Bertie Ahern (Dublin Central, Fianna Fail)

Deputy Ó Caoláin will be aware that the largest share of expenditure of additional revenues this year was given to health — over €1 billion into health resources and €500 million into the capital programme for health. That has been the case every year, with expenditure on health increasing from approximately €3 billion to €12 billion. Therefore, the resources are being provided. Most of that expenditure is reflected in staff, with approximately 35,000 more people, mainly medical and nursing staff, working to deal with these issues.

Most of the Deputy's questions were about accident and emergency units. He is right that this is the time of year to work on plans for the autumn. That is precisely what Ministers have been doing. Those of us who are on the Cabinet committee on health have regular meetings with the Department of Health and Children officials and the HSE with a view to improving the areas that need to be improved, dealing with problems where they exist and building on the successes. The key objectives are to try to tackle the problems in accident and emergency units in those hospitals where there are problems — I stress that is in a limited number, about 14 out of almost 60 hospitals — deal with the numbers of patients in accident and emergency units awaiting admission to an acute bed, the time those patients have to wait and the turnaround time for those patients who are treated without being admitted. They are the key objectives.

The number awaiting admission in June was 109, a reduction of 39% in the average numbers nationally between June 2005 and June 2006. I am not sure from where the Deputy got his figure. There was a 49% decrease in the average numbers waiting in the east and a 24% decrease in the average numbers waiting outside the east. The reduction can be attributed to a number of factors, particularly the impact of the private nursing home initiative for delayed discharges and increased management focus on accident and emergency units of hospitals. In recent months the seasonal factor has had an impact on the figures.

The Deputy asked about our plans. We will continue with the ten point plan and the short-term objectives that no patients will have to wait longer than 24 hours to be admitted to an acute bed. There will always be people on trolleys. Obviously when people come to accident and emergency departments they will be on a trolley. The elimination of trolleys in accident and emergency units is not the issue but rather that patients do not spend an excessive period there. No accident and emergency department is to have more than ten patients awaiting admission. The privacy and dignity of patients awaiting admission is to be preserved. The long-term objective is to ensure no patient will wait longer than six hours to be admitted after a clinical decision to admit has been made.

During June, 14 of the 18 targeted hospitals achieved their targets. The exceptions were Beaumont, Tallaght, Cork University Hospital and Drogheda hospitals. During the past two weeks eight of the 18 hospitals had patients waiting longer than 24 hours for admission. All this is being monitored closely.

The Deputy asked if I would say what is happening. The development-expansion of the minor injuries units, chest pain clinics and respiratory clinics is moving well with provision for these units in Connolly Hospital in Blanchardstown, Cork University Hospital, St. Vincent's Hospital and St. James's Hospital. Outside Dublin we have provided for the expansion of minor injuries units in St. John's Hospital Limerick and Waterford Regional Hospital. These units are fully operational. In regard to the second MRI at Beaumont, the interim arrangements with a provider are in place. The second MRI is due to be commissioned later this year.

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