Billy Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

21. To ask the Minister for Health the reason for the record overcrowding in hospital emergency departments to date in 2017; and if he will make a statement on the matter. [48416/17]

Billy Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

What is the reason for the record overcrowding in hospital emergency departments to date in 2017? Will the Minister make a statement on the matter? He is aware that all overcrowding records have been broken in hospital emergency departments this year to date. As recently as this morning, Temple Street Children's University Hospital has advised people not to attend its emergency department because of overcrowding.

2 o’clock

The issue, as it is now November, is very worrying. Are the hospitals prepared for winter? Will they be able to cope? I ask the Minister to make a statement on the record overcrowding in our emergency departments.

Simon Harris (Wicklow, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank Deputy Kelleher for his question. We all acknowledge the distress caused to patients and families, and indeed the impact on staff, when cramped and overcrowded conditions are experienced in some of our hospital emergency departments. I have outlined on many occasions what we need to do to break that cycle. I have referred to the bed capacity review and the need for significant capital investment. We need to turn Sláintecare into a reality and take some services out of our acute hospitals and put them into primary care. I opened a primary care centre in Castlebar, County Mayo, last Friday. In April of this year, there were 517 people were awaiting X-rays at Mayo General Hospital. That figure has now been reduced to zero as a result of the decision to provide such facilities in the primary care system.

By the end of September, emergency department attendances had increased this year by over 1.8%, or more than 16,000 patients. This includes a 5% increase in emergency department attendances by people over the age of 75. In this context, trolley numbers and patient experience times are showing some small improvements on this time last year. That is not to suggest there is anything to be triumphalist about. HSE data show that on 13 November 2017, over 1,000 fewer patients were waiting on trolleys this year compared to last year. It is important to acknowledge the progress that is being made by our hospital and our front-line staff.

According to the HSE's TrolleyGAR figures, which are published on the HSE website at 8 o'clock every morning, every day so far in November there have been fewer patients on hospital trolleys than there were on the same day last year. There have been fewer patients on trolleys 15 days in a row. Winter started on 1 November, presumably, and it is now 15 November. On every single one of those days, there have been fewer patients on trolleys. I accept that the number of patients on trolleys is still far too great. I do not accept the idea of constantly referring to new records at a time when some of our front-line staff and management personnel are making significant progress.

Several hospitals are showing significant overall improvements in trolley numbers. According to HSE data for the period to the end of September, the number of people on trolleys at Mayo General Hospital, Our Lady of Lourdes Hospital in Drogheda and Beaumont Hospital has reduced by between 30% and 40% compared to the same period in 2016. The Deputy is right when he suggests we have an awful lot more to do. I think we all share a view on what needs to be done in the medium term. What are we going to do right now as we come into the winter? I am happy to confirm that €40 million in additional funding has been made available as part of budget 2018 to address winter pressures and waiting lists over the rest of this year. A further €45 million has been allocated for measures to improve access to unscheduled care and other acute hospital priorities. That means more home care packages.

Additional information not given on the floor of the House

Some of this funding is already being utilised within the system, with an additional 45 home care packages and 20 transitional care beds being provided each week for the duration of the winter period. This funding will allow patients to return home or go to an appropriate community setting, when clinically appropriate, thereby helping to alleviate some of the pressures our hospitals are experiencing. Funding will be provided to increase bed capacity this winter and as part of service planning for 2018. The Department of Health is undertaking a health service capacity review in line with a commitment in the programme for Government. The findings of this review, which are due to be published before the end of the year, will provide an evidence base for future capacity decisions. All hospital groups and community health organisations have developed and put in place integrated winter preparedness plans for their localities focused on planning and escalation preparedness, maintaining patient flow processes and ensuring public health preparedness.

