Mary Harney (Dublin Mid West, Progressive Democrats)

There is no doubt that the volume of activity in our hospitals has increased significantly. While we must be fair and acknowledge that there are problems in accident and emergency services, they are part of the wider problem in the health system. Some people access hospitals through accident and emergency departments because they cannot access an appropriate outpatient department. There are many factors which must fit together. Increasing the number of consultant posts, especially in certain specialties and at regional level, is part of the solution in the medium term. The measures being taken are aimed at dealing with the crisis as we see it.

It is not acceptable that people should spend days on trolleys before being admitted to an acute hospital bed. Nobody could be happy with such circumstances. It may have been understandable in the mid-1980s when we had less resources and cutbacks were made in health because the economy was unable to sustain public spending levels but there is no explanation for it today.

I agree with Deputy Twomey about the more efficient use of facilities over longer hours. Part of the difficulty relates to industrial relations issues and the manner in which people are paid. We must therefore ensure greater flexibility in the way people are paid and facilities are used. It does not make sense for the taxpayers to spend millions of euro to buy equipment for hospitals if it is not used to the maximum capacity. We must deal with the factors which have resulted in the current scenario. As we know, it is often the case that people occupying hospital beds do not need to be there but are admitted while they await particular tests. If greater use were made of existing facilities, people would not have to avail of inpatient services to access appropriate tests. That is a fact.

I understand a number of initiatives are being undertaken on the north side of Dublin. A group called Touchstone has undertaken an initiative to provide general practitioner services in Mulhuddart. I understand doctors on the north side have come together and done very productive work on an out-of-hours facility. They will shortly be in a position to make an announcement. Existing general practitioners wish to provide the service themselves and I would be very supportive of that. They are engaged in intense discussions with Angela Fitzgerald to whom I have given responsibility for the implementation of the ten-point accident and emergency plan.

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