Ciarán Cannon (Galway East, Fine Gael)

I am taking this matter on behalf of my colleague, the Minister for Health. He is conscious of concerns about some hospitals in advance of the next rotation of NCHDs. Departmental officials are in constant contact with the HSE and relevant authorities to make certain the necessary steps are being taken to ensure ongoing safe delivery of service in hospitals and in accident and emergency departments, in particular.

The shortage of suitable NCHDs is an issue worldwide. The HSE has taken a range of actions to address NCHD vacancies to ensure the resulting impact on services is minimised and patient safety maintained. A recruitment drive abroad is included in this process. Officials from the Department of Health are at an advanced stage of drafting a Bill to amend the Medical Practitioners Act 2007 to support the recruitment process. This will empower the Medical Council to register doctors in supervised posts for a defined period. The aim is to ensure a speedy availability of suitably trained NCHDs. The Minister has stated publicly that it will be a challenge to maintain current services in all accident and emergency departments because of the difficulty in recruiting NCHDs. The measures he is taking are designed to address this challenge as effectively as possible.

The wider difficulties in accident and emergency departments, where patients wait unacceptably long periods, cannot be resolved solely within the departments themselves and must be addressed on the basis of a health system-wide approach. In particular, overcrowding in these departments is caused by many factors and any solution to problems that may arise from this issue must reflect this reality. We must ensure patients are treated in the most appropriate way in the most appropriate location. This means that, where and whenever possible, patients who can be treated in the primary care setting receive that treatment in a timely manner. This means that patients can be confident of receiving the necessary treatment on time and that there is less need for patients to attend at accident and emergency units.

The Minister recently established the special delivery unit, SDU, and assigned to it, as a priority, the task of addressing the issues arising in accident and emergency departments. The SDU is a key part of the Government's plans to reform the health system in Ireland radically, with the ultimate goal of introducing a system of universal health insurance. Its establishment was one of the Minister's key priorities for the first 100 days of the Government's term of office. Dr. Martin Connor has been appointed as adviser to the SDU. He has extensive experience in the NHS and led a similar initiative in Northern Ireland with considerable success. His principal task will be to build the SDU and to prepare proposals for the Minister on how best it can be placed on a permanent footing within the next six months. The SDU will work to unblock access to acute services by significantly improving the flow of patients through the system and by streamlining waiting lists, including referrals from GPs. The SDU is already working closely with the HSE, building on initiatives already under way, which include the clinical programmes developed by the HSE's national directorate for clinical strategy and programmes.

The SDU's priorities, set by the Minister, will encompass: emergency departments where waiting times for admission have been unacceptably high in several hospitals, often breaching the current six-hour maximum waiting time target; in-patient waiting times, where the trend recently has been upwards, despite the work of the NTPF; out-patient waiting times because the time from GP referral to an appointment with a consultant is unacceptably long in many specialties; and access to diagnostics which forms an essential part of the patient journey for all the areas of access mentioned.

I am confident that with improved processes for the recruitment of NCHDs, leadership from the special delivery unit, the implementation of the HSE's emergency medicine programme and related clinical programmes, we will be in a position to reassure patients that the challenges for the delivery of services related to emergency departments will be quickly and decisively addressed.

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