Jan O'Sullivan (Limerick East, Labour)
Link to this: Individually | In context

Question 10: To ask the Minister for Health and Children her views on figures provided for the board of the Health Service Executive which indicate that 44% of patients in hospital emergency departments had to wait longer than the maximum target time of 12 hours in the first two months of 2008; her further views on whether this is still a national emergency; the measures planned to address this situation, which is causing great distress to patients; and if she will make a statement on the matter. [16329/08]

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

A total of 184,159 people attended accident and emergency departments in January and February this year. Of these, one third, about 61,000, were admitted as inpatients. The vast majority of these patients were admitted without delay. The HSE reports daily at 2 p.m. on the numbers of remaining patients who have not been admitted immediately. The report cites the waiting times as being either between zero to six hours, six to 12 hours, 12 to 24 hours and more than 24 hours. The number of patients waiting in each category as a proportion of the total who are not admitted immediately can be calculated on a daily basis.

The number of patients waiting in each category as a proportion of total admissions is not immediately apparent from the published data. For example, yesterday was Monday which is traditionally a day of heavy demand and approximately 3,100 people attended accident and emergency departments. Of these, 1,000 would have been admitted for care, 870 were admitted immediately and 123 people were reported as waiting for admission. The total number of patients reported by the HSE as waiting for admission for more than 12 hours was 46 persons. I would much prefer if that number were much lower or even zero but it represents 4.6% of admitted patients and 1.5% of all patients presenting at accident and emergency departments.

It is important to set clear targets for improvement and to measure performance accordingly. This was never done in the past. In line with this approach, the HSE has introduced a target waiting time of no more than 12 hours from the time a decision is taken to admit a patient. A number of hospitals have commenced reporting information from the time the patient presents, and the HSE expects to be in a position to publish data on up to 18 hospitals in the next few weeks.

Significant additional resources have been provided to address problems arising in accident and emergency departments. These include additional long-stay beds and a range of community-based measures aimed at reducing the need to use acute hospital services.

Jan O'Sullivan (Limerick East, Labour)
Link to this: Individually | In context

Is the Minister disputing the figures that 44% of patients must wait 12 hours or more in accident and emergency departments to get into hospital? This is the figure published from a report given to the HSE and the target is 12 hours.

I refer to what the Minister said shortly after she became Minister for Health and Children:

I expect real and measurable improvements to take place in the coming months in the delivery of A and E services. A and E is the litmus test for me, for the Government and for the people of this country.

In view of those figures and of the stories in the media, is the Minister passing this litmus test? I met a man a short time ago who told me that he was in the accident and emergency department in the Mater hospital recently and he described it as being like a scene from the Crimean War. We have constant descriptions of what is happening in accident and emergency departments. Statistics were published in the newspapers last week from official figures given to the HSE.

Has the Minister given away her power? Is this something she wishes to be measured by? Has she any control as Minister over this situation? Can she do anything about it or is she a powerless Minister who has given the power to the HSE and who has stated she wants something done about accident and emergency departments? The HSE has stated it may cut accident and emergency services as one of the cutbacks.

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

We have made significant progress and this has been acknowledged by every single group. I refer to the significant progress made in dealing with waiting times in accident and emergency departments. There has been a 60% improvement in the past three years. I remind the Deputy that up to then, waiting times were never measured and we had no target times whatsoever.

Jan O'Sullivan (Limerick East, Labour)
Link to this: Individually | In context

Targets were set and they were not reached.

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

The accident and emergency initiatives we have funded through the HSE and for which we have set targets through the HSE are the final responsibility of each hospital. Among the changes that have taken place and the manner in which the health service is delivering services, greater accountability is achieved by measuring in the first instance. If one does not measure something one will not be able to manage it. We never measured in the past.

If Deputy Jan O'Sullivan is suggesting that 44% of the 3,000 people going daily to accident and emergency departments have to wait for more than 12 hours, that is not the case. She referred to a man she met recently. I met somebody on my way here who told me that a member of his family was in an accident and emergency department in this city at the weekend and they were astonished at how fast the person was seen and how clean the hospital was compared with previous visits. We can all refer to isolated cases.

I would love to get to a situation where nobody in an accident and emergency department would have to wait more than six hours to be seen and discharged or kept for observation, which is often the case, and admitted to a ward. This has to be the ambition. However, one does not achieve the ambition overnight, there has to be steady progress on the way and we have made enormous progress in the past few years with regard to accident and emergency attendances and waiting times.

Jan O'Sullivan (Limerick East, Labour)
Link to this: Individually | In context

Is the Minister saying it is not true that a total of 44% of patients in accident and emergency departments are awaiting admission and had to wait longer than the official maximum target period of 12 hours in the first two months of this year? This is what was in the report that went to the board of the HSE and either it is true or it is not true. If it is true, it is the Minister's responsibility.

What will the Minister do about the fact that so many people in acute beds, in the beds that the people in accident and emergency departments hope to occupy, are not able to leave those beds and go back into the community because of closure of respite beds? What will the Minister do about the overall problem, which is the great difficulties experienced by patients attending accident and emergency departments?

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

We are now clinically supporting 10,000 older persons who require respite care by providing them with medical supports in their own home. Four years ago, no such home support with clinical back-up was available. This represents great progress. There are 28,000 older people in residential care, which is higher than the international average for people over the age of 65. In the past, many people with low levels of dependency ended up in residential care because in-home and community supports were not in place.

The new nursing home support scheme, A Fair Deal, will make a major impact on the ability of families to afford long-term care. We currently have an unsustainable situation where 90% of the cost of care is funded in respect of public facilities and effectively only 40% in the case of private facilities. The increased affordability of long-term care will have a significant impact in terms of what are broadly referred to as late discharges in our acute system, which number approximately 700. This presents a major challenge for the acute system.

Jan O'Sullivan (Limerick East, Labour)
Link to this: Individually | In context

Are the figures to which I referred correct?

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

The figure of 44% of people attending accident and emergency departments is not correct.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

The Minister is rejecting her own figures.

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

Only one third of people who present at accident and emergency departments are admitted to hospitals. Deputy O'Sullivan is using the wrong statistic in the wrong context.

Jan O'Sullivan (Limerick East, Labour)
Link to this: Individually | In context

I am referring to the figures published by the Health Service Executive.

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

They do not relate to those attending accident and emergency units.