Micheál Martin (Cork South Central, Fianna Fail)

I have spoken to the ICTU. Even in the recent social partnership talks, the issue did not get a mention. It was fudged again. The health of workers is more important than the leverage 50 cent on a packet on a cigarettes gives the trade unions in trying to get pay increases in line with inflation. In 2000 the then social partnership agreement almost collapsed because of inflation going over 5%. The imposition of an increase of 50 cent on a packet of cigarettes in 1999 resulted in an increase in the CPI of about 0.8%. For the next year or two a barrier to increasing the price of cigarettes was the fear of undermining social partnership. I understand where the Department of Finance is coming from. We increased the price of cigarettes by 50 cent again this year. As a result of lobbying by me and others, the Minister responded with an increase. I hope people will begin to see sense on this issue because smoking is the biggest killer in the country.

Fair access, the second national goal of the strategy, is concerned with ensuring equal access for equal need is a core value for the delivery of publicly funded health services. The actions set out in the strategy will ensure all those eligible understand their entitlement, can easily access services they need and can be sure that, no matter where they live, there is a standard approach to eligibility for services. As part of ensuring fair access, the strategy identifies the need to ensure equitable access to services. This is primarily concerned with improved access to hospital services for public patients as well as recognising other barriers which affect people's ability to access services.

The hospital system in general is experiencing increased pressure due to a number of factors, including the growth in population, the availability of in-patient beds and the increasing number of elderly people who have a higher than average length of stay. The pressure on the hospital system, in particular hospitals providing accident and emergency services, is more severe over the winter months.

The Government has taken a number of measures designed to enhance accident and emergency services. A €41 million investment package was provided in the winter of 2000-01 aimed at alleviating service pressures and maintaining services to patients, particularly in the acute hospital sector. This provided, inter alia, for the recruitment of additional accident and emergency consultants – 17 of these posts have now been filled. The recruitment process is continuing in respect of the remaining posts. The House may be interested to know that in 2002 there were 1.2 million attendances at accident and emergency departments, which represents a decrease of 1.5% on the number of attendances in 2001.