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

I apologise to Senator Thomas Byrne for making a short speech. Sometimes, it is possible to say what one wants to say concisely without repeating the same things ad nauseamall the time, as if it would achieve anything. Solutions are not found in long speeches, commentary or analysis. That is why my job is to be in HSE headquarters, where I was today, in my Department, where I was yesterday, and on the ground in places such as Tallaght hospital, where I had intended to be this afternoon. I will reschedule my visit. I accept, however, that it is the duty of Opposition Members to put pressure on me to do my job, but they also have a duty to proffer solutions and I did not hear one in the entire debate from Fianna Fáil Members, which says much.

Senator Marie Moloney is correct that overcrowding in emergency departments is caused by a number of factors, most of which are outside the emergency department. It is not a simple function of bed capacity. If it were, we would have had the problems in Drogheda solved by now, given that there are 24 additional nursing home beds and 12 out of 24 open in the hospital. There are other issues, including how beds are used. A hospital in which the average length of stay is eight nights needs twice as many beds as a hospital in which the average length of stay is four nights. It does not get any more work done; it just does it slowly. The same applies to admission rates. In some hospitals 25% of patients who attend the emergency department are admitted, while in others 50% are admitted. The hospital that admits twice as many patients needs twice as many beds. There are many reasons a hospital admits more patients. Although I would love to be able to personally manage every hospital in the country, I cannot. I can give policy directions on how things should be done and try to fund them.

I can check the issue of the American nurse. Nurse training in America is different and not equivalent to training here. Our nurses earn BSc degrees, whereas American nurses are still trained in the old way. I am sure this applies to other professions also. GPs often have direct access to X-ray facilities. Although such access may not be available every day, it is available in most cases. On the western seaboard, we have a pilot project to give all GPs access to an ultrasound service within five days for urgent cases and ten for non-urgent cases. Expanding GPs' access to diagnostics in the coming years is part of the solution.

Senator Sean D. Barrett mentioned spending. It is important that we always compare like with like. Much of what the health service does in Ireland such as in providing social care services for older people is done by local authorities in the United Kingdom. Our spend includes both public and private services and the money spent on private services is probably not spent in the same way as it would be by the State. We are not an outlier in spending. We are somewhere in the middle and do not get the value we should. We have corresponded on Baggot Street hospital. I was there on Tuesday night to check out some of the sexual health services offered. There are no inpatients in the hospital; there have been no beds in it for 25 years. As it is used as a day facility, we are not losing beds.

I thank Senator Gerard P. Craughwell for his very measured comments. As he said, the issue of emergency department waiting times has plagued us for a long time and occurs in all countries in different ways. I want to do the best I can to alleviate the problem. There is variability in implementation and co-operation from site to site.

On ambulance service response times, the target is 80% or 60%, depending on whether it is an echo or a delta call. They have not been invented in Ireland because we are a rural nation; they have been taken from other jurisdictions. It is accepted worldwide that it takes longer for an ambulance to reach a remote location and it always will. No matter how many ambulances we have or who the Minister for Health is, an ambulance will not always get there on time. That is the truth of real life and people who think they can change it by changing the Government or the Minister are mistaken. We are increasing resources for the national ambulance service. During the recession spending was not cut back but increased. An air ambulance was provided. Last year the budget was increased by €5 million and it will be increased by €5 million next year.

Senators may not be aware that I visited Our Lady of Lourdes Hospital twice. I visited it once on the way home from the funeral of the garda who was murdered. I telephoned reception from the motorway to say I would be there in 20 minutes. I do not know how many patients they managed to move in 20 minutes, but it was probably not many, particularly in a crowded hospital.