Peter Fitzpatrick (Louth, Fine Gael)
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I raise the issue of overcrowding at Our Lady of Lourdes Hospital in Drogheda. As the Minister of State is aware, the hospital provides an essential service for the people of the north east. As part of the Louth-Meath hospital group, it is also a teaching hospital. It provides acute medical and surgical services, as well as an excellent maternity service, for patients from across counties Louth and Meath and parts of north County Dublin. A wide range of medical services, including cardiology, oncology, geriatrics and palliative care, are provided at the hospital. The main accident and emergency unit for the Louth-Meath hospital group is located at Our Lady of Lourdes Hospital. It is in operation 24 hours a day, 365 days a year, and supported in providing care for patients from the region by an interim medical assessment unit and short stay unit, both of which are on site, and by minor injuries units at Louth County Hospital, Dundalk and the emergency department of Our Lady's Hospital, Navan.

There has been significant investment at Our Lady of Lourdes Hospital since 2007, including in the construction of a new emergency department which opened last year and associated patient accommodation. Despite this investment, the hospital has suffered as a result of tighter funding restrictions owing to the economic crisis. I pay tribute to the hard working staff at the hospital who provide an exceptional service on a continuing basis, for which they must be applauded. I know from first hand accounts that doctors and nurses in the hospital have worked tirelessly to ensure services are maintained with less manpower and no extra money. No hospital across the country has gone unaffected as a result of the financial crisis. Hospitals have been told they must stick to their budgets. There is simply no money left to make up any shortfalls at the end of the year, a practice which led to poor management practices in the past.

Our Lady of Lourdes Hospital has certainly not escaped the challenges that have been brought by reduced spending in our health service. According to the Irish Nurses and Midwives Organisation, there are 36 people on trolleys at the Lourdes hospital today. I am sure the Minister will agree this is a deplorable situation. Patients and staff deserve more.

I know the problem of overcrowding in our hospitals is a complex one which will take time to resolve. However, people need to know that concrete action is being taken. The Minister established the special delivery unit, SDU, earlier this year to address this very problem. I am sure the Minister can understand that people are becoming anxious, as winter approaches, given that they cannot see significant progress to date.

I understand Dr. Martin Connor, as head of the SDU, has been visiting hospitals around the country and looking at the systems in place in a bid to identify how service provision can be made more efficient. Can the Minister of State tell me whether he has submitted a report on Our Lady of Lourdes Hospital and, if so, when it can be implemented? Can she give the people who use the Lourdes hospital assurances that the situation will be improved?

Kathleen Lynch (Cork North Central, Labour)
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I am grateful to the Deputy for raising this important issue. Our Lady of Lourdes Hospital, Drogheda, is continuously working across a number of levels to reduce the time patients wait on trolleys in the emergency department. The hospital is currently implementing a two-pronged approach to the management of overcrowding in the emergency department. First, it is working closely with the special delivery unit to improve capacity planning throughout the hospital. The clinical director and group general manager are fully engaged in managing scheduled care and unscheduled care under the direction of Dr. Martin Connor of the SDU. Second, the hospital is actively engaged in the implementation of the HSE's national clinical care programmes, which will focus on extending the hospital's acute medical assessment unit facility. In addition, the hospital is operating a proactive three-tiered response based on the level of overcrowding.

In response to the numbers of patients who have presented at the emergency department over the past month, the HSE arranged additional theatre time to facilitate the treatment of additional surgical cases. Additional diagnostic capacity was also provided to the medical assessment unit and to expedite discharge. Furthermore, for the past week the medical assessment unit and the day ward have remained open at night to accommodate patients from the emergency department.

The patient treatment plan of each patient is reviewed each morning by 8 o'clock and at regular intervals throughout the day, particularly when the escalation policy to deal with this issue is in place. Additional ward rounds are also undertaken throughout the day and on-call physicians and surgeons are met to review their treatment plans for patients. Where blockages are identified, the hospital management engages with the relevant service to expedite the provision of this service to the patients.

The situation in the emergency department earlier today was that there were 23 patients awaiting admission. While issues of overcrowding and waiting times in emergency departments, which are symptoms of broader hospital issues, are a source of concern, it is important to note that when a patient comes in to the emergency department, his or her treatment begins at triage and, in accordance with the priorities identified by way of the triage process, anybody requiring urgent care receives it.

The Minister, Deputy Reilly, fully acknowledges and has previously stated that the waiting times for admission for patients attending emergency departments in many hospitals are unacceptable, and he is determined that this situation should be addressed. Immediately following his appointment, the Minister set about establishing the special delivery unit to unblock access to acute services by improving the flow of patients through the system. The SDU is focusing initially on emergency departments and will work to support hospitals in addressing excessive waiting times for admission to hospital.

Peter Fitzpatrick (Louth, Fine Gael)
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I thank the Minister of State for her response and I look forward to hearing updates on this issue. I realise that repairing and reforming our health services at this time of economic austerity will take serious hard work, innovation and flexibility. I am confident the staff at Our Lady of Lourdes Hospital, Drogheda, have the determination to provide a high quality service, even if further challenges lie ahead. I ask the Minister to keep the house fully briefed on this situation.

Kathleen Lynch (Cork North Central, Labour)
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Dr. Martin Connor has been working with the hospital. The difficulty is sometimes not in the emergency department but at the other end, which is where the blockages occur. Although it will be difficult, this is the type of issue we will have to deal with. It is not always about money, but about processes, how people work, step-down facilities and ensuring people are discharged when they can be. The idea of the consultant, whether in surgery or medicine, having two rounds a day will help that process. Dr. Connor is working with the hospital, particularly in the run-in to winter, to ensure there is a smoother transition. I will keep the Deputy informed.