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

The way the Deputy spoke about it implied that she was. The Deputy chose to focus on my commitment to explore the lack of a model three hospital in this hospital group and ignored all of the other things that were said with regard to the opening of a paediatric area and an extra 17 beds, as well as our commitment to get the issues around the model two hospitals sorted to ensure that the beds, the urgent care centres and the services of the staff in those hospitals are used in an appropriate way.

The House is very aware that I regard trolley waits and other delays in the treatment of patients in emergency departments to be unacceptable. However, it should be noted that Deputy Kelleher has just stood up in this Chamber and said that a reduction from 569 people on trolleys on a given day in January 2011, when his party was last in government, to under 300 people on all days since May is the wrong direction of travel. Is the Deputy suggesting that we should be travelling towards 600 or 700 patients on trolleys? We all know that there are lots of problems in our emergency departments but responsibility for delays does not solely rest with those departments. As John Donne wrote, "No man is an island, entire of itself" and so it is with the health service. We cannot fix the emergency departments unless we fix hospital wards and we cannot sort the wards out unless we have access to long-stay beds in the community, home help and home care packages. We also need a properly functioning primary care system that catches illnesses early and treats patients before they require hospital treatment, particularly those with chronic illnesses.

All of the things to which I refer take time to achieve. We would love if they could be achieved more quickly but we are faced with the reality that the health service evolved chaotically over many decades. We are trying to bring order to the service for the benefit of patients.

The special delivery unit, SDU, has had a great impact in supporting those on the front line by means of the establishment of clinical programmes. Provisional patient experience times for May 2014 show that 68% of patients attending emergency departments were discharged home or admitted within six hours and that 82% where discharged home or admitted within nine hours. I accept that this means that 18% were neither discharged home nor admitted. However, when Fianna Fáil was in government it was common for people to be obliged to lie on trolleys for three or four days. A number of my patients have had experience of this, but it no longer happens. I have emphasised that rather than considering just the number of people who are on trolleys each morning, we must take account of patient experience times. I am aware that there are some people who are still obliged to lie on trolleys for more than 24 hours, which is unacceptable.

The 30-day moving average trolley count by the Irish Nurses and Midwives Organisation, INMO, remains below 300 patients per day. The figure as of 6 June last was just 227 patients, or more than 8% fewer than at the same point last year. To date this year, the system has reported 8.4% fewer patients on trolleys compared to the same period in 2013, which represents a reduction of 2,578 patients. Relative to the baseline year of 2011, the percentage reduction in the number of patients on trolleys is 31.9%. This is equivalent to a reduction of 13,224 patients. However, the task of further improvement continues. From the outset the aim has always been to provide the right care at the right time in the right place. One of the most essential actions to assist with this task is for patients to make use of the non-emergency facilities, such as urgent care and medical assessment units, in many of our smaller hospitals, which can cater for the majority of their injuries and episodes of acute illness. I urge people to make use of these facilities. I do not want my comments to be immediately interpreted as my saying that it is the people's fault. That is not the case. We must make people aware of the value of medical assessment units in particular.

As we have seen, there is potential for delays in the transfer of patients from ambulances to emergency departments. In order to address this issue the national ambulance service has developed a hospital turnaround framework, which clarifies the process of clinical handover, establishing clear lines of responsibility and the standards expected.

I could continue, but I will conclude by assuring the House that hospitals are working with the SDU to put in place all possible additional measures in order to support a safe and high-quality patient care service. I am a member of a Government that is committed to everything to which I refer. I do not set myself aside from the Government; I am an integral part of it. We are all striving to fix this problem.

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