Tom Parlon (Laois-Offaly, Progressive Democrats)

I thank Senators for their good wishes and join with them in wishing the Tánaiste well in the challenging job she faces. There was a suggestion that 1.2 million people attend accident and emergency units each day. Thank God, that is not the case. Some 1.2 million people attend per year. In fairness, the majority receive quite an efficient service but of course there are difficulties, as outlined.

Senator Terry asked about the acute medical units. Comhairle na n-Ospidéal's report on acute medical units published in October 2004 examined the role, organisation and staffing at acute medical and assessment admission units. Acute medical units will be put in place in Tallaght, St. Vincent's and Beaumont Hospitals and the hospitals are finalising proposals for the Health Service Executive.

It should be clear that the Tánaiste has put accident and emergency services at the top of her and the Government's agenda. The Government is committed to improving the public's experience of accident and emergency departments and improving conditions for staff therein. It is extremely important that highly qualified and specialised staff continue to be attracted and retained in this most important frontline hospital area.

Accident and emergency services present a particular challenge to hospital managements. In many instances, an accident and emergency unit is the only area in which the public experiences hospital services. As such, hospital managements must regard accident and emergency departments as the shop window for the hospitals. A much more customer-oriented approach must be adopted by hospital managements, consultants, nursing and other professional and support staff.

Delivery of hospital emergency services is interdependent on the inpatient elective service, day and outpatient care and on community services. The effective delivery of emergency services, therefore, cannot be dealt with in isolation from the delivery of all hospital-based services. The key to addressing the current problems is a whole systems approach which addresses people's needs on a timely basis in the most appropriate setting.

The need for additional acute beds in the hospital system has been well documented. The Government is well on the way towards building up the acute bed capacity in the acute hospital system. It is committed to increasing acute hospital bed capacity, as set out in the health strategy. Since the publication of the health strategy in December 2001, funding has been provided to hospitals to open an additional 900 beds.

A number of new units in acute hospitals throughout the country are in the process of coming on stream. New accident and emergency departments have also been provided under the capital investment programme. For example, a new accident and emergency department opened recently in Blanchardstown. On Monday last, the new accident and emergency department at Cork University Hospital opened. St. James's Hospital in Dublin will have a new accident and emergency department shortly. These developments, together with new day facilities, theatre and diagnostic capacity, will result in improved patient flows through the hospital system and make better use of existing beds.

The Health and Safety Authority, HSA, has completed its programme of inspections of 11 accident and emergency departments. The authority acknowledges that resolving problems in the delivery of accident and emergency services requires a system-wide response. However, the work of the HSA raises many issues for hospitals. The HSA has, however, acknowledged that the hospitals are fully engaged in the process of addressing health and safety in their accident and emergency units.

I am confident the actions being taken by the Government and the Tánaiste, including the provision of new beds will, over time, generate an appropriate, multi-faceted and multi-dimensional response to the problem in accident and emergency units. The Tánaiste outlined her action plan to improve the delivery of accident and emergency services, which will bring about significant improvements in patients' experiences of accident and emergency services.

I trust I have demonstrated that improving the delivery of accident and emergency services is our priority. We will continue to work in the best interests of patients and staff. I am confident we will improve the delivery of accident and emergency services so that patients receive the appropriate treatment as quickly as possible.