Fergal Browne (Fine Gael)

Does the Minister of State have an idea how many elective procedures are cancelled on a daily basis? Having people on trolleys in accident and emergency wards, which is bad in itself, also has a knock-on effect on elective procedures.

The Tánaiste has now annoyed everyone in the health service. It was regrettable that she was unable to attend the nurses' conference last week. I appreciate the pressure on her diary and the efforts made to facilitate her at the conference. The nurses working at the coalface in the accident and emergency wards, however, deserve to be heard and not spoken down to, as the Minister of State did. We need to bring everyone on board and it was a pity that she missed the chance to attend and listen to their concerns.

I welcome the proposal made at the Fine Gael Ard-Fheis about drunks. It is time to get real; when people deliberately go out and spend €100 on drink, drinking fat frogs and vodka and Red Bull, and are then injured, they should be fined in some way if they arrive in an accident and emergency unit as a direct result of overindulgence, as opposed to someone who might have a glass of wine and fall. The Minister of State, Deputy Tim O'Malley, was mocking this idea on the radio yesterday, saying that the gardaí are called anyway. How many prosecutions have arisen from public order offences in accident and emergency departments? The staff are demoralised and it is time to side with them and the genuine patients. Discretion could be used to ascertain if someone deserved a fine.

I also welcome the Fine Gael proposal that all children under five years of age should have a medical card. That will eliminate parents' concerns. It must be terrifying to see a rash on a young child, trying to ascertain if it is meningitis or something else. By visiting a GP they will be able to avoid a trip to the accident and emergency department.

The ten point plan announced by the Tánaiste has not worked. The lack of beds is the major problem. We must put back those beds that were taken out in the late 1980s and allow for the fact that the population has increased substantially and aged.

Fine Gael is proposing a number of 24 hour urgent care centres in areas that do not have a local accident and emergency ward, including Carlow, something I would argue for if I am elected to the next Dáil, and in areas where accident and emergency wards are under particular pressure. They would be staffed by GPs and nurses and would offer the option to patients in accident and emergency to be treated in properly equipped primary care centres which include diagnostic services such as blood tests and x-rays.

The patients who arrive in hospital are entitled to dignity and should be treated with such when facing illness. There should be no excuse for having patients on trolleys. The hygiene audit recently took place in our hospitals but maybe it is time for the Health and Safety Authority to go back into accident and emergency units and inspect them from that point of view. It is mad that a patient could arrive in hospital to face a greater risk of injury as a result of an assault by a drunk patient or overcrowded conditions.

Fine Gael will promote a general health screening programme to encourage people to be checked out regularly. Senator Glynn has often made the point that we do this with our cars and that makes sense. If we had a check up every year, it might eliminate problems down the line. The 60 primary care teams will improve access to local health care.

I look forward to a full debate on this issue and the Minister of State's answers to the questions I have raised.