Mary Harney (Dublin Mid West, Progressive Democrats)

Safety in accident and emergency departments is a matter for the individual hospitals. I do not intend to micro-manage each hospital as they have their own management teams. Hospitals must examine their own circumstances and put in place the best management system taking into account all the risks. This will increase safety. I share a view with others, including accident and emergency consultants such as Dr. Aidan Gleeson, that accident and emergency services must be seen as a wider hospital systems issue. Escalation policies and moving beds from accident and emergency units to wards is sometimes preferable to leaving patients on trolleys overnight.

Virtually every hospital I am aware of spends considerable resources on security. If these resources are inadequate due to the manpower being employed or the scale involved, the matter must be examined by the hospital. Hospitals will receive an extra €387 million this year to run their operations, which is almost half the total increase in health spending for 2005. If a wider hospital systems issue is addressed, including activity in respect of private patients, many of the matters I spoke about yesterday and the problems in accident and emergency units can be dealt with.

We have not ruled out the possibility of addressing the issue of people who present intoxicated as they pose the greatest threat to staff. Everyone presenting, including those who are intoxicated, must be dealt with by accident and emergency units. Someone else could be seriously injured. We cannot move a person out of the way without establishing whether they are intoxicated. Subject to appropriate medical and legal advice, we are open to using innovative approaches to deal with people who have presented in this state to provide a disincentive. As I said last night, 30% of those who appear in the accident and emergency unit of the Mater Hospital are intoxicated.

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