Joe O'Reilly (Cavan-Monaghan, Fine Gael) | Oireachtas source

It is important at the outset to establish what has been achieved to date and to acknowledge the proactive leadership role of the current Minister, Deputy Varadkar, and that of the Minister of State, Deputy Lynch. For 2016 health will have funding of €13.195 billion for current expenditure and €414 million for capital expenditure. This represents increases of €900 million and €36 million respectively. There has been a 10% improvement on the overall number on trolleys as against the same date last year. The nursing home support scheme has been augmented with an extra €35 million down to a three or four-week waiting list. Some 649 additional clients per week are dealt with. There is additional winter capacity and the closed beds initiative has been introduced. Some €18 million has been made available to support the opening of 321 beds, with a further 127 due to be opened in the coming weeks.

Under the HSE national service plan, an additional €20 million has been provided to maintain the 2015 outturns of 10,437 hours of home help. That is critical. A sum of €153 million has been provided for 15,450 home care packages and €6 million has been provided for 313 transitional care beds. This has delivered 109 places. An additional €200 million for refurbishment or replacement of older persons units has been provided and we have seen the extension of general practitioner care to under sixes and over 70s as well as 900 more nurses. That is the context of the debate.

I am very proud that the emergency department in Cavan General Hospital is 27 years open this year. It has an average of 80 patients per 24 hour period. Since 2011 the hospital's performance has steadily improved with patient volumes and waiting times reducing significantly. During the period from 1 October 2013 to 1 April 2014, Cavan General Hospital was one of the best performing emergency departments in the country and was rated green throughout this period on trolley ratings, with an average of approximately two patients waiting at 8 a.m. each morning. It is a great story for Cavan General Hospital, of which I am so proud. This is due in part to significant initiatives brought in by the Government since 2011. There has been an overall expansion of emergency departments. I wish to remind the Minister of the need for a new emergency department in Cavan and a new capital spend. There has been an expansion of the renal dialysis unit and we have seen the development of the paediatric assessment unit. These services have diverted patients from the emergency department, thus alleviating the pressure. There are new short-stay and stroke units and we have seen enhanced relocation of day ward services. There is a new cystic fibrosis suit with additional rooms for paediatrics and we have seen the establishment of a genitourinary medicine centre in Monaghan hospital. The story in Cavan is great and I am so proud of it. Monaghan hospital is augmenting that and doing an extraordinary job.

The issue of overcrowding in emergency departments cannot be resolved by emergency departments alone. A collaborative approach is necessary and must involve social care and primary care. I urge the Minister to be extraordinary, as he is in every Department, and to keep a major focus on this. I do not believe the potential of primary care has been fully exhausted yet. Apart from the number of primary care centres, I believe there is more potential within existing centres to have situations hived off. We need a collaborative, combined, holistic approach.

The emergency department task force was established to tackle the problem of overcrowding. A total of 88 actions were identified and these have to be worked through. Of course none of us is happy with the status quo. We want no one on trolleys. However, significant efforts have been made. I believe that should be acknowledged and the work needs to be kept going.

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