Mae Sexton (Longford-Roscommon, Progressive Democrats)

I take this brief opportunity to thank the Tánaiste for her clear and concise contribution on this motion yesterday evening. If it were needed, the House was given further reassurance on the significant endeavours and numerous plans that are being put into place to meet what I consider to be the challenge of the decade. I take this opportunity to place on record something that every Member possesses, namely, our esteem and respect for the work of nurses, doctors and staff in all accident and emergency departments, especially those who work under severe pressures in particular units. The Tánaiste has placed on the record her commitment to follow the recommendations of the Health and Safety Authority to move patients from accident and emergency unit trolleys. No one here would disagree there is an increasing problem of intoxicated persons turning up at accident and emergency departments.

We on this side of the House concur with elements of the Private Members' motion but difficulties are posed by the calls on the Government to act in certain ways to deal with the problems. The motion concentrates on those presenting with alcohol-fuelled aggression. It fails to take into account that 30% of male admissions, 10% of female admissions and almost 25% of all accident and emergency attendances meet the diagnostic criteria for alcohol misuse or dependency, which poses its own problems. Medically, it is widely accepted that this misuse of alcohol can be closely tied to deeper psychological issues and the measures required to adequately and safely address the issues are being developed to ensure the proper and long-term strategies are devised and delivered.

There is the danger that we may think of drunks in accident and emergency units as a single uniform group, but that is not the case. I welcome the Tánaiste's announcement of initiatives to identify appropriate care settings at community level and the development of accident and emergency triage arrangements to enable more appropriate assessments and treatments of people with psychosocial issues. The House is unanimous in that any and every possible threat or abuse a health care worker might face must be removed. I hope a working partnership of management and trade unions will be in place to enable the implementation of the HSA's guidelines in the near future.

We have a duty to ensure all possible and practical steps are taken as quickly as possible. To this end, the Minister for Justice, Equality and Law Reform, Deputy McDowell, is determined to see that all efforts are made to tackle disorderly behaviour, in particular, assaults on emergency workers such as those in accident and emergency units. The Criminal Justice Bill 2004 provides for a fixed charge procedure regarding certain public order offences, which is welcome. That is in addition to legislation dealing with disorderly behaviour. I hope the penalties for disorderly conduct and intoxication in a public place receive the support of all Deputies. I also welcome the Minister's decision to examine the current position of assaults specifically against emergency workers. There is an acute possibility of providing for a specific offence in this respect by way of an amendment to the Criminal Justice Bill and I welcome that.

Asking the House to approve a motion calling for the Government to round up "hangers on" reveals a disregard for medical, legal and civil liberties and focuses on just one factor that creates difficulties for accident and emergency patients, which, when solved, will not be a panacea for the enormous difficulties that exist. The combined efforts of the many sectoral workers in the interests of patients will be required, such as out-of-hours GP services, 24-7 diagnostic testing availability and the co-operation and goodwill of everyone working in the provision of health care to deliver the type of health service of which everyone inside and outside the House will be proud.

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