Jan O'Sullivan (Limerick East, Labour)
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Question 205: To ask the Minister for Health and Children the progress in regard to the commitment given in the programme for Government to further increase the number of accident and emergency consultants available around the clock in accident and emergency departments; and if she will make a statement on the matter. [18323/08]

Jan O'Sullivan (Limerick East, Labour)
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Question 206: To ask the Minister for Health and Children the progress in regard to the commitment given in the programme for Government to further develop chest pain and respiratory clinics to ease pressure on accident and emergency services; and if she will make a statement on the matter. [18324/08]

Jan O'Sullivan (Limerick East, Labour)
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Question 207: To ask the Minister for Health and Children the progress in regard to the commitment given in the programme for Government to establish a national network of local injury clinics; and if she will make a statement on the matter. [18325/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 205 to 207, inclusive, together.

Improving the delivery of Accident and Emergency services continues to be a high priority for this Government.

There has been considerable improvement made in the delivery of services in Emergency Departments over the past two years. The average monthly number of patients awaiting admission fell from 179 in 2005 to 92 in 2007. While there has been some increase in the figures to date in 2008 it should be stressed that the remaining difficulties are largely confined to a number of major hospitals. The HSE is working closely with these hospitals to bring about further improvements. The HSE focus is on improving and streamlining hospital processes and patient pathways to ensure that care is provided in a more timely, appropriate and efficient manner.

The Programme for Government contains a number of new commitments designed to further improve the delivery of Accident & Emergency services. These are to:

Increase the number of A and E consultants available around the clock in A and E departments;

Further develop chest pain and respiratory clinics to ease pressure on A and E;

Establish a national network of Local Injury Clinics.

The 100 + Scheme was introduced last year by the HSE to reward hospitals with Emergency Departments operating in line with established performance targets. Phase 1 of the Scheme involved the announcement last August of 60 consultant posts to be distributed across 24 hospitals and including posts in emergency medicine, radiology, general medicine, general surgery and geriatric medicine. An additional 20 Consultants in Emergency Medicine have been approved to support the delivery of A and E services since 2003. This represents an increase of 61% over the past five years in the emergency consultant numbers. A further 2 posts were advertised in April and the Health Service Executive expects to progress more emergency consultant posts during 2008 in the context of the 100 + Scheme.

In addition, the proposed new Consultant Contract provides for greater flexibility in the rostering of Consultants in Emergency Medicine and the consequent availability of consultant-provided services in line with clinical need. The new Contract includes provision for an extended working day to 12 hours Monday to Friday (8 a.m. to 8 p.m.), provision for rostering on-site at weekends and public holidays and by agreement, more flexible arrangements, including 24/7 rostering.

Significant capital provision has been included by the HSE within its Draft Capital Plan 2008-2013 for the enhancement of A and E facilities in line with the recommendations of the Emergency Task Force. The funding will be targeted at upgrading and extending existing departments and will also include provision for new departments.

Chest pain assessment and respiratory services are provided at existing Emergency Departments. However, there are dedicated practice examples where GP referrals are assessed by cardiology services in units such as the chest pain assessment units in the Mater Hospital, Connolly Hospital, Cork University Hospital and South Infirmary. Dedicated respiratory clinics are, for example, conducted at the Mater Hospital and Connolly.

A number of the new A and E Departments have provision for minor injury clinics, including Connolly Hospital, Blanchardstown, Cork University Hospital, St. Vincent's Hospital, St. James's Hospital and South Tipperary General Hospital.

Outside of Dublin, funding was provided for the expansion of minor injuries services at St. John's Limerick, and the provision of a minor injuries unit at Waterford Regional Hospital. These services are fully operational.

In line with the recommendations of the Teamwork Report "Improving Safety and Achieving Better Standards", the HSE is also committed to the development of Minor Injury Units in local hospitals in the North East. The first of these units is to be developed at Monaghan Hospital. Other units are to open at Our Lady's Hospital, Navan and Louth County Hospital, Dundalk.