Tim O'Malley (Limerick East, Progressive Democrats)

I am taking the adjournment on behalf of my colleague, the Tánaiste and Minister for Health and Children, Deputy Harney.

Tackling the current difficulties with accident and emergency departments is the Government's top priority in health. The service being provided to some patients in accident and emergency departments is unacceptable and must be improved.

The objectives are to reduce the numbers waiting for admission, the time spent waiting for admission and the turnaround time for those who can be treated in accident and emergency departments and do not require admission.

The HSE is continuing to implement the ten point action plan. In addition, it has been agreed with the HSE that a number of additional measures will be implemented by the executive. These include the setting of performance targets for individual hospitals. In terms of implementation, the HSE is tackling the issue on a hospital-by-hospital basis and is developing hospital-specific, time-based targets related to accident and emergency units and delayed discharges. The executive is also engaged in the development of financial incentives linked to performance in these areas and the development of additional targeted initiatives aimed at delivering an immediate and sustained impact.

In the immediate term, the HSE is introducing a series of measures to improve facilities for patients and staff in accident and emergency departments. Long-term care beds are being secured from within the private sector to facilitate the discharge of patients who have completed the acute phase of their care. The acute beds that become available as a result of this initiative will be ring fenced for those patients awaiting admission in accident and emergency departments. Funding is being made available within the capital programme to develop admissions lounges to ensure that patient privacy, dignity and comfort are preserved while awaiting admission to an acute bed.

The HSE has established a dedicated task force to oversee the implementation of the framework for improving the efficiency and effectiveness of services in our accident and emergency departments. The task force will support individual hospitals, including Letterkenny General Hospital, in identifying specific problems and addressing them. It will work with hospitals to introduce a system of whole hospital performance measures to improve the patient's journey, not alone through the accident and emergency department but through the hospital system, from admission to discharge.

Letterkenny General Hospital serves an estimated catchment population of more than 137,000 and employs almost 1,300 whole time equivalent staff. The Government is committed to the development of acute hospital services at Letterkenny General Hospital. Since 1997, the Hospital's annual allocation has increased by €60 million. In 2005, the hospital treated nearly 20,000 more in-patients and day cases than in 1997. There are now 550 more staff at the hospital and 70 more beds than in 1997.

With regard to accident and emergency facilities at Letterkenny General Hospital, the Tribal Secta report found that the hospital needs a larger, purpose-built, accident and emergency department to allow proper triage, streaming and care of accident and emergency patients. The HSE intends to provide a new accident and emergency department and medical admissions unit at the hospital. The medical admissions unit will streamline the processing of acute medical emergency patient referrals, ensuring that patients are prioritised on the basis of need and, where necessary, admitted to an acute in-patient bed. This project is currently at design and planning stage.

In the interim, the HSE has approved capital funding for the provision of 30 beds for Letterkenny General Hospital. These beds will be provided by way of a modern modular building to be erected on the campus of the hospital. A planning application has been submitted and tender documents are in the process of being completed. It is intended that this modular building will be procured through an accelerated tender process, with a view to having the beds available for use before the end of 2006. This development, which is in addition to 11 new beds already opened this year, will increase capacity at the hospital from 313 to 343, an increase of almost 14% from the start of the year. It is expected that current capacity pressures at the hospital, including pressures in the accident and emergency department, will be greatly alleviated under this initiative.

The HSE has also had detailed discussions with the hospital with regard to implementing interim measures to improve the facilities at the accident and emergency department, as recommended in the Tribal Secta report. A number of proposals are being examined, including the options for increasing the space and providing additional facilities for the accident and emergency department by relocating other departments at the hospital.

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