Liz McManus (Wicklow, Labour)
Link to this: Individually | In context

This is the first time in my recollection that relatives of very sick people lying on trolleys have taken to the streets and have stood outside the gates of Dáil Éireann. They have come from the Mater Hospital, from Tallaght and from James Connolly Memorial Hospital in Blanchardstown. Nurses and nurse managers, who have been driven to these extraordinary lengths, have joined them.

Let us consider the Mater Hospital as just one example, where between 20 and 35 people are stuck on trolleys at any one time. The accident and emergency department is short four nurses and needs more medical staff. There are 60 nurse vacancies in the hospital. More than 70 beds are inappropriately occupied and 100 additional beds are desperately needed. This hospital is in the Taoiseach's constituency. He was even employed there at one point. However, his response in the House earlier reveals an extraordinary disregard for the harsh reality facing patients waiting on trolleys and chairs and unable to obtain the treatment they need.

There are patients who never reach a hospital bed and who spend their entire stay in hospital on a trolley. Lying on a trolley in an accident and emergency department means discomfort, sleeplessness, and total lack of dignity and of privacy. Has the Minister for Health and Children considered the health and safety issues in accident and emergency departments where the pressures are so great that, in some cases, even the toilet facilities are grossly inadequate? The previous Minister for Health and Children failed to address the problem. In fact, it is now worse than ever and we have not yet even faced the onset of winter.

Is the Minister not afraid of the impact a flu epidemic could have on an already pressurised service? In this city there were 164 patients waiting on trolleys in our accident and emergency departments today. However, hospital wards are closed, new facilities remain unopened and more than 300 beds are inappropriately occupied. Countrywide today, there were 222 patients on trolleys in accident and emergency departments. The response of the Taoiseach earlier was bereft of a single solution. Instead he returned to the mantra of investment in the health service that he has depended on since he came to office.

The response, or lack thereof, of the Minister for Health and Children has been even more disconcerting. It seems that she has even refused to do interviews in recent days in respect of the escalating crisis in accident and emergency services and to inform us with regard to how she intends to respond and deal with the situation. I welcome the fact that she is present to reply to this matter.

In July 2002 the then Minister for Health and Children announced 850 community nursing beds to help alleviate the crisis. As of today, not one of these beds has been provided. So much for the much vaunted public private partnership process. It has not worked, nor has it delivered. We need to hear what will be the alternative. According to hospital consultants, there are 3,500 fewer hospital beds than there were in 1990. In my estimation, a pitiful 700 beds have come on stream in recent years. This is nowhere near sufficient to meet demand.

Will the Minister of Health and Children introduce a Supplementary Estimate at this stage and will she take initiatives in the following areas? Will she use spare private nursing home capacity, open up the new facilities immediately, provide a significant number of additional beds, deal with the nursing shortage, particularly in ICU and accident and emergency departments and lift the cap on medical training places for doctors? On a day on which 222 Irish citizens are lying in discomfort and pain on trolleys in hospital corridors, it is not good enough for the Government to run away from this problem any longer.

Mary Harney (Dublin Mid West, Progressive Democrats)
Link to this: Individually | In context

Deputy McManus acknowledged that I am present in the Chamber. She might also have been gracious enough to acknowledge that I was here on time. When a Deputy is delayed, it is customary to acknowledge the fact that the relevant Minister was present on time.

The difficulties being experienced in accident and emergency facilities throughout the country are not acceptable to me, to the Government or to the average person who cannot understand how, at a time when we have trebled spending on health care to €10.5 billion, these things can happen. Many patients are experiencing long delays and difficulties, notwithstanding the enormous efforts made by the dedicated and caring staff who look after them.

The problems of the accident and emergency services are not unique to them. They also affect the health service as a whole. When seeking solutions, we must consider those that are sensible, sustainable and which fit into the overall strategy of reform. Everyone in the House acknowledges — as those who have reviewed the health services have already acknowledged — that there are no quick fix solutions or magic wands that can be waved. If it were easy, it would have been done a long time ago.

I intend to bring forward a package of measures to improve the experience of all patients who enter our hospitals via accident and emergency departments. As Members are aware, 78% of patients who enter accident and emergency departments in the six hospitals in the Dublin area do not require to be admitted. The 22% of patients who require admission are experiencing particular difficulties. When I met the chief executive officers of the six Dublin hospitals, I asked them to provide patient data. I received that data this evening from the Mater Hospital. If we are to make sensible decisions, we must do so on the basis of the best possible information. We do not need to know who the individuals are but we need to know their circumstances.

Among the issues we will have to address in the context of the package I will bring forward will be those relating to step-down facilities. As Deputy McManus has acknowledged, some of the patients in our hospitals at present do not require an acute hospital bed, provision of which can cost up to €5,000 per week. Other patients require different medical facilities. In some cases, they may require access to rehabilitation facilities. Cancer patients may require hospice related facilities. I need to have that data if we are to come forward with an appropriate package of measures to address the difficulties being experienced.

I will, however, give this commitment. There will be no grandstanding on my part. I will not build up any false expectations and I will not play politics with seriously ill people. However, I will work as hard as I possibly can with the resources available to me to bring forward radical, sensible and sustainable solutions that will form part of the package not only of the accident and emergency reforms I want to bring forward but the overall reforms I wish to introduce in respect of the health services.

From 1 January, the Health Services Executive will assume operational responsibility for the work currently done by the health boards. I intend to take the legislation through the Oireachtas before Christmas to ensure this becomes a reality. I am delighted to inform the House that the chief executive officer designate of the Health Services Executive has agreed to bring forward the start-up date of his contract from 1 April to the end of January. This will mean he will be in place to ensure that the new systems of administration, accountability and responsibility will work more efficiently and effectively for all patients.