John Deasy (Waterford, Fine Gael)
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Question 123: To ask the Tánaiste and Minister for Health and Children the progress to date on the ten point plan for the accident and emergency crisis; and if she will make a statement on the matter. [35379/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The Health Service Executive is advancing the implementation of a series of measures to improve the delivery of accident and emergency services. These measures take a wide ranging approach and are aimed at improving access to accident and emergency services, improving patient flows through accident and emergency departments, freeing up of acute beds and providing appropriate longer-term care for patients outside of the acute hospital setting.

A particular focus has been placed on those patients in acute hospitals who have completed their acute phase of treatment and are ready for discharge to a more appropriate setting. The HSE is making sustained efforts to arrange for the discharge of these patients in order to have more acute beds available in hospital for emergency patients.

The following new and extended units have been funded through the ten point plan: completion of a new accident and emergency unit at Portlaoise General Hospital; commissioning of the new accident and emergency unit at St. James's Hospital, Dublin; minor injury unit at St. John's Hospital, Limerick; a chest pain unit and a minor injury unit at Waterford Regional Hospital; paediatric emergency services in Limerick; medical assessment unit and soft tissue trauma clinic for Cork University Hospital; and new 25 bed unit at the Mater Hospital.

The following initiatives have been taken with regard to care of the elderly: 48 high dependency beds have been contracted in private nursing homes for those patients with more demanding care needs; 427 patients have been discharged through 100 intermediate care beds for six to eight weeks stays since contracts with private providers commenced in May; 70 patients in St. Mary's in the Phoenix Park were identified as suitable for transfer to private nursing homes. The beds freed up has allowed for the discharge from the Mater Hospital and Beaumont Hospital of 35 high dependency patients each; 45 public long-stay beds in nursing facilities on the southside of Dublin have reopened; and additional homecare packages and enhanced subventions have facilitated the discharge of 429 patients in the Dublin area.

The results of the national hygiene audit will form the basis for the changes that are required in both work environments and work practices so as to meet the highest possible standards of cleanliness in hospital settings. The HSE is making an initial capital grant of €20 million available to hospitals to implement the recommendations of the audit.

The HSE will also publish national infection control standards and national cleaning standards — a consistent and robust set of hygiene standards for hospitals. Where previously standards may have depended on the approach of a particular hospital or health board, the HSE can now ensure every hospital will share and meet the same high standards of cleanliness and infection control. The national hygiene audit of acute hospitals will be repeated in early 2006 in order to assess the extent of the improvements made at hospital level since the publication of the first audit report.

The assessment and analysis of clinical and organisational processes has been completed in the ten hospitals nationally. A draft overview report on the findings from the ten hospitals is being prepared at present for the Health Service Executive. In 2006 the National Hospitals Office will prioritise the implementation of the findings and recommendations of this report. An additional six palliative care beds have been commissioned in Blackrock hospital and recruitment of staff is complete. They are fully operational and the day hospice is also in operation. My Department and the Health Service Executive will continue to work closely to maintain a focus on the implementation of system-wide measures to improve the delivery of accident and emergency services.