Liam Twomey (Wexford, Fine Gael)
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Question 82: To ask the Minister for Health and Children if accurate figures are available to him regarding the extent of emergencies such as trauma and medical emergencies; the way that this is impacting on planning for the future of the ambulance services and resourcing accident and emergency departments here; and if he will make a statement on the matter. [13280/11]

James Reilly (Dublin North, Fine Gael)
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Emergency departments are the front line for our health services and have a higher public awareness profile than virtually any other service. Almost 1.2 million individual emergency presentations were made to acute hospitals during 2010, with almost 370,000 emergency admissions recorded.

While the numbers presenting to emergency departments in 2010 were broadly the same as 2009, overall hospital activity has grown significantly in the past four years, in line with policy objectives. This places particular pressure on admissions through the traditional route of the emergency department. There has been:

· an increase of over 30% in day cases (up by 169,000 since 2006 and by 52,000 in 2010), which now outnumber inpatient discharges;

· a 28% increase in outpatient attendances anticipated by year end (by 760,000 since 2006 and by 162,000 in 2010), at a time when bed capacity and staffing is contracting because of the financial environment and staff moratoriums.

· a relatively constant level of inpatient discharges over this period (-0.59%).

· a reduction in average length of stay from 6.4 days to 6.1 days.

In addition, preliminary data on activity to the end of April 2011 highlights the following when compared with the same period in 2010:

· an increase of 1.5% in ED presentations (+5614)

· an increase of 3.7% in emergency admissions (+4535)

· an increase of 1.1% in inpatient discharges (+2053)

· an increase of 2.6% in day case rates (+6226).

The HSE has undertaken a range of actions since 2006 to deal with emergency department issues. The approach and actions have been informed by a range of national and international reports and literature, much of which aligns on key messages, including surge protocols and the need to adopt a whole system approach, with a specific focus on:

· internal hospital processes and factors that can influence bed occupancy/utilisation and length of stay

· the capacity of primary and community services to respond and avoid unnecessary admissions to acute care and to facilitate earlier discharges

· the need to prevent and manage chronic illness to reduce demand on the acute setting.

Trauma and medical emergency figures are available to the National Ambulance Service through its command and control systems. Utilising this and other data, the Pre-Hospital Emergency Care Council published a recent Spatial Analysis Report of the country. These types of data and reports are considered by the National Ambulance Service in the planning, allocation and deployment of pre-hospital emergency care resources.