I propose to take Questions Nos. 196 to 198, inclusive, and 201 together.
I have said very clearly on many occasions that the situation in our hospital emergency departments where people must wait for unacceptably long periods on trolleys will not be allowed to continue. For this reason, one of my first actions as Minister for Health was to set about establishing the Special Delivery Unit.
The SDU is establishing an infrastructure based on information collection and analysis, hospital by hospital, so that we will know what is actually happening in real time. It is providing information tools for hospital managers, including clinical managers, to map and measure bed capacity in their hospital depending on variations in for example the average length of stay of patients. This will allow us to begin to embed performance management in the system, to manage bed capacity and to sustain shorter waiting times.
The problems in our emergency departments are complex and they did not arise overnight. The particular issues vary from hospital to hospital and some of the solutions will depend on local factors. As part of the process of forming the overall picture of the emergency department situation nationally, the SDU has identified fifteen hospitals which between them account for 80% of the trolley wait problem in the hospital system. Eight Hospitals have been identified for very high support including Our Lady of Lourdes in Drogheda. Liaison Officers from the SDU are working pro-actively to support these sites.
I have also agreed that some additional funding may be provided, on a strictly once off basis, based on specific proposals from the hospital to reduce waiting times between now and the end of the year which will help address issues such as delayed discharges. Adherence to the agreed criteria will be closely monitored by the SDU.
The conditions and performance measures which Our Lady of Lourdes and other hospitals will have to meet are as follows: for the remainder of the year and throughout January 2012 no patient will wait more than 23 hours in the hospital's Emergency Department. In addition the trolley wait target must be maintained at least 70% below the maximum daily trolley count since January 2010. Other conditions/performance measures include:
Seven day ward/discharge rounds
Achievement of all Acute Medicine Programme milestones
Implementation of approved measures to effectively stream elderly patients.
In relation to Drogheda some €725,000 (including specific funding for Louth/Navan hospitals — see below) has been approved to help alleviate emergency department pressures including:
Extending the Medical Assessment Unit service including an increase in the opening hours from a five to a seven day a week basis.
Opening 8 medical beds in Drogheda
Opening 28 low acuity beds in Louth/Navan hospitals to provide intermediate care discharge area
Opening 27 beds in community/ private facilities to accommodate delayed discharge patients
Various measures for early assisted discharge for medically fit patients including additional home care packages, home IVs, and additional aids and appliances.