Michelle Mulherin (Mayo, Fine Gael) | Oireachtas source

I welcome the opportunity to speak on this. I am looking at the Minister while people are asking for more resources. The Minister would happily take more resources and would absolutely love to be able to deliver on the request being made here for more beds and staff. Who would not? The idea that he does not want that and wants something inhumane to happen to somebody on a trolley is not the truth. It is not the truth of anybody in the House. However, there are realities about budgets. The health budget has been severely cut from €4 billion and many efficiencies have been sought.

My local acute hospital, Mayo General Hospital, has fantastic management and staff and, for the first few years of austerity, was better than the national average in reducing trolley figures. This was brought about by better bed management practices such as weekend discharges and same-day procedures. Step-down facilities were used to try to alleviate the problem of delayed discharges. There have been many think tanks around how the problem of trolleys and people on waiting lists for scheduled care and operations, outpatient and inpatient, can be addressed. However, during recent months, the trolley figures in Mayo General Hospital have increased. There has been a surge during the summer that has never been seen before. It is normally associated with winter. Flus and colds have increased. The August figure for people on trolleys was ten in 2014 and 130 in 2015. Clearly, there is a problem.

There is increased demand and we have an underlying problem in our health system which we must face and plan for. The issue will not be just hospitals, trolleys and the existing physical structure. We must face and plan for our ageing population. Many of the additional people attending the emergency department are elderly people with chronic illness and, ideally, they should be managed at primary care level to avoid the deterioration of their conditions and their presenting to the emergency department. This can best be done through GPs, specialist community intervention teams and home care packages. Further funding needs to be directed towards this to avoid the bottlenecks happening in emergency departments.

There is also a capacity problem in our hospitals, including in Mayo General Hospital. The emergency department in Mayo General Hospital was initially designed to deal with 20,000 patients per year but is now dealing with 35,000 patients per year. In the longer-term planning we need investment to ensure chronic illness is managed more in the community. These realities are dawning on us, given that we are growing older and living longer. A business case was made to the west-north west hospital group for an extension to the emergency department and additional medical beds. I wish for these plans to progress in order that we can not just always be firefighting the trolley situation but have a longer-term solution. Community and primary care also need to receive funding.

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