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

I thank Deputies Billy Kelleher and Finian McGrath for raising this issue. Many emergency departments are currently experiencing overcrowding, although Beaumont is one of the worst. It is a busy time of the year, with increased numbers presenting for treatment and requiring extended observation or admission. This is compounded by a rise in winter-related illnesses.

As well as larger numbers attending emergency departments, including those attending Beaumont, the older age profile and nature of their medical needs result in longer than average stays in hospital and delays in discharges. This is a further difficulty in the management of patient flow. Additional funding of €25 million has been provided in 2015 to address delayed discharges. These funds are targeted at hospital and community services which can assist in discharging patients by addressing their care needs outside of an acute hospital setting and will free up bed capacity and, therefore, reduce emergency department overcrowding. An extra €3 million was allocated in this year's recent Supplementary Estimate for health to allow the delayed discharge initiative to start this year, rather than next year as originally intended. This has facilitated the allocation of 1,000 additional fair deal and nursing home places in the past week, compared to the usual 700, an additional 400 home care packages and the provision of step-down and community beds, including 19 for Beaumont, for patients who do not yet have a long-term care place or an appropriate support package to facilitate their return home. A number of patients who had been awaiting discharge from Beaumont have been able to leave hospital as a result. Many others have been approved for funding but there have been delays in getting them to the nursing home or back home.

As well as allocating additional physicians to the emergency department to assess patients, Beaumont hospital has cancelled elective surgery and is currently accommodating patients who have been waiting the longest in its day ward. The media have highlighted the pressures on the hospital, and this has helped reduce presentations. Patients have been advised, where possible, to attend GPs or other health care clinics. GPs are also being asked to consider referring frail elderly patients who require rapid geriatric assessment to the Mater-led clinic in Smithfield so they do not have to wait in busy emergency departments.

Hospitals have been working with the special delivery unit on winter planning initiatives to address the anticipated seasonal surge arising principally from changing weather conditions. However, the successful management of access to emergency and acute care cannot be solely dependent on intensive, short-term solutions. The emergency department task force is being re-established to develop such solutions. It will meet for the first time on Monday, 22 December - I intend to be present - and monthly thereafter in order to address solutions to problems being experienced by emergency departments.

Overcrowding in emergency departments has been a feature and failure of our health service for as long as I can remember. It was a problem this time ten years ago when I was a senior house officer in Beaumont's emergency department, and it was a problem when I visited the emergency department last week to speak with patients on trolleys and chairs. Overcrowding waxes and wanes and its severity varies from place to place but I want to get a handle on the issue in the coming year. The report due to be published later this week will show a significant improvement in ambulance hand over times, which is evidence that the actions we put in place are producing results. Short-term actions are under way but they are not enough. We also need long-term solutions. On the northside of Dublin and in other parts of the country there are simply not enough nursing homes, even if fair deal packages were available.

Generally, people in Dublin are not willing to send their relatives to nursing homes hundreds of miles away and, frankly, they are right.

It was not, in fact, the last Minister who described this as a national emergency, but a Minister ten years ago. He was an Independent Minister in a Fianna Fáil-led Government. Declaring it a national emergency ten years after it was declared a national emergency seems a little silly. What is important is to get things done.

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