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

I thank the Deputy for raising this important issue. As he knows, I visited Cavan General Hospital not long ago as we met at the time. From January to the start of April this year there were just 195 patients waiting on trolleys at the hospital, whereas in 2011, during the same period, there were 1,825 patients waiting on trolleys. This is a decrease of almost 89.3% on the number who must endure long waits on trolleys at the hospital. I congratulate the staff for their great efforts in achieving this improvement.

An acute medical assessment unit, AMAU, was officially opened at Cavan General Hospital on 11 April. The introduction of this unit, alongside the emergency department, benefits patients by allowing for their assessment in a much more timely fashion. From the patients' perspective, attending the AMAU reduces their waiting time and means a senior doctor can make a prompt clinical decision on whether a patient needs to be admitted. A decision on discharge or admission is facilitated by radiology, laboratory and other dedicated services, including nursing, therapy professionals and medical social workers. If admission is required, the patient will be admitted to the most appropriate area of the hospital. If admission can be avoided, the patient will have access to appropriate and timely outpatient follow-up care.

As well as the AMAU, a separate paediatric assessment unit, as mentioned by the Deputy, was introduced in the hospital in July 2011. An outpatient facility for paediatric cystic fibrosis patients opened in April and I was pleased to attend at the time. Development work has been undertaken in respect of the short stay and day wards and the minor injuries unit in Monaghan also assists in ensuring only cases which genuinely require emergency care are directed to the emergency department in Cavan. The Deputy knows that the hospital in Cavan is not just a single hospital operating on two sites.

It is now part of the Dublin North East group and has a very bright future within that.

This development has significantly improved patient experience and reduced wait times in both the acute medical assessment unit and the emergency department, ED, with a daily average of two patients waiting for admission, and these waits being less than nine hours. I am determined to see that this good practice and organisation, which has been put in place in Cavan and resulted in such great ED improvements in recent years, will be repeated in other hospitals and lead to further improvements in EDs across the country.

I am conscious that the infrastructure of the ED in Cavan General Hospital is now 25 years old, and that the number of presentations has grown by around 33% from 2011 to 2013, with an average of 80 presentations each day. In many of our hospitals, the physical structures which were acceptable at the time of construction were not future proofed. When judged against recently developed guidelines, such as the Children First guidelines or the standards defined in the emergency medicine programme, they cannot meet the more stringent standards that have developed in their lifetime. Despite constrained resources, we try to ensure that essential service developments are undertaken. Since 2011, Cavan has seen the expansion of its renal dialysis unit, the development of the paediatric assessment, short-stay and stroke units and the expansion in 2010 of the ED. As resources allow and service needs are determined and prioritised, such developments will continue in the future.

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