Cecilia Keaveney (Donegal North East, Fianna Fail)

I am delighted to make a brief contribution to this important issue. I have a report entitled Alcohol and Injuries in the Accident and Emergency Department: a national perspective. I am interested in this report and I note that alcohol has not been mentioned by a number of contributors. I am Chairman of the Oireachtas Joint Committee on Arts, Sport, Tourism, Community, Rural and Gaeltacht Affairs and we are examining the proposal to bring alcohol under the national drugs strategy.

The report to which I referred confirms that alcohol injuries carry a significant burden for accident and emergency services in acute hospitals in Ireland in terms of increased numbers in attendance, the range of presenting injuries and the high level of repeat visits. It also states that there is an increased risk for staff working in the accident and emergency departments due to the level of intoxication among patients, which has significant health and safety implications. A quarter of all those who arrive in accident and emergency departments present with an alcohol related injury, while others delay attending hospital so that the blood-alcohol levels can drop. Therefore, the figures in the report may be an under-estimation. We cannot afford to ignore the alcohol issue much longer.

Is the Government examining the experience in the UK with the alcohol bus? People are being picked up by the bus and if they only have a minor problem, they can be driven home rather than presenting at an accident and emergency department at the peak time of 3 a.m. on weekends. We must impose imaginative solutions like that and we should look at what other countries are doing.

The role of the GP is very important. There are more co-operatives working at that time of the evenings where people may not have access to patient records. As the GP is unsure and is liable to litigation, the person is referred to an accident and emergency department. I believe that there should be more support at primary care level. People could be x-rayed in the local primary care centre and we have excellent examples of those in Donegal. These centres could have their services strengthened and that may take the burden off the main hospital such as the one in Letterkenny. I hope the Tánaiste expedites the proposal on the Letterkenny accident and emergency department which is at the planning stage and which will add 70 beds to the accident and emergency department there.

The overall bed problem has been eased by the new 11-bed oncology unit, but I feel a manager should be put in place as soon as possible. Management is a very important issue for the efficient use of the hospital and the manager's post has already been advertised. Intervention should occur to ensure that we have a full multidisciplinary cancer team with a permanent consultant and radiotherapy as well as the expediting of the BreastCheck programme. Prevention is ultimately better than cure.

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