Brian Cowen (Laois-Offaly, Fianna Fail)

As I said in a previous reply, the question of ministerial intervention as the solution to the problems being spoken about does not comprehensively deal with the issue. Full co-operation from everybody is needed to deal with the issue that has arisen recently in respect of accident and emergency services. The industrial relations machinery should be utilised by everybody for the purpose of finding solutions to these problems. I reiterate, however, that these problems will not be solved on the basis of status quo plus. They will continue to revisit the service if we do not overhaul and reorganise the way we deliver the services in the acute hospital system and how that relates to the availability of primary care, and ensure that people who present to accident and emergency units require the services in those units.

I saw a statistic recently which indicated that four out of five people who present to accident and emergency units are not admitted to hospital. We must ensure that the accident and emergency services that are required by the people who need them are available. We must ensure also that other parts of the service outside the acute hospital sector meet their responsibilities in dealing with patients who do not require accident and emergency treatment or hospital admission. Hospitals are for acute admissions.

We must ensure also that where problems arise in accident and emergency services, hospital management gives priority to reducing elective admissions so that the immediate short-term problem can be dealt with. We need co-operation on the part of everyone to ensure that those who require accident and emergency services get them. It must be said that those experiencing genuine emergencies are dealt with in the health service but we must ensure also that where service pressures arise, elective admissions are reduced to allow those emergencies to be dealt with. That is the way to deal with this issue sensibly, but it requires the co-operation of everybody.

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