David Cullinane (Waterford, Sinn Fein) | Oireachtas source

We have to examine why we are seeing this high level of presentations. The Minister is right, in that many of those attending are doing so with more acute needs, which is presenting more challenges for hospitals. Another reason is the lack of out-of-hours GP services. The NAS has told me that there is an absence of a treat and refer policy that is underpinned by clinical governance and that there needs to be movement in this regard. Many people are calling ambulances because they cannot get access to GPs, meaning that more people are presenting to emergency departments. We are still not managing enough people in the community, in particular people with chronic pain, respiratory illnesses, diabetes and other conditions that can be treated in the community.

Every hospital I have visited across the State has said that it has submitted a capital application for new beds in single-bed isolation units - 42 beds in Sligo, 98 in Limerick, 50 in Cork and the same in Galway and Laois - but that, apart from dealing with all of the other problems, there is no urgency to put capacity in place. That is why there is such pressure on the emergency departments, which is causing havoc in those hospitals and stress for the people working in them.

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