A&E Crisis
67. Mr. Gormley asked the Tánaiste and Minister for Health and Children if the state of emergency in relation to accident and emergency departments will continue for the foreseeable future; her views on whether the lack of bed capacity is the main cause of the accident and emergency crisis; the status of her ten point plan; the reason she has failed to deal with the accident and emergency crisis; and if she will make a statement on the matter. [15392/06]
139. Mr. Eamon Ryan asked the Tánaiste and Minister for Health and Children the reason she disagrees with the IMO which claims that one of the main causes of accident and emergency crisis is lack of bed capacity; and if she will make a statement on the matter. [15397/06]
Tánaiste and Minister for Health and Children (Ms Harney): I propose to take Questions Nos. 66, 67, 101, 111, 139 and 144 together.
Tackling the current difficulties with accident and emergency departments is the Government’s top priority in health. The service being provided to some patients in accident and emergency departments is unacceptable and must be improved. Our objectives are to reduce the numbers waiting for admission, the time spent waiting for admission, and the turnaround time for those who can be treated in accident and emergency departments and do not require admission.
The HSE is continuing to implement my ten point action plan. In addition, it has been agreed with the HSE that a number of additional measures will be implemented by the executive. These include in particular the setting of performance targets for individual hospitals. In terms of implementation, the HSE is taking the following approach: tackling the issue on a hospital-by-hospital basis; developing hospital-specific time-based targets in relation to accident and emergency departments and delayed discharges; development of financial incentives linked to performance in these areas; and development of additional targeted initiatives aimed at delivering an immediate and sustained impact.
In the immediate term, the HSE is introducing a series of measures to improve facilities for patients and staff in accident and emergency departments. Long-term care beds are being secured from within the private sector to facilitate the discharge of patients who have completed the acute phase of their care. The acute beds that become available as a result of this initiative will be ring-fenced for those patients awaiting admission in accident and emergency departments. Funding is being made available within the capital programme to develop admissions lounges to ensure that patient privacy, dignity and comfort are preserved while awaiting admission to an acute bed.
Funding has been provided for an additional 900 acute beds-day places since the publication of the Review of Acute Hospital Bed Capacity in 2002. More than 800 of these are in place, and the HSE has advised that the remainder will come on-stream over the coming months. A further 450 acute beds-day places are in various stages of planning and development under the capital investment framework.
I share Professor Drumm’s views that the achievement of improvements in accident and emergency services is dependent on fundamental changes both in hospitals and in other areas of the health service. It is not just a question of putting extra acute beds in place. In this regard, measures being examined by the HSE include: improvements in the processes and procedures in hospitals to ensure that they operate in the most efficient and effective way; the introduction of rigorous admission and discharge planning processes; the broadening of access to diagnostic facilities; and the enhancement and development of primary and community care services.
The HSE has established a dedicated task force to oversee the implementation of the framework for improving the efficiency and effectiveness of services in our accident and emergency departments. The task force will support individual hospitals in identifying specific problems and addressing them. It will work with hospitals to introduce a system of “whole hospital” performance measures to improve the patient’s journey not alone through the accident and emergency department but through the hospital system from admission to discharge.
My Department is currently in discussions with the Department of Finance and the Health Service Executive to agree increases in the employment ceiling for the health sector. My Department is advised by the executive that a significant number of staff have been recruited under the accident and emergency action plan.
I am confident that by improving hospital processes and procedures, by providing additional step-down beds for those patients who do not require acute hospital care, and by expanding and enhancing primary and community care services we can achieve a sustained improvement in our accident and emergency services.