Keith Swanick (Fianna Fail) | Oireachtas source

It is timely we are having these statements on emergency department waiting times given that our health system hit a new low on Monday last. The Euro Health Consumer Index 2017, on which I understand people place different weight, ranked Ireland among the worst in Europe for waiting times for health care. Ireland is now in 24th place, down two since last year's index. The mismanagement of our health system is now being blatantly exposed.

In 2011, the former Taoiseach, Deputy Enda Kenny, vowed to bring to an end the overcrowding crisis. Seven years later, however, the problem is worst than ever with record breaking numbers of patients languishing on trolleys across the entire country. This has been a persistent problem but the Government has simply failed to take the required steps to tackle the crisis.

During a meeting of the health committee last year, I mentioned to the Minister the progress Macedonia has made by implementing the e-health platform, Pinga. Macedonia has reduced hospital waiting times to approximately six months by means of a simple online live system. GPs can go online during a consultation with a patient and access consultants' diaries, see what physicians have vacancies and refer appropriately. That system can also be used for diagnostic scans. In 2013, Macedonia was placed 27th in the Euro Health Consumer Index rankings. In 2014, it rose to 16th place. I asked the Minister at that time if we could look at adopting or investigating such a system. At the time the Minister said:

I will certainly look at the suggestion regarding Macedonia. We need all the suggestions we can get on this. If there is good practice, we will look at it.

I understand that these matters cannot be dealt with overnight. However, the Minister has asked for suggestions and they have been provided.

I do not believe that the problem with our health system can be the subject of an easy fix but it is infuriating to see areas where improvements could and should be made but in respect of which action has not been taken. In my district, Mayo University Hospital was on course to have a piloted scheme for modular buildings last February. Many local authority members, including councillor Michael Loftus, have contracted me about this. The idea is that modular units would be put in place as extensions to existing emergency departments in some hospitals in order to relieve pressure. This has not happened. In fact, the plan, which was much sought after, appears to have fallen off the face of the earth. Mayo University Hospital has used its budget wisely. It has struggled on and been frugal with what it was given. As a result, it appeared to have been punished through the withholding of the promised modular buildings. Can the Minister advise me when it can expect those modular units to be delivered? This is another solution to chronic overcrowding of an accident and emergency department but it has not been acted upon.

There is an urgent need to increase the number of beds available in our hospitals to help ease the burden. Ireland has one of the lowest numbers of acute hospital beds - 2.4% per 1,000 of population compared with an average of 3.6% per 1,000 in 2015 - in the OECD . We need to see an increase in the number of beds in our hospitals. That is the only way overcrowding will be tackled in the long run. The Irish Nurses and Midwives Organisation, INMO, trolley watch-ward watch figures for the first week in January showed overcrowding records being broken. The daily average so far this year is 560 people on trolleys. This is the last day of January and I hope that it will be the last day of record breaking figures.

Currently, the HSE target for patients in accident and emergency departments to be seen by a doctor is six hours. That is our target but in reality it should be an absolute limit. International research suggests that there is an increased incidence of adverse outcomes for patients who have been in emergency departments for more than four hours. Long waiting times, that is, greater than six hours, should be an exception; it should not be the norm.

I will conclude with a quote from the Irish Association of Emergency Medicine which states:

This was always going to be how 2018 started in our EDs. Everyone, from the Minister for Health to the clinician on the frontline, knew it - yet little of substance was done by the DoH and the HSE to address it.

Knowing what I know and having spoken to people on the front line, I can only conclude that people's medical outcomes are being compromised. People are dying as a result of chronic overcrowding in our hospitals.I do not say that lightly, but it is a reality. I would be grateful if the Minister would revert to me regarding the situation at Mayo University Hospital.