James Leonard
Ceist:31 Mr. Leonard asked the Minister for Health the increase or decrease, if any, in general practitioners referring patients to hospital casualty departments in 1995. [5121/96]
Written Answers. - Hospital Referrals.
Limerick East): The Irish hospital service has encountered problems in the provision of accident and emergency services over the past number of years. Various measures have been taken by successive Minister for Health in an endeavour to alleviate the problem.
This is not a phenomenon confined to Ireland but is a feature in other developed countries also. At present a £12 charge is levied on eligible patients who attend accident and emergency departments. This charge replaced an earlier £6 charge. However, notwithstanding these charges the number of patients who attended at the six major accident and emergency hospitals in Dublin increased by 39 per cent over the years 1988 to 1995. This increase in the volume of attendances at accident and emergency departments has also been a feature of hospital services around the country.
I have been particularly concerned about the accident and emergency services provided by hospitals. That is why I was anxious that a more comprehensive and integrated approach be adopted to tackle this problem and I introduced a plan to tackle the serious difficulties in Dublin.
I have already spoken of the need for hospital management to give priority to the problems that have emerged in the organisation and delivery of accident and emergency services. Hospitals have been asked to re-focus their activities to a greater degree on bed utilisation policies and admission and discharge procedures. Each hospital should agree a series of measures that will result in a better and more streamlined response.
The plan which I have introduced to deal with the accident and emergency difficulties in Dublin includes tackling a number of these areas which are internal to the acute hospital together with improving a range of services outside the acute hospital setting e.g. services for the elderly, services for the chronically disabled and sub-acute services to ease the pressure on the acute hospitals. When taken together these measures provide a comprehensive and integrated response.
In addition, the health board general practice units are involved in the development of closer links between hospitals and general practitioners including the introduction of admission and discharge Protocols between hospital consultants and general practitioners. A major investment is also being made in the improvement of facilities and equipment within general practice. This will encourage general practitioners to undertake procedures which have traditionally been provided in a hospital setting but which are more appropriate to the primary care services.
In addition a public education campaign co-ordinated by the Eastern Health Board on the appropriate use of accident and emergency services was launched on 15 January 1996. While it is too early to assess the full impact of this campaign I understand that the Eastern Health Board will shortly be reporting to me on the impact of this campaign and the benefits which should flow from the project. I will continue to monitor the service over the coming months.