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

I thank the Deputies for raising this issue. It will also be discussed during Private Members’ business tonight and tomorrow and at committee tomorrow as well.

At the outset I emphasise that the Government regards trolley waits of more than nine hours to be unacceptable and acknowledges the difficulties which any overcrowding in EDs causes for patients, their families and the staff who are doing their best to provide safe, quality care in very challenging circumstances.

As of this morning at 8 a.m. the TrolleyGAR update from hospitals indicated that there were 298 patients on trolleys. The figure includes patients on trolleys in regular wards but not those in day wards. The figure fell to 217 at 2 p.m. today and 131 of those were on trolleys for more than nine hours. Most such patients will be in beds tonight but of course more patients will come in in the meantime. While 298 people waiting for a hospital bed is nothing to be proud of, we should all acknowledge that through the hard work of staff, hospitals working together, supported by HSE services, management and my Department, we have significantly reduced the numbers.

The nurses' union trolley watch number this morning, at 268, was the lowest in seven years for the equivalent peak Wednesday in January. The last time it was lower was in 2007. This morning's SDU TrolleyGAR figure stood at 298. That is the lowest figure recorded for the equivalent peak Wednesday in the four years of recorded hospital statistics. When recording started in 2012, the figure for the equivalent peak Wednesday in January was 355.

All hospitals have escalation plans to manage patient flow and patient safety in a responsive, controlled and planned way that supports and ensures optimal patient care. Triage is used to prioritise patients in order that those with the most acute needs are seen and treated as soon as possible. Senior clinicians are a key part of the process. As part of their everyday duties, they work closely with hospital management to minimise potential risk and ensure the safest possible care.

Measures to manage ED surges involve the health service as a whole, including primary, community and continuing care. The aim is to ensure that all available capacity and options are utilised and brought to bear on the situation. Some of the measures taken to reduce overcrowding include opening additional overflow areas and community and transition beds - hundreds of beds have been opened in the past week; the curtailing of non-emergency surgery, which unfortunately will impact on waiting lists later in the year, but it must be done; the provision of additional diagnostics; and a focus on discharge planning and additional home care packages as well as fair deal nursing home places – 400 of the former and 300 of the latter were approved in December but, unfortunately, they did not all come through until January.

Members will all be aware that I convened the emergency department task force to develop lasting solutions to overcrowding by bringing a new focus to the challenges presented by this chronic problem that has been ongoing for 15 years. The task force comprises stakeholders such as senior doctors, lead hospital consultants, GPs, HSE national directors, union representatives and senior officials from my Department. The task force will meet on a monthly basis to develop and oversee the implementation of effective measures to improve access to acute hospital services. It works in partnership with primary, acute, community and ambulance services.

I attended today's ED task force meeting. I take this opportunity to welcome the appointment of Mr. Liam Doran as co-chair of the task force. An important point to make because the task force is not the only thing happening in this regard is that conference calls among several HSE staff and hospital group chief financial officers, CFOs, are happening daily, twice daily and sometimes three times a day since the beginning of the year. I have participated in some of the conference calls.

I am aware that the INMO is threatening industrial action as a response to this very difficult situation. I am also aware that seven out of 26 hospitals are affected by the threat of industrial action, which is a most unfortunate situation. While I am assured that a work to rule will not affect patient care, I was present in hospitals and working there for previous work to rule situations and I am aware of their impact which will make life harder for other front-line staff, in particular junior doctors. The issues currently experienced across EDs require co-operation across all areas. Only by working together can we give patients the services they need.

I reassure the House that we are all working hard to find solutions to the management of emergency care, with optimal patient care and patient safety at all times remaining a Government priority. I am out of time but I will respond to some of the Deputies’ points when responding to supplementary questions.

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