Enda Kenny (Mayo, Fine Gael)

Deputy Adams looks fine and I am sorry he fell off the bicycle. If he feels up to it, he can join me and the Minister for Arts, Heritage and the Gaeltacht, Deputy Deenihan, for a charity cycle on the Ring of Kerry. There is no disagreement about the stress, tension and imposition on people who must lie on trolleys. I have had it in my family, like everyone else. Deputy Adams points out the value and commitment of front line professionals in the way they do their business but also points to why the structure must be changed. Change is always difficult to bring about. Deputy Adams makes the point about ambulances transporting him here and there but there must be a more efficient method of dealing with patients. Stepdown facilities, community facilities and the opportunity for people to remain in their homes for as long as appropriate will allow us to avoid sending elderly people to longstay institutions long before they should be there. The question of restructuring the health delivery system for the future, away from what we had in the past, is obviously complex and tortuous. This applies not only in Ireland but to all countries where change has been attempted for the betterment of the population.

There is no argument about the stress and pressure people exhibit on trolleys and in distressed positions. I am glad Deputy Adams has recovered. The point he makes about front line professionals is accepted. The point he makes about himself as a patient is obvious but the method of dealing with such cases should be restructured to give it greater effect. There was a perception of catastrophe coming down the tracks when so many professional left at the end of February but it did not happen because clinical and medical teams and hospital personnel signed up to a plan or programme for each hospital. They exhibited diligence and the capacity for change rosters and travelling distances for those redeployed in order to give of their professional services. I accept that. We want to get to a point where the service is effective and in the best interest of every patient.

Over the years, I have been in so many wards and corridors, talking to people lying on trolleys having suffered an accident. It is distressing. The Minister for Health has set out commitments to reduce times on trolleys and to have it reduced to no time if possible. There is a sense of achievement but it requires further work in the future.

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