I propose to take Questions Nos. 2 and 3 together.
This Government has over recent years introduced a number of initiatives aimed at improving the delivery of acute services and alleviating the pressures on accident and emergency departments. Improved and expanded accident and emergency departments are being provided. Recently, new departments have been provided at Cork University Hospital, James Connolly Memorial Hospital, Naas General Hospital, South Tipperary General Hospital, and Clonmel and Roscommon general hospitals.
Following a submission from the Eastern Regional Health Authority in June 2004 my predecessor approved proposals for short and medium-term action to be taken to address the problems associated with emergency departments in the Dublin academic teaching hospitals. The cost of these new initiatives is €2.4 million in a full year and includes the appointment of specialist nurses, the establishment of rapid assessment teams, a clinical decisions unit and the provision of multidisciplinary teams to assess patients.
An additional 29 emergency medicine consultant posts were approved under the winter initiative 2000-2001. There are now 51 emergency medicine consultant posts in acute hospitals which is a 260% increase since 1997. The availability of senior medical staff in emergency medicine departments should facilitate rapid clinical decision making, enhanced management, diagnosis and treatment of patients.
Pressures on the hospital system, especially in the eastern region, arise from demands on emergency departments and on difficulties associated with patients who no longer require acute treatment but are still dependent. Funding of €16.8 million has been made available to the ERHA which has resulted in some 520 patients being discharged and work is continuing to facilitate the discharge of a further 80 patients.
Planning for the discharge of patients by acute hospitals and the liaison with the community services has been prioritised on an ongoing basis by the Eastern Regional Health Authority. Initiatives such as Homefirst, Slán Abhaile and home subvention all contribute to providing alternative care packages for older people so that they can be discharged. Increasing acute bed capacity will also have an impact on the delivery of emergency services.
Notwithstanding the initiatives introduced over a period of years, there remain too many difficulties and delays in accident and emergency departments which I have already said are not acceptable. They are, however, a symptom of the underlining problem in the health care system. In dealing with the difficulties being experienced by patients, it is therefore necessary to take an holistic approach.
The effective delivery of emergency services cannot be done in isolation of all hospital services. Resolving the problems is a priority of mine. I am identifying the particular pressure points within the health system that effect the efficient delivery of emergency services. I intend to ensure the most pressing problems are addressed as a matter of urgency and in the context of the upcoming Estimates. I intend to introduce a wide-ranging package of measures that will address the problems to which I have referred.