Liam Twomey (Wexford, Fine Gael)

We should always aim to set high standards rather than minimum standards. Is it true that a specified minimum space of approximately 1.62 m should be kept between beds in hospital wards? There is a contradiction in requiring a fixed distance between beds on wards when patients are practically stacked on top of each other in accident and emergency departments while they wait on trolleys. We must examine why there are 20 to 30 trolleys in accident and emergency departments. Something seems to be wrong.

Will the Tánaiste to provide more information on the cleanliness of our hospitals. Patients are very unhappy and persistently complain that facilities are not clean. Will the Tánaiste confirm that 450 cases of MRSA septicemia have occurred? These cases did not involve the infection of people's skin, but of their bloodstreams. Given the mortality and morbidity rates associated with MRSA, it is a very significant number of cases.

Most of the Tánaiste's ten-point plan to address the accident and emergency crisis focuses on the Dublin region in which the incidence of trolley use is highest. However, can she explain why a level one trauma unit which caters to the whole south of the country had to close its accident and emergency department to walk-in casualties last week? Is it not ridiculous that the second largest city had to close its major accident and emergency department to walk-in patients for any period, even if it was only four or five hours?

I presume the MRI scanner at Beaumont Hospital is there to cater for patients who have been transferred from hospitals nationwide out of hours and require emergency scans. Will the Tánaiste explain what she will do about the switching off of CAT scanners throughout Ireland at 4 p.m. or 5 p.m.? Why is there no proposal in her ten-point plan to deal with CAT scan machines throughout the country which are not operational 24 hours per day, seven days per week?

Will the Tánaiste provide more detail on the out-of-hours co-operative on the north side of Dublin city? What is its structure? While the co-operative represents an important, positive move forward, like all such facilities it must be established in a way which ensures it operates with maximum efficiency.

It is disingenuous to say that patients suffer when nurses go on strike as patients are already suffering as a result of our failure to deal with the health service crisis. I worked in the hospital service until ten years ago, including the accident and emergency department in Cork to which I have referred and the Meath Hospital in Dublin. While things were bad then, there were only between ten and 20 patients on trolleys in Dublin city. There are now up to 300 patients on trolleys here. Nurses do not strike because, as the Tánaiste said, there are too many of them. They do so because the service continues to disimprove remarkably. Accident and emergency staff operate in circumstances of significant stress, which the Tánaiste should take on board. She should visit an accident and emergency department on a Saturday night to witness the behaviour of people who have had too much to drink.

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