Written Answers. - Accident and Emergency Services.
Richard Bruton
Ceist:
117
Mr. R. Bruton
asked the
Minister for Health and Children
the detailed requirements in extra staff, extra beds and extra facilities of improving accident and emergency services to significantly reduce waiting times and to have senior doctors available at all times.
[14106/02]
A number of significant initiatives have been taken to improve services in accident and emergency departments. A €40.63 million investment package was provided by the previous Government in the winter of 2000-01 aimed at alleviating service pressures and maintaining services to patients, particularly in the acute hospital sector. This investment package provided for the recruitment of an additional 29 accident and emergency consultants and for the contracting of additional private nursing home places 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 more than 700 beds under this initiative in the winter of 2000-01. This level of funding was repeated over the period October 2001-March 2002 and has been of significant benefit to health agencies in responding to the high level of demand for hospital beds over the winter periods.
Funding was also provided by the previous Government to the ERHA and the health boards to support a further range of initiatives in accident and emergency departments. These include: £5.19 million towards the development of accident and emergency facilities at St. James's Hospital; the provision of minor injuries units in Beaumont, Mater, James Connolly Memorial, St. James's and Tallaght hospitals; development of an accident and emergency department at the Mater Hospital; extension to the accident and emergency department at St. Columcille's Hospital; development of pilot services for deep venous thrombosis in Beaumont Hospital; provision of a chest pain service at St. James's Hospital; the provision of a pilot discharge lounge in Beaumont Hospital; the recruitment of discharge planners and patient liaison personnel at accident and emergency sites in the eastern region; development of new accident and emergency department at St. Vincent's Hospital, Elm Park; development of new accident and emergency department at the Children's Hospital, Temple Street; planning of a new accident and emergency department for Cork University Hospital; development of accident and emergency department at Galway University Hospital; development of accident and emergency department at Castlebar General Hospital; development of accident and emergency department at Tullamore General Hospital; appointment of a design team for the development of a new accident and emergency department at Roscommon County Hospital; and upgrading of accident and emergency facilities at Our Lady of Lourdes Hospital, Drogheda, Monaghan General Hospital and Our Lady's Hospital, Navan.
My Department, in conjunction with the Department of Finance and in consultation with the social partners, has conducted a comprehensive review of acute hospital bed capacity needs. On foot of that review entitled, Acute Hospital Bed Capacity – A National Review, the previous Government decided to provide an additional 3,000 beds in acute hospitals over the next ten years. On 16 January 2002, a €65 million investment package was announced by me for the com missioning of 709 of these 3,000 beds in acute hospitals. Commissioning of the 709 beds is currently under way by the Eastern Regional Health Authority and the health boards.
A major refocus on primary care services, marked by the introduction of new models of care involving core multi-disciplinary primary care teams, which will work with a wider network of health and social care professionals and which will offer 24 hour cover to patients, has taken place. This will also help to reduce demand from, and treat appropriately, patients who would otherwise have to attend at an accident and emergency department. This sector will therefore take on a pivotal role in helping to reduce pressures in accident and emergency departments. Investment of €17.29 million will be made in the development of this service in 2002.
Other initiatives have been identified in the national health strategy which are designed to improve the operation of accident and emergency departments. These include: 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 accident and emergency departments; the appointment of advanced nurse practitioners in acute hospitals; the use of admission protocols to ensure that emergency patients will be the only group of patients admitted to hospital through accident and emergency departments; the appointment of additional personnel to liaise with patients while they await diagnosis and treatment at accident and emergency departments; and the introduction of information systems that record comprehensive, comparable and reliable data on activity in accident and emergency departments. Such information will provide staff with a valuable tool in structuring services to meet the needs of patients.
At my request, Comhairle na nOspidéal has undertaken a review of the structures, operation and staffing of accident and emergency departments. The report of the review entitled, Report of the Committee on Accident & Emergency Services, examines and makes recommendations on the provision of emergency services in public hospitals in the State. It explores factors that affect efficiency and effectiveness of hospital emergency services and links reform of accident and emergency departments with the need to look critically at hospital processes and patient flows throughout the hospitals. I am confident that its work will contribute significantly to advancing the existing and proposed policy framework for accident and emergency services as set out in the health strategy.
The Deputy will be aware that action was taken earlier this year by nursing staff employed in accident and emergency departments in order to highlight difficulties being experienced in service provision. Proposals put forward by the Labour Relations Commission aimed at resolving the difficulties which had arisen were accepted by all parties. One of the proposals included a requirement that a national accident and emergency nursing staffing structures review group would be established to carry out an immediate examination of existing structures and staffing levels in accident and emergency departments. In this regard, I am pleased to inform the Deputy that both sides have agreed on an independent examination to take place in a timely fashion.
Earlier this year, I established an accident and emergency forum to identify urgent measures which can be taken to enhance accident and emergency services in acute hospitals, consistent with the commitment in the health strategy. Participants included hospital management, members of the medical and nursing professions, para-medical and non-nursing personnel, staff representative associations and unions, patient advocacy groups and other interested parties. The work of the forum, which took place on 20 March and 1 May this year, will help build on the existing and proposed policy framework for accident and emergency services as set out in the strategy. A number of short, medium and long-term actions aimed at alleviating service pressures were identified and these will now be advanced by the national partnership forum through the involvement of partnership groups at local level. I am committed to ensuring that accident and emergency departments are in a position to respond to the need for their services. I am confident that hospital management and staff in hospitals providing accident and emergency services will continue to work together to respond to any difficulties presenting and to ensure that a high quality service continues to be provided to patients in the best conditions possible.
