Jim Daly (Cork South West, Fine Gael) | Oireachtas source

I thank the Deputy for highlighting this issue. Of course, all Members accept the seriousness of the overcrowding issue. On several occasions in various forums I have addressed overcrowding at the emergency department in Limerick. We are determined to tackle it. Deputy Kelly made a valid point about more joined-up thinking and better utilisation of the model 2 hospitals which offer great value for money, service, capacity and huge benefits in terms of dealing with chronic overcrowding. Some 82% of respondents to the recent patient experience survey indicated that they had a wonderful or excellent experience in our hospitals. The issue is access. The only way to be admitted to our hospitals is through an emergency department. We must address that.

As Deputy Kelly rightly stated, we face a particular challenge over the winter months. The winter plan will be published tomorrow. As the Deputy is aware, many of its elements are already in the public domain and more will be teased out. The winter plan is not an annual event. Rather, the HSE has been progressing a three-year plan to deal with the acute pressures in our hospitals throughout the year for some time.

The Deputy is aware of the measures being taken to tackle these issues. He is a member of the Oireachtas Joint Committee on Health and is up to speed on measures such as the 550 intensive home care packages and the €10 million that has been allocated for aids and appliances. We also need to utilise better the capacity in the model 2 hospital system and step-down and transitional care. Efforts in that regard are working very well in some areas. The Deputy is familiar with Bantry General Hospital which is a model 2 hospital in my constituency. It is the only remote rural hospital. This issue was debated at length on Monday with the hospital management group.

I have done a lot of work over the past three or four months with the chair of the University Limerick hospital group, Mr. Graham Knowles, on the issue of delayed discharges. For far too long, our focus has been on the number of people waiting on trolleys. It has been an obsession for some politicians and the media. RTÉ and similar agencies periodically highlight the number of people waiting on trolleys. That misses the point substantially.

Deputy Kelly will agree that it is far more important to put energy into recognising the number of people who are in hospitals but ought not to be. As the Deputy is aware, I have particular responsibility for older people. The most dangerous place for an older person who is vulnerable to infection to be is in an acute hospital for any longer than he or she ought to be.

The amount of time spent on trolleys is of more relevance than the number of people on trolleys. To focus on the latter is to miss the point, but it an easy headline to generate. Many politicians and members of the media focus on trolley numbers rather than examining the more substantive issues in regard to the causes of delays in our hospital, such as freedom of movement into hospitals and the issue of delayed discharges. The chairman of the UL hospital group chaired a working group for me in recent months to identify several initiatives to address that issue in a constructive attempt to create space in our hospitals. We will roll out those initiatives to free up emergency departments and stop the chronic overcrowding.

We obviously have a lot of work to do with general practitioners to ensure patients go to the emergency department only when they absolutely have to do so and avail of healthcare at more local level in primary care centres. That is the objective of the Sláintecare project in the medium term. There is also a short-term objective which comprises the winter plan and the winter initiative. In that regard, a sum of €10 million has been announced. There is a medium-term plan, with which the Deputy is very familiar from his work in the implementation of Sláintecare, key to which is better utilisation of model 2 hospitals.

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