Joe Costello (Dublin Central, Labour)

I am grateful for the opportunity to raise this important issue of the need for the Minister for Health and Children to outline her plans for resolving the bed and space crisis in the accident and emergency unit of the Mater hospital.

The position has been fairly dire for many years. The circumstances in very many accident and emergency units are unacceptable in normal health terms. They are located in prefabricated buildings. The space area is inadequate and they are very often in corridors. Trolleys are used as beds and people are in chairs. The existing set-up in the Mater hospital leaves much to be desired but a worse state of affairs will be reached with the announcement that 60 beds are due to close, with the possibility of an additional 20 beds closing. A bottleneck has been continuing for many years and in terms of the number of people on trolleys or chairs, the trolley count is always in the high twenties. It used to be quite low in mid-summer. In the past it might have been in the high twenties in the middle of the winter, but in the summer months the trolley count is as bad as it was some years ago in the winter.

The position is not improving. It is deteriorating by the day. There are continual delayed discharges. People are coming in at one end but they are not leaving at the other, and the reason for that almost beggars belief because the thrust of the Minister's policy was to ensure there would be step-down facilities in the community. The Minister, who is six years in her position, promised that from the outset in her ten point plan. The problem is that the number of delayed discharges continues to rise. Bed blockages are increasing in number and the promised step-down facilities have not been delivered. Neither is there any relationship with the local authorities to ensure that necessary adjustments to homes are made in time to allow people move back into the community and into their own homes. The position is dire.

I had a call today from the daughter of an 88 year old woman who told me her mother had been attending the fracture unit in the Mater hospital for 13 days. She eventually got a bed tonight but the staff in the fracture unit made it clear that they needed the bed for hospital treatment. That type of treatment, or lack of treatment, for somebody as elderly as that woman, and the pain and suffering they are put through, is wrong, and eventually they end up in the accident and emergency department waiting to be received.

I will give the Minister some examples. Yesterday, the acute unit in the Mater hospital could only contain nine patients at any given time. There are only nine beds. The staff got a call that somebody had been sent up from Sligo and now they were being sent back to Sligo because a bed was not available for them. That type of operation is expensive. It is poor treatment and bad medical practice. It is a case of constant overcrowding and confusion.

Everybody recognises that when people get in, the quality of the services from the doctors and the nurses is superb. The problem is the mismanagement, the failure to do anything about it and the fact that it has been going on so long, yet there is still no light at the end of the tunnel.

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