Dáil Éireann debate -
Thursday, 31 May 2001

Vol. 537 No. 4

Written Answers. - Accident and Emergency Services.

Noel Ahern

Question:

109 Mr. N. Ahern asked the Minister for Health and Children if there is a set of standards or criteria for waiting time in accident and emergency departments in hospitals generally and specifically for the Mater and Beaumont Hospitals; if details of target waiting time can be given for the different degrees of patients; if there is any measurement of actual targets; and if any details of occasional or constant surveys can be given. [16449/01]

Minister for Health and Children (Mr. Martin)

Hospitals providing accident and emergency, A&E, services operate a triage system whereby each patient attending an A&E department is assessed and treated in accordance with his/her medical priority. The objective is to ensure that people requiring treatment at A&E departments have access to a senior clinical decision making service and are treated without undue delay.

As a general rule, the categories of assessment in the eastern region, which includes the Mater and Beaumont Hospitals, are as follows: category 1 – patient seen by medical staff immediately; category 2 – condition requires medical attention within ten minutes; category 3 – condition requires medical attention within one hour; category 4 – condition requires medical attention within two hours; category 5 – condition requires medical attention within four hours.

The majority of patients waiting to be seen but not requiring admission to hospital are in categories 3-5. Details of occasional or constant surveys of target waiting times are not routinely collected by my Department. I have, therefore, asked the regional chief executive of the Eastern Regional Health Authority to compile the information requested and to forward it directly to the Deputy.

It must be stated that levels of attendance at A&E departments are complex and cannot be predicted accurately in advance. In this regard periods of exceptional demand may be experienced and waiting periods for treatment may vary particularly during the winter period. However, I would like to assure the Deputy that every effort is being made to keep waiting times to an absolute minimum.

Measures which I have taken to improve our A&E services include the provision of a £32 mill ion investment package aimed at alleviating anticipated service pressures and maintaining services to patients, particularly in the acute hospital sector, over the winter period. The investment package has been targeted at a number of key service areas, including the recruitment of an additional 29 A&E consultants. The recruitment of additional consultants to this key area is designed to reduce any unnecessary delays experienced by patients attending A&E Departments and to ensure that patients have improved access to a prompt senior clinical decision-making service. Additional funding was also provided for the contracting of additional private nursing home places by the Eastern Regional Health Authority, ERHA, and the health boards. These places are for patients whose acute phase of treatment has been completed but who require additional care in an alternative setting. The ERHA and the health boards contracted 761 beds under the initiative and this helped to free up acute beds for patients awaiting admission to hospital.

I have also provided funding to support a range of further initiatives at hospitals in the eastern region which are designed to improve patient services. These include: funding of £300,000 towards the enhancement of security cover in A&E departments; £5.19 million towards the development of A&E facilities at St. James's Hospital; approval for the recruitment of an additional ten temporary A&E consultants; the provision of a minor injuries unit in Beaumont, Mater, James Connolly Memorial, St James's and Tallaght Hospitals; development of pilot services for deep venous thrombosis in Beaumont Hospital and for chest pain management at St. James's Hospital; the provision of a pilot discharge lounge in Beaumont Hospital; the recruitment of discharge planners at nine adult A&E sites.

In recent weeks funding of £3 million has also been provided to the Eastern Regional Health Authority for the enhancement of acute hospital services within the region, including the appointment of patient liaison personnel in eight A&E departments across the region.

I have also requested Comhairle na nOspidéal to review the structure, operation and staffing of A&E services and departments with the aim of improving the provision and quality of patient care. The review, which is now under way, will take into account the report of the Medical Manpower Forum, policies of the Irish Accident & Emergency Association and the Institute of Orthopaedic Surgeons, international best practice, the views of health authorities, management, medical practitioners and other relevant matters. The findings of this review will inform future policy decisions in relation to the development of A&E services. I am satisfied that the initiatives which I have outlined above will help to relieve some of the pressures although I accept that that there is a need for additional targeted investment to the A&E service to allow for future improvement in services.

Finally, I have initiated a national review of bed capacity in both the acute and non-acute settings, on foot of the commitment by this Government in the Programme for Prosperity and Fairness. The bed review, which is at an advanced stage, is being conducted by my Department in conjunction with the Department of Finance and in consultation with the social partners. The review involves the development of a longer term investment strategy for the acute and non-acute sectors and is specifically examining the need for acute beds on a national basis.