Gabrielle McFadden (Fine Gael) | Oireachtas source

I welcome the Minister of State to the House and thank the Minister, Deputy Simon Harris, for his attendance today as well. We all know that there is a huge issue with people on trolleys. It did not happen today or yesterday, although I understand January's numbers are down on those for last year, which is welcome. Listening to some, one would think the Government was happy with the situation and that the Government's aim was to have people on trolleys. It is obviously not the Government's aim. No one wants to see anyone on a trolley, particularly an elderly person. I also feel strongly that those involved in this issue should be offering suggestions on how we make this better rather than constantly criticising on the airwaves.

This is not just a case of throwing money and beds at the problem. This becomes clearer when we talk directly to those at the coal face. A multifaceted approach is required. One area I wish to highlight - I often speak on it - is the need to develop a sustainable and effective model of geriatric care in the community. Last year on a given day, three quarters of the patients in the accident and emergency department in a midlands hospital were elderly patients. They were presenting with various needs and some of them required intravenous medication, including antibiotics and basic hydration.If there was more joined-up thinking within the HSE in terms of the development of an effective community geriatric service model, many of these frail elderly people would not have to be treated in hospital and could be treated at home. These services should also be available on a 24/7 basis because patients, and elderly patients in particular, do not choose when to get sick. Connolly Hospital in Dublin is showing the way in this regard. I understand that the consultant geriatricians based at that hospital visit all nursing homes attached to it and hold regular team meetings with family members. They also liaise with palliative care teams and engage in decision making processes with multi-disciplinary care teams. This all adds up to preventing the needless transfer of patients to hospital by treating and caring for the elderly in the community, thus relieving pressure on the accident and emergency department and the hospital in general. In November 2013 Ms Mary Burke of Nursing Homes Ireland, in a statement to the Joint Oireachtas Committee on Health and Children, said she believed that the Connolly Hospital approach should be rolled out nationwide. She said that it would prevent readmission to acute hospitals. People might argue, rightly, that Connolly Hospital has patients on trolleys at the moment but it has definitely reduced the number of frail, elderly patients on trolleys.

A number of hospitals provide different models of geriatric care, including geriatric assessment units and outreach facilities. I would like to see community geriatricians teaming up with specialist nurses based in the community, visiting local nursing homes, community units and elderly patients in their own homes and treating them without the need to transfer them to hospital. As I have said already, this would not only help to reduce overcrowding but, more importantly, would preserve the dignity of older people and reduce the stress on families brought on by the ordeal of having an elderly person admitted to hospital. I have asked, on several occasions, for such a model to be rolled out across the country and I would appreciate a response from the Minister of State in that regard.