Brian Cowen (Laois-Offaly, Fianna Fail)

With regard to housing, the rental accommodation scheme, RAS, is not the only initiative. There always has been a rental sector to help deal with local authority housing lists. In many cases that arrangement, more than others, suited people. That arrangement will continue and it is not the only means available. As I mentioned, there is the question of acquisition and long-term leasing etc. Some construction is taking place, much of it in specialised sectors to provide for the elderly and people with disabilities. The objective is to build community-based models of health care, quite rightly, for people in those situations and to give them the prospect of independent living, supported living etc. All of that work is ongoing. The Minister of State, Deputy Finneran, is committed to that area.

On the question on health, the Cabinet Committee on Health meets regularly, has worked through the service plans of the HSE and has been very instrumental in bringing forward the cancer strategy. I am sure the work the Oireachtas committee has done on primary care will have an input into policy for the Department and the Minister. There is a clear commitment to move to a greater degree of primary care and greater co-ordination and collaboration among GPs and other people in nursing, physiotherapy and the various care professions to work together. Many primary care centres have been set up and, from my experience, they have significantly improved the provision of primary care services to the people.

With regard to accident and emergency services, the central points are highlighted in the report. First, actions have been taken in line with this report and improvements have been made. For example, in October 2006, only 11 of the 34 emergency departments were consistently admitting patients within 24 hours. In December 2009, 29 of the 34 emergency departments were consistently admitting patients within that period, which is almost a threefold improvement. Second, a critical issue highlighted by the report is access to decision making by senior clinicians, that is, by consultants. The Minister has pointed out that, under the new consultants contract, we have appointed clinical directors to every hospital and that is bringing its own improvements and benefits. Consultants are now working in teams. They have an extended working day and structured weekend work. A key task for this year for the HSE is to have these features of the new contract fully implemented. That would mean responsibility to achieve the best clinical care and to improve patient experience at the hospital at all stages of care, including at the emergency department, would be shared by the consultant team and the management of each hospital. The report sets challenging benchmarks against which to judge the performance of emergency departments. The HSE's waiting time targets for admissions to emergency departments has been reduced from 24 hours in 2007 to six hours now. Since the data for the Comptroller and Auditor General's report were completed, the HSE's information on actual waiting times of all patients has improved. Waiting times from arrival at emergency departments are now being measured alongside many other criteria of good patient services. The HSE's service plan for 2010 includes actions to reduce waiting times, including-----

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