James Reilly (Dublin North, Fine Gael)

I propose to take Questions Nos. 45, 46, 59, 71 and 85 together.

I have said clearly on many occasions that the situation in our hospital emergency departments, where people must wait for unacceptably long periods on trolleys, will not be allowed to continue. For this reason, as I have already outlined to the House, one of my first actions as Minister for Health was to set about establishing the special delivery unit.

The problems in our emergency departments are complex and did not arise overnight. The issues vary from hospital to hospital and some of the solutions will depend on local factors. Delayed discharge, for example, is an issue in some parts of the country but not in others. A common factor is the need for reliable real time information, agreed standards for safe care and relentless performance management against those standards.

Following considerable analysis of the problems in individual hospitals, I recently approved an initiative whereby funding will be made available to ease pressures in certain emergency departments. The supports being funded are dependent on certain conditions and the money will be released based on specific performance. The supports may involve providing funding for smaller hospitals in the group to ease pressures on the major centre. As I have frequently said, I want to ensure that as many services as possible can be provided safely in smaller local hospitals.

In the case of Our Lady Of Lourdes hospital, Drogheda, the hospital has requested a range of supports and the special delivery unit has agreed to a set of proposals which will cost more than €700,000 between now and the end of this year. More than €300,000 is being made available to Galway University Hospital. The special delivery unit has indicated to me that considerable improvements can be made at Limerick hospital within existing budgets and I have requested the HSE to implement these changes. These include some reallocation of existing staffing resources, a better bed management system and the shifting of day case capacity to other hospitals in the group. The issue of further support for Limerick is under consideration by the special delivery unit.

The HSE has indicated that the impact of the emergency department changes introduced at Roscommon County Hospital in July 2011 has been marginal. The figures for the three month period to the end of October indicate an increase of 127 patients at Galway during this period, which is equivalent to ten additional patients per week or less than two per day.

Peaks and troughs are a feature of attendances at emergency departments. The special delivery unit is working with hospitals to use the data on attendance patterns to plan for the variations which will inevitably occur. At my behest, the unit is driving this approach to radically reduce the overcrowding in our emergency departments which has been tolerated for far too long.

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