Pat Moylan (Fianna Fail)

I welcome the Minister of State to the House and compliment him on the ongoing work carried out in the health sector. When one examines the total figures in accident and emergency departments, it is clear that great credit is due to those who have ensured that a considerable number of people are being cared for in accident and emergency departments. Speaking as one who served on a health board for a considerable number of years and often visited hospitals and accident and emergency departments, I am struck by the changes that have taken place and the changes the Department of Health and Children has been forced to introduce in accident and emergency departments.

A few years ago, accident and emergency departments cared for people who were injured or required medical attention. The scene has changed to the extent that security is a major cost in accident and emergency departments. Hospitals are forced to install cameras to make accident and emergency departments more secure. I support the call by a number of speakers today for charges to be introduced. A range of different accident and emergency charges should be introduced to distinguish between genuinely injured people or those injured in road accidents for which they bear no responsibility and other people who attend at accident and emergency departments. The gardaí are regularly called to accident and emergency departments to protect staff and patients because of the actions of people who, in many cases, should not be there.

The issue of care of the elderly and the attendance of elderly people at accident and emergency departments has been raised. I have encountered cases which involved patients with multiple sclerosis — a disease which can, unfortunately, strike at any age — who cannot access long-stay care because they are under 65 years of age. I ask the Department to re-examine this issue because these people require regular attention and, therefore, regularly attend accident and emergency departments because they cannot access full-time, long-stay care because of their age. I encountered one case involving an individual who was seriously ill with multiple sclerosis and attended accident and emergency departments for 11 years because they could not access long-stay care. This person required intensive nursing care which, unfortunately, placed considerable strain on other members of the family, who were forced to leave work early to come home to care for the person in question. Using age as a criterion for entry to a nursing unit discriminates against a range of patients.

The Department is developing different GP services and such services are very good in the midlands. In some cases, it is not patients' general practitioners who are present, rather GPs who are filling in. They will not take any chances because of litigation and so on and will send patients to accident and emergency units. Often, those patients hold up that system.

I compliment the nurses and doctors in accident and emergency departments on their excellent work. At Christmas, I was an accident and emergency unit patient in two hospitals, Tullamore General Hospital and Tallaght Hospital. The latter was very busy but the staff gave the best of care and attention and are due much credit.

With the increase in the size of our population, we will never get the situation perfect, but significant improvements have been made. Many extra services have been brought on stream in many hospitals across the regions. We can never please all of the people all of the time but we are doing a good job. I apologise for exceeding my time but I compliment the Minister of State, his officials and the frontline professionals on their work.