Bertie Ahern (Dublin Central, Fianna Fail)

As I have stated before, for one reason or another, accident and emergency facilities are not up to scratch but it is not the situation in all hospitals. New accident and emergency departments have been opened in hospitals such as St. James's Hospital and Blanchardstown but problems still exist in a number of hospitals.

Deputy Kenny asked me to state the present position. Approximately 3,300 people a day are treated in accident and emergency departments which is 1.2 million a year. The Tánaiste's ten point plan is a dedicated funding of an additional €80 million this year. The Government is confident that this plan has already achieved results in some hospitals but not in all. For example, the special home care packages to allow people to leave hospital are to help those who require better facilities at home and cannot leave hospital until these are provided. The first of the 500 step-down places are now being provided by the private sector. This is important as it releases acute beds in general hospitals. Nursing home places for long-term stay will soon be contracted. Several hundred beds need to be outsourced and this is under negotiation. Site visits to determine the suitability of facilities will be completed at the end of this week.

The GP out of hours service is operational in most parts of the country but not on the north side of Dublin. However, 150 north side GPs have now indicated they are prepared to work an out of hours co-operative and this will have an impact. It is the case that there is no GP service after 5 p.m. and people have no alternative but to go to accident and emergency units. Progress has been made in discussions with private hospitals to provide additional access to MRI and CT scans in order to reduce waiting times. This is important and it is happening now. The Health Service Executive is putting in place a permanent system of audit inspection for cleanliness in acute hospitals and which was previously identified by Tallaght, Beaumont and St. Vincent's hospitals. The new St. Vincent's Hospital will open shortly. Tallaght, Beaumont and St. Vincent's hospitals are working to install new acute medical units and a number of other medical initiatives are being taken. These units are being funded by the €80 million funding announced by the Tánaiste. Others are already in place as I announced previously.

I acknowledge the frustration of the nursing staff in hospitals in particular. The accident and emergency consultants are now in place but some further work remains to be done because the difficulty is that accident and emergency consultants leave at 6 p.m. and the busiest time is after 6 p.m. This is an industrial relations issue that will need to be negotiated. The Tánaiste is involved in this matter. It would be very helpful to the service if the accident and emergency consultants were in place. These are some of the issues.

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