I propose to take Questions Nos. 63, 87, 164, 170 and 191 together.
The Health Service Executive is advancing the implementation of a series of measures to improve the delivery of accident and emergency services funded from the €70 million current funding that was made available in the Estimates for 2005. Some of the specific projects now approved include: a new accident and emergency unit at St. James's Hospital Dublin; a new 25 bed accident and emergency admissions unit for the Mater Hospital; the completion of an accident and emergency unit in Portlaoise; a minor injury unit and a chest pain unit at Waterford Regional Hospital; a minor injury unit at St John's Hospital, Limerick; and a medical assessment unit and soft tissue trauma clinic at Cork University Hospital.
A detailed process mapping exercise is being conducted in advance of final decisions being taken on the provision of acute medical units at Tallaght, St. Vincent's and Beaumont hospitals. Tenders to undertake this exercise at ten hospitals nationally have been received by the HSE and are being evaluated at present. This hospital-by-hospital work to improve procedures in order to speed up patient services at accident and emergency departments has proved successful in the UK.
In relation to the provision of more appropriate care for older people who have completed the acute phase of their treatment, the following steps have been taken: 74 public intermediate-long stay beds are to be opened; 38 beds have been contracted for high dependency patients in the eastern region, to date a total of ten patients have been transferred from acute hospitals in the region; an initial 65 intermediate care beds were sourced under the tendering process for the eastern region and to date 95 patients has been discharged through those beds; in Cork, 30 intermediate beds were sourced under the tendering process and to date 36 patients have been discharged to these beds; 87 older people and eight young chronic disabled persons have been discharged through home-care supports; and an additional six palliative care beds have been commissioned in Blackrock Hospice.
Other measures under way include the following: a national audit of cleanliness in hospitals, to be undertaken by external consultants, will take place in July and August this year; funding has been provided to hospitals in the HSE-southern area for direct access to private diagnostic services; and in relation to broader range of GP direct access diagnostic services it has been agreed that the HSE will explore entering into local arrangements with the private sector to match capacity with needs.
In addition to these approvals, the HSE has asked each hospital network to: undertake a detailed analysis of patient throughput in each hospital; review existing practices to match staffing and other resources to peak patient attendance times; ensure efficient bed management and discharge planning to improve throughput; and promptly implement accident and emergency escalation plans when there is a significant surge in demand for accident and emergency services.