Mary Harney (Dublin Mid West, Independent)

I propose to take Questions Nos. 1 and 2 together.

The waiting times for patients attending emergency departments in many hospitals during the first week of January were unacceptable and I very much regret the delays that patients experienced. I have discussed plans with the HSE for ensuring that this situation does not recur. The HSE has assured me that it will take all possible steps to improve waiting times in emergency departments, so that all patients are assessed, treated and discharged or admitted without unnecessary delay. The HSE has taken specific steps to cope with the increase in activity that is normally experienced at this time of year. These include opening beds which are normally closed for seasonal reasons.

Other actions taken by hospitals include increasing the number of ward rounds to ensure that any patients who are ready to go home are discharged with support as necessary from community-based services. Hospitals are also ensuring that discharges are carried out early in the morning and over the weekend to make beds available for patients being admitted through the emergency departments. In addition, the HSE is working to have senior clinical decision makers and diagnostic services speedily available for emergency departments. The HSE has also provided for enhanced GP out-of-hours services through the expansion of the GP co-operatives.

The steps I have outlined are taken to address the current short-term difficulties. Improving access to hospital services requires a wider health-care approach. In recognition of this, the HSE has undertaken a number of initiatives in recent years. These include the winter initiative programme, the introduction of the code of practice for integrated discharge planning and actions to reduce the number of delayed discharges, including the introduction of the fair deal. Other innovations undertaken by the HSE include the development of emergency care networks and the acute medicine programme which involves the establishment of acute medical and surgical assessment units, rapid access clinics and minor injury units. The programme seeks to channel patients quickly to the service best suited to their needs and to reduce the usage of emergency department services by those who can be best treated elsewhere. A new acute medical unit was opened at Cork University Hospital last Monday. Other similar units are already in place at Kerry General Hospital and St. Luke's General Hospital in Kilkenny. The HSE service plan for 2011, which I recently approved, commits to the establishment of 12 acute medical units during 2011 with an investment of €8.5 million.

Emergency departments have particular infection control protocols in place for staff to manage patients attending with flu-like illnesses including the H1NI virus to minimise risk to patients and staff. The key to addressing the emergency department challenge is an integrated proactive management by all concerned throughout the system. I have asked the HSE to ensure that minimising waiting times in emergency departments is a key priority in their service to patients.

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