James Reilly (Dublin North, Fine Gael) | Oireachtas source

There has been no spike of up to 400 people on trolleys in emergency departments this year. The Deputy opposite should get his facts right. What has happened here includes ward watch figures, which we accept and acknowledge, where people are on trolleys elsewhere up through the hospital, but there has never been 400. The Deputy should get that right.

Ward watch came in during the course of last year. Therefore, it is very difficult to compare what is happening this year with last year and certainly impossible to compare what is happening this year with what happened in 2011 when we know there were 569 people on trolleys in one day and that was in the emergency departments. That did not include ward watch or how many people were inappropriately placed throughout the system. There has been a massive improvement.

I have always regarded trolley waits to be an unacceptable feature of the Irish health system, which is the reason I set up the special delivery unit in 2011. Since then we have a 33.8% reduction in the number of patients waiting on trolleys, that is, 29,200 fewer people waiting. While such improvements are significant, I accept the challenges continue, particularly in the early part of the year.

It is more than unfortunate but not unanticipated that a number of our hospitals have been experiencing pressures since last week. Many hospitals are coping well with the demands arising from emergency department pressures and the main difficulties are concentrated in a relatively small number of hospitals and I will outline those in the course of my response.

The trolley counts of the last few days are disappointing and both I and the HSE acknowledge the distress and discomfort for patients so affected. This is, in part, as a result of the seasonal flux in hospital activity that traditionally takes place after Christmas and the new year. A similar pattern has been occurring in emergency departments across Northern Ireland and England, with a large surge in activity and waiting times since the start of the year.

Many of our hospitals are reporting increased admission rates with higher acuity of presentations noted, particularly among the frail elderly. In response, there has been an intensive engagement between the special delivery unit and the hospitals affected, concentrating on those with the most pressures particularly in recent days. Hospitals are working with the special delivery unit to ensure they balance the demand for scheduled and unscheduled care, maximise discharge planning and take additional measures to relieve pressures as required.

Additional funding has been provided for enhanced home and community care packages. Funding has also been targeted to address areas of acute services which are likely to experience increased service demand.

In regard to the implementation of the HIQA report on Tallaght Hospital, work is well under way to implement all of the recommendations in hospitals. In line with established HSE policy on the implementation of major reports, the HSE established an implementation oversight group to progress the report's recommendations, which reports to HIQA on its progress regularly. Updates on progress are available publicly on the HSE website.

In all there are 17 recommendations which relate to unscheduled care of the 33 total recommendations in the HIQA Tallaght report. In general terms, there is strong evidence of progress in key areas such as the completion of early morning ward rounds, the application of the Manchester triage system and the robust review of waiting lists. This progress is indicative of the strong national leadership and levels of local engagement around these critical issues. The implementation of the national early warning score and maternity early warning score have also added significantly to the care of patients.

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