Bertie Ahern (Dublin Central, Fianna Fail)

I have already answered this. The Deputy asked me to explain matters in my own words, something I did for Deputy Kenny. He wanted to know what actions were currently being taken, and I gave him those. They are under way now, in addition to what has already been put in place. I will give those points again. Those actions are significant.

Why is there a problem in accident and emergency? Many people argue there is not a problem in that department but with beds elsewhere. That is why we have added 500 beds. Step-down places are being provided in the private sector so that people in acute hospitals can move to suitable and excellent care facilities not in such hospitals, thus freeing the beds so that people can move through accident and emergency more quickly. That is the issue.

As I said, everyone accepts that, whether with cancer, cardiac or other services, when people are in hospital, they receive good treatment, operations and aftercare. However, with accident and emergency, because of people staying a long time in beds — far longer than was traditionally the case — one needs more beds. That is why we have the step-down beds. We already have 200 extra public beds this year, as well as out-of-hours GP services. People do not stop getting sick at 5 o'clock in the evening. Where there are no such services in communities, people go to the accident and emergency department, and that exerts further pressure.

When people are blind drunk or drugged and start to fight or become involved in public order disturbances, they often end up in accident and emergency departments, which puts further pressure on such services. A significant proportion of the €11.5 billion allocated each year to the health service, which has 100,000 staff, is spent by the Government on measures to improve the accident and emergency service. The Government is confident that such measures will help to alleviate some of the difficulties we have encountered in recent years. The Deputy is aware that the Government is also investing in a substantial capital programme that will bring new hospitals and services on stream.

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