Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I welcome the opportunity to update the House on what is being done to improve access to services in hospitals. I acknowledge that too many patients across Ireland are still spending far too long in emergency departments waiting to be seen, admitted or sent home. This causes difficulties and distress for patients and families and makes working conditions difficult for staff. That is why dealing with the issue remains a key objective for the Government.

There is no simple quick-fix solution to the problems which are long standing, complicated and have multiple causes. They all need to be addressed and any effort and action must be sustained. I convened the emergency department task force in 2014 to provide a focus and momentum in dealing with the challenges presented by emergency department overcrowding. The Government allocated more than €117 million in additional funding this year to reduce overcrowding; it has reduced the fair deal scheme waiting time to between three and four weeks, thus freeing up hundreds of hospital beds everyday, and it is supporting hospitals to reopen closed beds and add more. Some 197 hospital beds have been opened nationally since October, with a further 44 due to be opened in the next two weeks.

Some 750 more nurses are working in the health service than this month last year. It is important that we compare this figure with that in the same month in the preceding year because there is a seasonal variation in nursing staff levels based on when pregraduate nursing students qualify. At 19,000, we also have more registered doctors than ever, including more in the public health service than ever before. Some 338 non-consultant hospital doctors, NCHDs, and 78 consultants have been appointed this year, many more than last year. In this context, the Irish Nurses and Midwives Organisation's ballot is regrettable, particularly when we are starting to see the emergency department task force's plan taking effect. Industrial action will not get a single patient off a trolley, but it will make life harder for other non-nursing staff.

The significant increases in capacity are being reflected in emergency department performance. While it is still challenging and there is a long way to go, the average number of patients waiting for longer than nine hours on trolleys was 111 in November. This compares with 127, on average, in June and 173 in February. There are 15% fewer patients on trolleys for nine hours, longer or at all than on this day last year. While a number of hospitals were overcrowded this morning, the total number of patients on trolleys for any length of time was 244, 90 of whom had spent longer than nine hours on trolleys. This compares with a figure of 289 on this day last year, or 123 waiting for longer than nine hours. This represents a 15% improvement on the figure for patients spending any amount of time on a trolley and an improvement of approximately 30% for those spending longer than nine hours on a trolley. By 2 p.m. today, the numbers had fallen to 136. For example, the Mater Hospital which was overcrowded this morning with 33 patients, had 12 waiting on trolleys by 2 p.m.

While the Irish Nurses and Midwives Organisation and the special delivery unit calculate the numbers slightly differently, both sets of statistics agree on the following. The level of overcrowding in November 2015 is lower than the level in November 2014. The picture has changed considerably since August, when the situation was 40% worse year on year, to a position where it evidently is not. We are nowhere near the figure of 500 or 600 that we witnessed in the new year. We should all be focused on implementing the task force's plan. It would be regrettable if a focus on industrial relations and talks at the Workplace Relations Commission on how many staff there should be per trolley distracted us from implementing it and getting patients off trolleys altogether.

The number of delayed discharges is reducing steadily. The latest figure is 558 compared with 830 last December. This is the lowest number in nearly seven years. By the end of 2015, we will have provided more than 1,200 additional home care packages, 149 additional public nursing home beds, 24 additional private contracted beds in Moorehall Lodge, Drogheda and 65 short-stay community beds in Mount Carmel Community Hospital and elsewhere.

When it comes to scheduled care, health services are expanding and the level of activity is increasing, with an average figure of 250,000 outpatient appointments and between 120,000 and 130,000 inpatient or day case procedures each month. The public health service provided more than 1.1 million inpatient and day case treatments and more than 2.4 million outpatient appointments up to the end of September this year, an increase of 8% in the number of inpatient and day case treatments or procedures and 2.3% in the number of outpatient appointments compared with the same period in 2014. Anyone who talks about cuts needs to examine the facts.

Additional funding of €51.4 million provided by the Government in 2015 has allowed the HSE to increase capacity across public hospitals and outsource activity where capacity is not available to meet patient needs. These are real actions, implemented at my direction with funding that I secured from the Government. The detached commentators are those on the Opposition benches who have nothing to offer other than criticism that is often based on a poor or limited understanding or knowledge of the real issues and how the health service works.

The latest National Treatment Purchase Fund figures - these are not the HSE's figures - published on 6 November showed reductions in the total inpatient day case waiting list and the numbers of patients waiting between 15 and 18 months or longer than 18 months. Similarly, there was a reduction in the total number waiting for outpatient appointments, which has fallen below 400,000 for the first time this year. Senators shouild bear in mind that this figure includes anyone waiting any amount of time, including three, four, five or six weeks. Some 85% of patients still wait less than one year to be seen.

We are facing into what is likely to be a challenging winter period. It is imperative that we sustain the momentum of the various initiatives under way. In politics the Opposition will try to exploit problems in the health service for political gain. It was always thus, including when we were in opposition, and always will be. When the Opposition has no solutions other than calling on the Government to do what it is already doing, just a little more or a little faster, it resorts to attacking the Minister for Health of the day personally. That is how politics works, but my focus is not on politics but on finding solutions and implementing them. That is what I will continue to do.