Frank Feighan (Fine Gael)

I thank the Minister of State for coming to the House to debate the accident and emergency crisis, which is something most of us do not wish to encounter. One only arrives in an accident and emergency unit if one is ill or has an accident and one wants to get emergency care.

There are many pluses and minuses in the health system. Two years ago, my elderly mother went to Sligo hospital for a routine procedure. While everything appeared to be going well, she was in the accident and emergency unit for approximately ten hours. While I am not sure whether anything was wrong, it took ten hours from the time she arrived at the hospital to the time we left to have a routine procedure carried out. I do not know whether the problem was with the accident and emergency unit or the hospital, but obviously there was a serious problem on that day. I do not think that a lady of 76 or 77 years of age should have to wait ten hours in an accident and emergency unit. There should be other ways of dealing with these cases.

Last Saturday night, my mother had an accident in Dublin when she fell and cracked her hip. This happened in the CityWest Hotel. While I must praise the ambulance staff for their efficiency, professionalism and courtesy, it took approximately 35 minutes to get from CityWest to Tallaght Hospital. While it is no reflection on the health service or the ambulance driver, it is a reflection on the roadworks on the Naas Road. No one appears to be able to find their way off the Naas Road in order to get back to Dublin. Taxi drivers have been caught in this dilemma. The following morning, I was almost in Naas before I could turn for Dublin. We must examine how to carry out roadworks more efficiently. While ambulance drivers are very efficient and know the city well, the ambulance driver could not get off the dual carriageway to return to Dublin until he was almost in Naas.

When my mother arrived at Tallaght Hospital, I was very happy with the service she received. She was treated efficiently and well. However, there were one or two men in the accident and emergency ward, and while it was not very threatening, I was a little uneasy because they were under the influence of substances other than alcohol. While the nurse said it was a quiet night, I would not like to work as a nurse in that atmosphere in an accident and emergency unit on a busy night. I pay tribute to the nurses, doctors and emergency teams who must work in these units. I would never use this or any other situation to score political points and I pay tribute to the people working in Tallaght Hospital on Saturday night.

When I remarked to the staff that the unit appeared to be remarkably quiet, they said that Saturday night is no longer busy in the accident and emergency unit. The busy nights now are Friday night and Monday night, which was news to me. There is a problem with drunks, especially in the construction industry. These people finish work on Friday and then go boozing. They are young and healthy and may become aggressive as a result of drink and end up in accident and emergency units on Friday night. What is even more worrying is that they end up in accident and emergency units on Monday because they take Monday off and drink too much alcohol and perhaps take other substances.

Fine Gael has policies on how to deal with drunks in accident and emergency units. We must explore the issue further. We are talking about recurring offenders who are clogging up the accident and emergency units. There must be some penalties and deterrents when dealing with these people. I saw the logistics involved in bringing just one lady to hospital, including an ambulance crew and hospital staff. The logistics involved in dealing with these mindless people is difficult to believe, and some deterrent must be put in place.

The Fine Gael proposals should be examined carefully, and if they are good, they should be taken on board. No matter what resources are put into accident and emergency services, it will not be sufficient to deal with mindless characters who return to these units each week.

The accident and emergency crisis reflects a crisis in the wider health system. Any attempt to address the problems with accident and emergency departments will have to involve the primary care sector. Many people cannot believe that the number of home help hours available to people have been cut. Home help is, in some ways, the backbone of our primary care system. If elderly people do not have the home help they need, they may fall and end up in the accident and emergency department of their local hospital. We must provide more resources for primary care, particularly home help.

General practitioners are not prepared to work the same hours as in the past, when one could call them at any time of the day or night. Most general practitioners now work from 9 a.m. to5 p.m., five days per week. They are not prepared to work an excessive number of hours every week.

Ireland is changing. A lot of money has been invested in the health service in the past ten years but we have not addressed the problems therein. Our lifestyles have changed greatly in the last decade. Our diets have improved, we are more conscious of our general health and of the importance of moderate alcohol intake. Unfortunately, however, there are those who binge drink and take illegal drugs and such people must be diverted from their damaging behaviour.

The 24-hour urgent care centres proposed by Fine Gael are not intended to replace existing accident and emergency departments but to complement them and relieve some of the pressure they are under. This is a satisfactory idea and one which should be taken on board by the Government.

The subject is a difficult one. Nobody wants to be in an accident and emergency unit. When the experience is good, that is to be welcomed but when it is bad, it must be highlighted and that is what I intend to continue to do, as does my party.