James Reilly (Dublin North, Fine Gael)

I propose to take Questions Nos. 110 and 121 together.

In July last year I announced the establishment of the special delivery unit, the development of which is a key part of my plans to radically reform the health system in Ireland. I identified two key priorities for it, namely, addressing trolley waiting times and reducing the maximum waiting time for elective surgery. I am happy to say the SDU has delivered notable improvements on both objectives.

The next phase of work in the area of unscheduled care includes a focus on monitoring the total patient journey time, including time spent on trolleys, as part of the new national score card for measuring performance. New target times which are being introduced this year are for 95% of all attendees at emergency departments to be discharged or admitted within six hours of registration and that those who need to be admitted through emergency departments should wait no more than nine hours from registration. Galway and Roscommon hospitals will be expected to comply with these targets. This phase commenced in February.

Acute hospital services, including complex emergency medicine, must be delivered safely. We know that the requirements for safe delivery of a clinical service include a sufficient volume of activity to maintain clinical skills. The delivery of any service in a given hospital will be determined by the level at which that service, in the context of changing clinical and technical practice, can be provided safely.

All services provided by the HSE are carried out in the context of HSE service plans and informed by a range of issues, including clinical best practice and patient safety. The HSE is working with the Health Information and Quality Authority to determine the type of services that can be safely provided across the range of acute facilities. However, I have requested that no changes take place in service delivery without informing me before their implementation.

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