Dáil Éireann díospóireacht -
Wednesday, 30 Jan 2002

Vol. 547 No. 1

Written Answers. - Accident and Emergency Services.

Seán Haughey

Ceist:

505 Mr. Haughey asked the Minister for Health and Children the measures he is taking to improve services in accident and emergency departments in public hospitals, particularly in Beaumont Hospital, Dublin 9 and the Mater Hospital, Dublin 7; and if he will make a statement on the matter. [1326/02]

Minister for Health and Children (Mr. Martin)

In relation to Beaumont Hospital and the Mater Hospital, a range of measures have been taken to assist both hospitals in coping with pressure on their accident and emergency departments. These measures include, in the case of Beaumont Hospital, the provision of an additional 37 beds, arising from the national review of bed capacity which will be designated for elective work and which will allow the hospital to schedule urgent cases more effectively and thereby avoid patients being admitted through A&E. Further proposals from Beaumont in relation to the provision of additional beds in 2003 and beyond will be considered as part of the next phase of the national review of bed capacity; additional long-stay beds are becoming available in the hospital's catchment area; a new 50 bed unit in Lusk was opened by the Northern Area Health Board in November 2001 – it will be fully operational in February 2002 – and this will increase the number of public extended-care beds in the area; a new joint project between the Northern Area Health Board and Beaumont Hospital was initiated and funded by the Eastern Regional Health Authority in 2001. Called the Home First project, this is designed to allow elderly patients to return home after hospitalisation with the necessary support services being provided in their homes. The hospital also introduced an outreach chronic obstructive pulmonary disease service in 2001. This service is provided to patients in their own homes and avoids unnecessary A&E attendances.

With regard to the Mater Misericordiae Hospital, a major re-development is planned which will include expanded and improved facilities and the construction of a new children's hospital (replacing the existing children's hospital at Temple Street) on the hospital Campus. A new accident and emergency department will be part of this re-development. Initiatives approved within the last year to improve services in the Mater's accident and emergency department include the following; the re-organisation of services for medical emergency admissions through a project known as the medical emergency division, to improve the flow of patients through the department thereby decreasing delays for patients awaiting admission to in-patient beds; the provision of a chest pain assessment unit and a respiratory unit; the appointment of nurse practitioners and cardiac nurses; and the appointment of patient liaison officers to provide information and support services for patients awaiting treatment.

At national level I have 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. Comhairle has been engaged in an extensive consultation process, meeting with and receiving submissions from representatives of each health board, relevant voluntary hospitals, appropriate professional bodies and other interested parties. It has also obtained information on attendances in each A&E department and has also reviewed extensive literature regarding A&E services in Britain, Europe, the US, Canada and Australia. I am informed by Comhairle that the report is expected to be completed shortly.

The new health strategy, Quality and Fairness: A Health System for You, outlines a number of initiatives which will be taken to improve the operation of A&E departments including the establishment of 24-hour GP co-operatives which will help reduce demand from, and treat appropriately, patients who would otherwise attend at an A&E department; the establishment of minor injury units to ensure appropriate treatment and management of non-urgent cases; the use of chest pain clinics, respiratory clinics and in-house specialist teams to fast-track patients as appropriate; the re-organisation of diagnostic services to ensure increased access to, and availability of, services at busy times in A&E departments; the appointment of advanced nurse practitioners – emergency – in acute hospitals; the use of admission protocols to ensure that emergency patients will be the only group of patients admitted to hospital through A&E departments.