James Reilly (Dublin North, Fine Gael)

The target to which the Minister alluded was a six-hour target which the HSE has set itself that starts from the time the decision has been made to admit the patient. However, even here there is disingenuity because the decision to admit the patient may well have been made by the doctor in accident and emergency but the clock does not start running until the admitting doctor from the various specialties within the hospital can make that decision. This can often take many hours, as I know only too well.

The Minister alluded to the 5% capital fund and spend in this country being second only to Norway in the OECD, yet we have the second lowest expenditure on health and education in the OECD. As I stated in last night's debate, our GNP last year contained a 7.2% spend on health. It has been acknowledged that we have fallen behind in health spending due to the many cutbacks in the 1980s and 1990s and that we are playing catch-up. Will the Minister outline how we can possibly catch up when we are still spending less per capita than the European average, which is 8.6% and Germany and France which are at 10%?

I am pleased to hear the Minister is looking outside accident and emergency services because this area is merely the symptom of the problem. A bottleneck has been caused by a lack of beds and inappropriate use of beds on the one hand and a lack of diagnostics, to which the Minister has alluded, but also the lack of a proper preventative medical scheme. Fine Gael had promoted the latter, in addition to a chronic illness scheme prior to the general election to keep people out of hospital and identify illness early. It is well known that for every euro one spends on prevention, one saves €20 on treatment.

I recall the Minister referred to the accident and emergency crisis as a national emergency but I do not recall when she declared that was no longer the case. Perhaps she will inform the House of when she made that announcement.

Where are the acute medical admission units that were promised? One such unit was promised for Beaumont Hospital on the north side of Dublin. This would have alleviated the situation in accident and emergency departments. GPs are highly experienced doctors who, when they have seen patients and examined them, know whether they need admission. It is regrettable to have to route patients through accident and emergency departments and for them to have to put up with all the unpleasantness that goes with that kind of experience in the current poorly-funded health system.

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