James Reilly (Dublin North, Fine Gael)

I thank the Deputy for raising this issue. To tackle unacceptably long waiting times in emergency departments on a sustainable basis, immediately following my appointment I set about establishing the special delivery unit, SDU. It will not have escaped the Deputy's notice that this problem is the legacy of his Government, although, as the former Ceann Comhairle, he may claim not to have played any part. The aim of the SDU is to unblock access to acute services by improving the flow of patients through the system. The SDU is focusing initially on emergency departments and will work to support hospitals in addressing excessive waiting times for admission to hospital. Our Lady of Lourdes Hospital in Drogheda is working across several levels to reduce the time patients wait on trolleys in the emergency department. The clinical director and group general manager are fully engaged with the SDU in this regard.

As part of the process of forming an overall picture of the emergency departments situation nationally, the SDU has visited units throughout the State and conducted a data analysis. It has identified several hospitals providing unscheduled care that require support. Eight of these, including Our Lady of Lourdes Hospital in Drogheda, require a very high level of support. As part of the process of engagement with the SDU these hospitals have prepared plans setting out measures that could be taken quickly in the hospital and-or closely related community setting that would significantly relieve pressure on the emergency department by, for example, addressing delayed discharges.

This is a new approach. Staff at the SDU visit the hospital and undertake the analysis in co-operation with staff and management. Following that, the SDU asks management to set out what it considers to be required in order to addressed the hospital's difficulties. The SDU will discuss these proposals with the management, questioning particular costs, asking why particular actions are being taken and others not attempted. The bottom line is that we are seeking to identify how, for a limited expenditure, we can secure maximum results.

Following consideration, and as part of the overall process of SDU engagement, a package of short-term measures has been agreed for Our Lady of Lourdes Hospital in Drogheda. The supports being provided to it and other hospitals and associated community services are dependent on a range of conditions being met. These include a commitment on the part of the hospital to progress implementation of the HSE's acute medicine programme and ensure the hospital has seven-day ward discharge rounds in place. In particular, additional capacity, funded by the initiative, must not be offset by reductions elsewhere.

A sum of €725,710 is being made available in respect of proposals relating to Our Lady of Lourdes in Drogheda between now and the end of this year. The measures being taken, though aimed at easing the pressure on trolleys in Drogheda, involve Louth County Hospital in Dundalk and Our Lady's Hospital in Navan, as well as measures in the community. To reiterate what I said elsewhere, no part of the health service works in isolation.

The measures include additional assisted discharge packages including home help, home care and funding for aids and appliances, which will be implemented immediately; the extension of the hours of the acute medical assessment unit at Drogheda to 18 hours a day seven days a week, which will happen by the end of the month; the opening of eight medical beds in Drogheda by the end of the month; the opening of an additional 28 low-acuity beds in Louth and Navan; and the opening of an additional 27 low-acuity beds in the community.

The funding support is dependent on the hospital meeting the performance conditions set down. The SDU will be monitoring the position closely. Owing to its central position and the expertise that is available to the special delivery unit, it is able to develop and roll out solutions that will quickly resolve situations as they arise. I anticipate that the plans being implemented in Our Lady of Lourdes Hospital will quickly address the unacceptable levels of overcrowding in its emergency department.

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