Bertie Ahern (Dublin Central, Fianna Fail)

The step-down facilities provide continuing care. With regard to the report mentioned by Deputy Kenny, no report like that was done before. This was a detailed report on ten individual hospitals. Until now they were always classified in statistics that were grouped together and did not look at the individual requirements. This is the first time a report has examined the individual difficulties on the ground by talking to the staff who deal with the problems. The report shows that there are different problems and issues. The issues are not all the same in different areas.

The HSE has looked at the recommendations. They deal with the issues of beds, step-down beds, general practitioner out-of-hours service and the ability of general practitioners to access diagnostic services, whether those services are in public hospitals or private operations. It is a huge benefit for general practitioners to be able to get quick diagnostic turnaround. It means patients do not have to go to accident and emergency departments and those departments can be used for their real purpose. Community intervention teams have been established by the HSE which are hugely helpful in dealing with people in their homes and communities. Primary care teams have been set up and the HSE has worked on the chronic illness management programmes.

Many of these programmes are not new. In the past few years, we have examined the best practice we have seen in hospitals such as St. Luke's Hospital in Kilkenny, where there is very good community access. I spoke about this previously. We are trying to take that best practice into other hospitals.

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