John Deasy (Waterford, Fine Gael)
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Question 22: To ask the Minister for Health and Children the action she will take to address the increase in the number of patients waiting on trolleys in accident and emergency which reached an unprecedented high of 569 in January 2011; and if she will make a statement on the matter. [1709/11]

Joe Carey (Clare, Fine Gael)
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Question 28: To ask the Minister for Health and Children in view of the unprecedented number of patients waiting on trolleys in accident and emergency, the precautions being taken to protect patients from cross infection from swine flu and other hospital infections; and if she will make a statement on the matter. [1762/11]

Bernard Durkan (Kildare North, Fine Gael)
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Question 51: To ask the Minister for Health and Children the action taken in response to previous parliamentary questions calling for the provision of adequate back up facilities in the various hospitals throughout the country to prevent bed or ward closure or decommissioning for whatever reason which have subsequently resulted in patients being consigned to trolleys for long periods, causing hardship and suffering for patients, anguish and understandable concern of relatives and consequent demoralisation among front line health workers; if she will further indicate given the clear evidence of a recurrence of this problem, the reason adequate forward planning and necessary provision did not take place; if it is true that there is now a substantial reliance on agency staffing at many public hospitals; her views on whether the public health service is being run down and demoralised; if she will specifically address the issues in each of the hospitals referred to in recent media reports with a view to indicating the reasons patients have again found themselves on trolleys awaiting attention in lobbys, corridors and alcoves given that a world class health service was promised several years ago; and if she will make a statement on the matter. [1661/11]

Jim O'Keeffe (Cork South West, Fine Gael)
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Question 63: To ask the Minister for Health and Children her views on whether the recent water restrictions have adversely affected the functioning of accident and emergency departments in hospitals throughout the country; the measures that have been taken to deal with this problem; and if she will make a statement on the matter. [1439/11]

Denis Naughten (Roscommon-South Leitrim, Fine Gael)
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Question 66: To ask the Minister for Health and Children the steps she will take to address the crisis in accident and emergency departments; and if she will make a statement on the matter. [1782/11]

Jim O'Keeffe (Cork South West, Fine Gael)
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Question 67: To ask the Minister for Health and Children if enough doctors have been hired in accident and emergency departments in hospitals throughout the country to deal effectively with the increase in seasonal flu and swine flu cases; and if she will make a statement on the matter. [1440/11]

Mary Harney (Dublin Mid West, Independent)
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I propose to take Questions Nos. 22, 28, 51, 63, 66 and 67 together.

The HSE has stated that the Acute Services Division of the Integrated Services Directorate has not received any reports on whether the recent water restrictions have adversely affected the functioning of emergency departments.

The waiting times for patients attending Emergency Departments in many hospitals during the first week of January were unacceptable, and I very much regret the delays that patients experienced.

I have discussed plans with the HSE for ensuring that this situation does not recur. The HSE has assured me that it will take all possible steps to improve waiting times in Emergency Departments, so that all patients are assessed, treated and discharged or admitted without unnecessary delay.

The HSE has taken specific steps to cope with the increase in activity that is normally experienced at this time of year. These include curtailing elective surgery and opening beds which are normally closed for seasonal reasons. Other actions taken by hospitals include increasing the number of ward rounds to ensure that any patients who are ready to go home are discharged with support as necessary from community based services.

Hospitals are also ensuring that discharges are carried out early in the morning and over the weekend, to make beds available for patients being admitted through the ED. In addition the HSE is working to have senior clinical decision makers and diagnostic services speedily available for Emergency Department needs. The HSE has also provided for enhanced GP out of hours services through the expansion of the GP co-ops. Where deficits in staff numbers have occurred a mixture of cross-cover, overtime, locum cover and agency staffing has been used to ensure continuity of service and the provision of a safe level of service for patients.

The steps I have outlined above are taken to address the current short-term difficulties. Improving access to hospital services requires a wider healthcare approach. In recognition of this, the HSE has undertaken a number of initiatives in recent years. These include the Winter Initiative Programme, the introduction of the Code of Practice for Integrated Discharge Planning and actions to reduce the number of delayed discharges, including the introduction of the "Fair Deal".

Other innovations undertaken by the HSE include the development of Emergency Care Networks and the Acute Medicine Programme which involves the establishment of Acute Medical and Surgical Assessment Units, Rapid Access Clinics and Minor Injury Units. The programme seeks to channel patients quickly to the service best suited to their needs, and to reduce the usage of Emergency Department services by those who can be best treated elsewhere.

A new Acute Medical Unit was opened at Cork University Hospital last Monday. Other similar units are already in place at Kerry General Hospital and St Luke's General Hospital in Kilkenny. The HSE Service Plan for 2011 commits to the establishment of 12 Acute Medical Units during 2011 with an investment of €8.5m.

Emergency Departments have particular infection control protocols in place for staff to manage patients attending with flu like illnesses including the H1NI virus to minimise risk to patients and staff.

The key to addressing the ED challenge is an integrated pro-active management by all concerned throughout the system. I have asked the HSE to ensure that minimising waiting times in EDs is a key priority in their service to patients.