Mary Harney (Dublin Mid West, Progressive Democrats)

We need to recognise that the way we work together, our practices, rules and procedures can change and can be improved for patients' sake. We must also recognise that change does not threaten us or require us to be compensated. If we all agree we want to improve care for patients, should we not reward and incentivise innovation, ideas and new ways of working that do so? Rather than reward the squeakiest wheels, we should reward the most effective work for patients by the most effective hospitals.

This is the context in which I believe we should follow the recommendations of the Health and Safety Authority to move patients from accident and emergency trolleys to additional beds in hospital wards at certain times. That is why hospital consultants and other groups can better work for patients with better round the clock rostering and why speedy access to diagnostics and GP services round the clock must be the norm. These are just some examples of how we can change our system to improve accident and emergency services for patients. This is not about quick fixes or command and control from the centre, it can only work if we all focus on achieving better outcomes for patients.

Looking at it this way, our accident and emergency services and health generally have many parallels with the economic challenges we faced in the 1980s and early 1990s. The partnership process helped all players to lift their heads above the trenches to see that we all had a stake in the whole economy working much better. We took ownership and responsibility for how the whole economy worked, and we can do this for health. Just as we proved that the economy was under our influence and control, so too we can show that our health system is under our control and can be improved by change and reform together.

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