Billy Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

The Government is making an effort to normalise misery and mediocrity in all areas of Irish life. The Taoiseach recently spoke about the normalising of homelessness. This can be seen in the crime statistics as well. Now there seems to be an acceptance that having 500 people on trolleys is the new norm. It is simply not acceptable. I recently received information in replies to parliamentary questions about the number of people over 75 years of age who are waiting 24 hours or more on trolleys in emergency departments. The Government is failing to achieve the targets it has set for itself. Elderly people are lying on trolleys. All the clinical evidence shows that if proper wards are not accessed in a timely manner, there are adverse health outcomes. Overcrowding is costing us lives. The statistics are there. This can be seen every day of the week. The individuals behind the statistics are lying on trolleys. Some of them are having adverse health outcomes because of the extraordinary lengths of time that people are waiting in our emergency departments on a daily basis.

Simon Harris (Wicklow, Fine Gael)
Link to this: Individually | In context | Oireachtas source

With regard to the question of misery, when I refer to publicly available data to counter the figures put forward by the Opposition, why is it acceptable for me to be accused of trying to normalise a bad situation? Nobody, least of all me, has said it is good to have anybody on a trolley. Of course it is not. It is socially unacceptable. We have to do a hell of a lot more. I am not going to stand here and allow Deputy Kelleher to decide the narrative. I am going to follow the evidence and see where it brings us. Every single day so far in November, there have been fewer patients on trolleys. I will send a copy of those figures to the Deputy. Perhaps I will put them on the record of the House. The idea that the Deputy has decided that this is the worst winter ever, even though the winter period just started at the beginning of this month, is not factually backed up. That is not to say we do not need to do much more. The Deputy is particularly right when it comes to older people on trolleys. That is why we are putting in place a programme of frailty teams. This will mean that older people are streamed to geriatricians when they come through the doors of our emergency departments. We need to do more with home care packages. Funding has been provided for an additional 45 home care packages each week from now until the end of the year. This will be sustained throughout 2018. More transitional care beds are being provided. More hospital beds are being opened. An additional 60,000 flu vaccines are being given out this year. We have a lot to do. The statistics show that some hospitals are making progress.

Billy Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

The Minister is quoting statistics for November, but the annualised figures show the reality that the health services are still under huge stress.

Simon Harris (Wicklow, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Absolutely.

Billy Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

Our emergency departments are the point where this is most obvious on a daily basis. The Minister can pick out statistics to show there has been a small reduction in the number of people on trolleys so far in November, but the overall position points to the fact that our hospitals simply do not have sufficient capacity. I refer to the numbers of beds, clinicians and front-line staff dealing with patients. That is manifesting itself in the consistent need to keep elderly people on trolleys for long periods. Front-line staff are saying that this is jeopardising patient safety. With the onset of winter, the concern is that this could have profound implications for the ability of our emergency departments to cope in the event of an outbreak of flu or the winter vomiting bug. I do not believe we are prepared to deal with that if it happens, as it probably will.

Simon Harris (Wicklow, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I do not disagree with the Deputy's analysis. Our hospitals are overcrowded. There is not enough capacity. We need a bigger health service in terms of bed capacity. The Sláintecare report, which the Deputy helped to co-author, provides a roadmap in this respect. I look forward to going before the Joint Committee on Health and Children next Thursday to outline the steps we have taken in this regard. The bed capacity review I will receive by the end of this year will tell us how many hospital beds and other beds we need right across the health services and for the next 30 years. It will set out how many beds will be needed if we stand still and do nothing and how many beds will be needed if we implement Sláintecare. The Deputy is right when he says we need to get on with expanding capacity. As of today, I have to use all the levers at my disposal, including more social care, more community intervention teams, opening transitional care beds, encouraging people to get the flu and trying to encourage people to go to the appropriate place, which is not always the emergency department.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

I am sure the Minister means that people should get the flu injection.

Simon Harris (Wicklow, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Very much so. People should get the flu vaccine, rather than the flu.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

I am pretty sure the Minister does not want to encourage people to get the flu, especially after last year.

Simon Harris (Wicklow, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Certainly not.