Brian Hayes (Dublin South West, Fine Gael)
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Question 67: To ask the Minister for Health and Children if she is satisfied with the finding of the recently published accident and emergency task force report which states that at least seven accident and emergency units are unfit for their purpose; and if she will make a statement on the matter. [18003/07]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The HSE recently published the emergency department task force report. The infrastructural deficits identified in the seven hospitals referred to are being addressed through a combination of interim and long-term capital improvements and refurbishment.

The task force recommends that the issues in emergency departments be examined on a whole-hospital and whole-system basis. It identifies the requirement for hospital-specific initiatives as well as the development of national responses in regard to key structural issues. A key requirement is the development of strong internal management control processes at hospital and community levels to ensure capacity is fully optimised and that measures designed to unlock capacity are supported by strong controls that enable appropriate balancing between emergency and elective workloads.

My Department is assured by the HSE that a series of additional measures are being put in place to ensure the delivery of an improved service for patients and to reduce pressure on accident and emergency departments. These include a series of hospital avoidance measures including the following: the expansion of the hospital in the home scheme to the Dublin academic teaching hospitals; the development of community intervention teams; the roll-out of more primary care teams; the expansion of out-of-hours GP services and the expansion of community diagnostic services. Measures being taken to improve and optimise acute hospital capacity and capability include the following: seven new community nursing units in Dublin, additional long-stay beds outside Dublin, development of admission lounges, acute medical assessment units at Navan and Naas, acute medical admission units at Beaumont, Sligo and Tallaght and the development of enhanced diagnostic capability in hospitals.

Brian Hayes (Dublin South West, Fine Gael)
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Will the Minister confirm that this damaging report, which showed that seven accident and emergency wards were unfit for purpose, was effectively suppressed until after the general election? The report was published on 1 June but was expected at the end of last year. Why was this bad news left until after the general election?

Returning to a point made by Deputy Liz McManus, who will take responsibility for the guarantee given that by February 2007, six hours would be the longest waiting period for patients in accident and emergency wards? This is another deadline missed. Who takes responsibility for that in the brave new world that is the HSE?

Mary Harney (Dublin Mid West, Progressive Democrats)
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In the previous question the Deputy asked me if I had confidence in Professor Drumm. I have 100% confidence in him and think we are very lucky to have someone with his vision, determination and courage at the head of our health services. Given his clinical background, he brings enormous credibility to the HSE.

On the matter of publication of the task force report, I had no hand, act or part in its publication. I am unsure whether it was published or whether it came into the public domain by way of response to a freedom of information request. However, it is no secret to any active citizen that deficiencies exist in many of our accident and emergency departments. That fact is of no surprise to anybody. The challenge now is to put in place infrastructural improvements, some of which I mentioned. For example, significant investment is about to take place in Drogheda and we have already made significant investment in Wexford. Since the compilation of the report, many of the matters referred to in it have been dealt with.

The matter of the time, from arrival in accident and emergency units to admittance or going home, is one on which we need to concentrate. We should not just concentrate on the time spent on a trolley from the time a decision has been made to admit a patient. Often, the experience is that from the time people arrive, it is a couple of hours before any clinical expertise is available to them. That is the issue. I hope that in future the HSE will be in a position to put in place short time lines throughout the country.

Some 95% of the 3,000 people who visit accident and emergency units every day have a relatively pleasant experience. Research has shown that the issue concerns the remaining 5% in a few key hospitals. The HSE is working with those hospitals to improve performance.

Brian Hayes (Dublin South West, Fine Gael)
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Will the Minister accept that the key problems within the accident and emergency departments referred to in the report are the lack of beds and the need for additional capacity? Given that we have missed the stated, firm deadline that by February 2007 no one would be left waiting for more than six hours, what is the latest commitment? Will it be October, November or February 2008? I have only been spokesperson on health for a matter of weeks, but it appears we have a shifting deck of responsibility with regard to certain people taking responsibility for actions that are unmet. The Minister is very keen to inform the House of the responsibility of the private sector when it comes to deadlines and commitments, but when it relates to the HSE and matters falling under her Department, she is less responsible. When will this commitment be met?

Mary Harney (Dublin Mid West, Progressive Democrats)
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As the Deputy is aware, the HSE acquired the assistance of outside expertise to visit a number of hospitals, look at their processes and make recommendations. Many of those recommendations related to improved procedures and processes within the hospitals and had nothing to do with extra capacity. For example, the HSE has acquired diagnostic capacity at Smithfield in Dublin for approximately 2,000 older patients who suffer from chronic illnesses who are directly referred there. The HSE required capacity for the waiting list in the Mater for an MRI and that was cleared in a matter of weeks by a private provider.

Direct access by GPs to diagnostic facilities will greatly improve performance in accident and emergency units, as will the provision of the out-of-hours service, particularly in the north of Dublin and in other parts of the country where many people end up in accident and emergency units who do not need to be there. These improvements will work together like a jigsaw — one does not work without the other. Simply providing more capacity without changing the way we do the business and what we do at acute hospitals will not lead to the improvements to which we all aspire.