Enda Kenny (Mayo, Fine Gael) | Oireachtas source

The question is how to deal with all these issues. The transition and the work under way in the Department of Health will certainly not be easy to conclude successfully. Every person I meet who has been through the health system and had treatment has nothing but the highest regard for those who work on the front line, including nurses, doctors etc. The problem in our system is getting in to get that treatment. Trolley numbers are not as high as they used to be but they are still too high. Clearly, the issue has been addressed, in part, by the Government in making further funding available in the transition to the setting up of the hospital groups. That is complex because in some areas they are all HSE hospitals and in others, there are private or voluntary hospitals involved. Careful scrutiny is required so that there can be responsibility allocated to each group. This will eventually transition to a trust to make decisions about what services can be best supplied in an area.

A senior consultant said to me only last week that we could look at it in the following way. He said that in his hospital, the question is what it does as well or better than anybody else, as if a hospital cannot measure up in the standards of what it does, the hospital fails itself, the patient and the system. Many accident and emergency departments are under pressure but all have escalation plans in place to manage the movement of patients through the system in a safe, controlled and planned way. That supports and ensures the delivery of patient care.

The task force convened in December last year had the purpose of providing focus and momentum in dealing with the challenges of overcrowded accident and emergency departments. The Deputy knows from the experience of Our Lady of Lourdes Hospital the problems that can cause pressure because of the footprint, the numbers of people coming through and the stress that staff experience. The HSE published the task force action plan in April with a range of time-defined actions to optimise the existing hospital and community capacity, develop internal capability to deal with the issues as they arise and improve leadership, governance, planning and oversight.

On top of that and based on that report, there was an extra allocation of €74 million provided in 2015 to increase the number of long-term nursing home care places and reduce the waiting time for the funding in such places, as well as providing additional care, beds and home care packages that would provide viable supports for those who no longer need acute hospital care. I saw reports on that recently and if people are asked their preference, they will of course say they prefer to be at home for as long as possible. The additional funding came on top of some budgetary measures, when the Government provided an extra €25 million to support alternatives to and relieve pressure on acute hospitals.

The number of delayed discharges is reducing steadily to a current figure of 650, or a reduction of over 20% since November last year. The waiting time for funding under the nursing home support scheme has reduced from 11 weeks at the beginning of the year to four weeks at the moment, which is a significant improvement. The numbers waiting for the support scheme funding have reduced to 535 and are stable; the funding is set to support an additional 1,604 people this year. I understand that 1,513 transitional care places were provided in the first four months of this year and that will benefit patients who require a transfer from the acute hospital system. There are 140 from a total of 173 additional short-stay, non-acute beds available in public units across the country, and the remaining numbers will be provided over the next number of weeks. The Deputy knows that Mount Carmel opened on target in April and that will provide a further 65 beds by the end of this month, with 45 currently in place, which is welcome. An additional 400 home care packages have been provided to specific hospitals in the greater Dublin area since January this year, with a further 860 additional home care packages to be provided from June to the end of the year.

I spoke to relations of a good lady who was approved for a home care package quite recently and it is extraordinary to hear of the change in her comfort and convenience arising from a good home care package. It can complement their private resources and make for a very comfortable position for the person in question. We need to see more of that rather than having people transition at a very early stage into a long-stay institution, where they may not wish to be in the first instance, until they might have to go because of physical or medical conditions.

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