Mary Harney (Dublin Mid West, Progressive Democrats)

I do not accept that the accident and emergency action plan has failed. On the contrary, a wide-ranging approach has been adopted by the Health Service Executive to improve access to accident and emergency services, improve patient flows through accident and emergency departments, reduce waiting times, free up acute beds and provide appropriate longer-term care for patients outside the acute hospital setting. A particular focus of the action plan has been placed on those patients in acute hospitals who have completed the acute phase of their treatment and are ready for discharge to a more appropriate setting.

The HSE has made considerable progress and is continuing to make sustained efforts in this regard. A range of measures, including the provision of high dependency beds, intermediate care beds in private nursing homes, additional beds in public nursing homes, home care packages and enhanced subventions, have facilitated approximately 1,500 patients to leave acute hospitals. In addition, €6.6 million is targeted at increasing the level of home support available in the community, which should assist in keeping people well in their homes and thus avoid the necessity for presentation at accident and emergency in many cases.

Within the context of the action plan, the HSE undertook an audit of efficiencies and process. The study was conducted in ten hospitals, and its conclusions point to a number of areas for further improvement. These include strengthened discharge planning processes, improved clinical decision making at every stage and better co-ordination of and access to diagnostic services. A key action for 2006 for all hospitals with accident and emergency departments will be the full implementation of the efficiency audit recommendations. In tandem with this, a programme of financial incentivisation will be introduced, aimed at rewarding those hospitals that are meeting agreed performance targets and facilitating overall improved performance.

The HSE will continue to maintain a focus on the implementation of system-wide measures to further improve the delivery of accident and emergency services.

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