Dáil Éireann Debate, Tuesday - 22 June 2004
61 Mr. J. Bruton asked the Minister for Health and Children if he has made an estimate of the population of visits to accident and emergency departments that were by persons whose conditions might more appropriately be treated at primary care level; if he has analysed the reason accident and emergency departments were used in those cases; and if he will make a statement on the matter. [18395/04]
Amharc ar fhreagraThere are some 1.2 million attendances at emergency departments each year. While individual hospitals have systems and procedures in place to record attendance at the emergency department information in relation to the extent or severity of injuries or conditions of people attending is not routinely collected on a national basis by my Department. However, information supplied to my Department by health boards and hospitals indicates that approximately 25% of those who attend the emergency department require admission to hospital.
While many of the balance require hospital treatment, it is recognised, that a number of those who attend emergency departments may more appropriately be treated in a primary care setting.
The strategy, Primary Care: A New Direction recognises that the Irish health system places considerable reliance on hospital care and that an appropriately developed primary care system can meet between 90% and 95% of all health and personal social service needs. This strategy sets out a new direction for primary care as the central focus for the delivery of health and personal social services. It promotes a team-based approach to service provision which will help to provide a fully integrated primary care service. A properly integrated primary care service can lead to better outcomes, better health status and better cost effectiveness. Appropriately developed, primary care services can help prevent or reduce the impact of conditions that might later require hospitalisation, and can also facilitate earlier hospital discharge. Overall a strengthened primary care system can have a significant impact in alleviating demands on specialist services and the hospital system, particularly accident and emergency and out-patient services. General practitioner out-of-hours co-operatives have been established and are operating in at least part of all health board areas, with one health board, the North Eastern Health Board, having a region wide project. Between 2000 and 2003, €46.5 million has been allocated to the health boards for the purpose of out-of-hours co-operatives and this figure does not include the fees paid to participating general practitioners. An amount of €24 million has been allocated for 2004. The satisfaction rate with the GP co-op service is very high from both patient and provider perspectives. In fact a recent survey by the Western Health Board's service, WestDoc, indicated that of the persons surveyed 30% said that they would have gone to the emergency medicine department if the service had not been available.
In order to address the needs of patients presenting at the emergency department some hospitals have established minor injury or illness units. These units provide rapid assessment and appropriate treatment of minor injuries by nurse practitioners or junior doctors. The main advantages of having a separate minor injuries area within the emergency department include the better streamlining of patients and decreased waiting times.
