Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

There will be a job to be done in educating the public and, to a lesser extent, GPs about where patients should go and when. Ideally, an older patient with pneumonia should be referred by his or her GP to a medical admissions unit, if there is one available. He or she should not - at least not during the day - be calling an ambulance to take him or her to an emergency department. The same applies to minor injuries. Where there is a minor injuries unit available, a patient should go to it rather than the emergency department. Certainly, he or she should not be calling an ambulance. There is a significant job to be done to change mindsets around this issue.

In some countries ambulance crews can discharge patients from the ambulance and not take them anywhere if they do not need to go to a hospital. Similarly, ambulance crews have more autonomy in deciding where they take the patient, and there are many such systems that can change in time.

Any decision to reconfigure services among the hospitals in Limerick, Nenagh and Ennis is a matter for the hospital group to decide, not me. Unfortunately, that group is running very much over budget. It is the one running most over budget among all the hospital groups, and that is a matter of concern in itself.

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