hospital will be available from August 2005. Planning is continuing on the provision of acute medical units at Tallaght, St. Vincent's and Beaumont hospitals, which have been asked to deliver interim arrangements pending the construction and commissioning of the new units.

The tender process for the provision of high dependency beds in private nursing homes is being examined and is at an advanced stage. The final tenders were opened this week and it is expected that the process will be concluded in the coming weeks, after analysis, evaluation and site visits have taken place. Contracts will be awarded in the coming days for the provision of intermediate private nursing home care for 500 patients per year.

Additional home care packages for patients have been made available in each of the six major acute hospitals in the Dublin area. A steering group of general practitioners, based on the north side of Dublin, is examining the requirements, locations and arrangements for the establishment of an out-of-hours GP service. The director of the National Hospitals Office is finalising arrangements for the establishment of a national audit and an inspection process to measure cleanliness in all acute hospitals. Regarding access for GPs to diagnostic services in the Dublin area, it has been agreed to procure a range of diagnostic services from private hospitals and negotiations are ongoing in that regard.

I welcome the recent intervention of the Health and Safety Authority. We all want to ensure that patients and staff working in hospitals have a safe and healthy environment. The authority asked hospitals to conduct a comprehensive risk assessment of their accident and emergency units. The authority said it is satisfied with the good level of response to its letter. It has decided to pursue a targeted programme of inspections, with visits taking place to 11 units by 8 April. The authority's review is expected to inform priorities for action by the National Hospitals Office on health and safety issues.

The wide-ranging actions to improve the delivery of accident and emergency services are aimed at improving access to accident and emergency services, improving patient flows through accident and emergency units, freeing acute beds and providing appropriate long-term care for patients outside the acute setting. We would like to see more immediate solutions and to that end we are working with hospitals to deliver the measures and to ensure that the investment produces sustainable and long-lasting solutions.

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