Kathleen Lynch (Cork North Central, Labour) | Oireachtas source

I will begin by addressing some of the points raised by Deputies opposite. Deputy Maureen O'Sullivan made reference to people with disabilities, addiction problems and dementia or Alzheimer's disease and the confusion that reigns when they have to attend at emergency departments. Last Tuesday in the Mater hospital, together with the chief executive officer of the Health Service Executive, I launched national guidelines on accessible health and social care which will see extensive training given to staff to help them to recognise that people with certain difficulties may have a problem understanding questions or instructions and ensure those patients are treated in an appropriate fashion. That type of work is going on behind the scenes all the time.

Deputy Finian McGrath suggested that opening up nursing home beds would solve all our problems. I agree it would solve some of them. However, we do not want a situation in which people in Dublin North, for example, are offered a bed in a facility at the furthest edge of Kildare or Kilkenny. I am not saying they are not nice places, but they are not very appropriate in terms of patient comfort, accessibility for visiting family and so on. We have beds, but they are not always where we need them to be. That is a difficulty we will have to resolve.

Notwithstanding claims to that effect, the problems in our emergency departments are not all down to late discharges. The numbers in that regard change regularly. The current difficulty in emergency departments is a combination of factors. For instance, I was informed recently by a person who advises the HSE that the uptake of the flu vaccine this year is much lower than it was in previous years. We need to start asking people to get that vaccine. As sure as night follows day, there is a flu outbreak on the way.

Turning to the motion itself, I am keenly aware of the issues raised and have listened closely to the concerns and frustrations expressed by Members in regard to the number of patients on trolleys, the overcrowded conditions in which they must wait for treatment and the associated difficulties in moving patients from acute care to long-term community or home care. The Minister, Deputy Leo Varadkar, spoke in detail last night about the wide-ranging actions and integrated approach being taken to managing these issues in order to improve the delivery of emergency care and meet the needs of elderly patients in a responsive, controlled and planned manner. I am particularly struck by the work of the community intervention teams to help older people avoid hospital admission and facilitate early discharge, which is essential in assisting them in returning to their own homes.

On the third Thursday in April 2014, there were 309 patients on trolleys, according to the Irish Nurses and Midwives Organisation, INMO. On the equivalent Thursday in 2011, there were 383 patients on trolleys. This morning, there were 316 such patients. This illustrates clearly that this is not a new problem. Moreover, it shows that the current emergency department situation did not happen overnight. I agree wholeheartedly with the Minister that local leadership, comprising staff, unions and management, with a common view of the issues impacting on their hospitals and an equally common desire to address those issues, is the key to providing an effective and sustainable response. It is appropriate to acknowledge that through the hard work of hospitals, supported by other HSE services, HSE management and the Department, we have made significant inroads on numbers in the past week. The engagement of senior hospital consultants, GPs, unions, senior HSE and Department managers, our incredible workforce of nurses, and the emergency department task force co-chaired by the general secretary of the INMO, all working together, has given a focus to the issue and driven momentum towards finding both short- and longer-term solutions to deal with trolley waits. Consultation and partnership with primary, community and ambulance services mean we are now addressing access to urgent hospital care in a comprehensive manner, which has not been seen before.

The €3 million funding allocation given in December 2014 and the €25 million allocated in 2015 to address delayed discharges have resulted in 300 extra approvals under the nursing home support scheme, a reduction of six weeks in Fair Deal approval times, and the provision of 50 additional short-stay beds, a further 65 transitional care beds and 389 additional home care packages. I am pleased to state that, at this time, no patient who has received approval for home help or home care is waiting for funding for these services in order to be discharged from hospital.

I conclude by reiterating that the problems we have seen in hospital emergency departments are not caused just by the number of elderly people awaiting discharge. It is much more complex than that. I would hate the message to go out from this Chamber that the only people responsible for this particular issue are the older patients who are being cared for in an environment in which they do not want to be and should not be. I would appreciate very much if, instead of repeatedly tabling motions on health, Fianna Fáil would come up with a policy on health.

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