Catherine Noone (Fine Gael) | Oireachtas source

I welcome the Minister. The Government, as I do, fully acknowledges the difficulties with overcrowding in accident and emergency departments and the problem this causes for patients and families and staff who are doing their utmost to provide safe, quality care in extremely challenging circumstances. It is my understanding optimum patient care and patient safety at all times remains a priority of the Minister and the Government. A wide ranging set of actions has been put in place by the HSE to achieve improvements which it is important to highlight. They include specific measures which have been put in place to address hospital waiting lists more efficiently and effectively through initiatives covering colonoscopies, special funding for scoliosis and ophthalmology services, additional consultations and the extension of ultrasound access to additional primary care sites.

Actions taken to date to address overcrowding in accident and emergency department include the opening of additional overflow areas; providing for additional diagnoses and strengthening discharge planning with a range of measures, including 900 transitional care beds funded in private nursing homes to assist the discharge of patients from acute hospitals; the opening of 173 short stay public beds across the country for three months; agreement on additional nursing posts; the opening up of 300 overflow beds in acute hospitals; and the introduction of additional community interventions introduced in Naas and Drogheda, with 11 such teams now in operation.. This year the number of nurses directly employed in the public service will increase by at least 500, which was a welcome announcement recently made by the Minister.

The Minister convened an emergency task force last year to find long-term solutions to overcrowding by providing for an additional focus on dealing with the challenges presented by trolley waits. The HSE is finalising an action plan under the auspices of the task force to be implemented immediately to specifically address emergency department-related issues across hospitals, social care and broader community services with a view to achieving a significant reduction in trolley waits this year. I hope this will prove successful.

Actions being taken by the HSE to address waiting lists include observations on the national waiting list protocol, prioritising day of surgery admission where clinically appropriate, provision of new patient care pathways such as medical assessment, minor and local injury units and urgent care centres and provision of care in non-hospital settings to support the efficient use of hospital resources. Waiting list targets have been changed and the HSE is finalising an action plan for waiting lists with a focus on long waiters such that by mid-year nobody will wait longer than 18 months for inpatient and day case treatment or an outpatient appointment, with a further reduction to 12 months by the end of the year. The HSE has committed in its national service plan for 2015 to the publication of waiting lists online at consultant and specialty level and aims to reduce waiting lists by way of process redesign, consolidating further the work of the special delivery unit to date.

The Government has made provision for a welcome increase in the total financial resources available to the HSE this year, the first such increase in seven years. The HSE knows that there is an urgent service requirement to recruit the necessary staff, including additional nurses, doctors and therapists. The Government provided additional funding of €3 million last December and €25 million in 2015 to address delayed discharges and this funding is targeted at hospital and community services which can enable initiatives to address specific needs of delayed discharge patients positively and, thereby, aims to improve timelines for admission from emergency departments and reduce waiting lists.

The review of the nursing home support scheme which is under way and due to be completed shortly will consider the future funding and sustainability of the scheme, as well as how community and residential services are balanced. We all remain hopeful the measures that have been implemented in the recent past will have the effect of improving health services and reducing waiting lists.

I would like to highlight the hypocrisy of Fianna Fáil, given its failure to make proposals on health in its alternative budget for 2015 and not least that it created the HSE which, as previous speakers said, is a basket case. The structural problems in the organisation are difficult for any Minister, but despite serious work on the part of Ministers, one wonders whether those working in the HSE are motivated to improve the system at all, given the internal politics. Contrary to comments made by the Opposition, I have every confidence that the Minister is committed to and passionate about the health service. His only motivation is to make a genuine effort to improve health services. I have every confidence that he will be successful in both the short and long term.