I propose to take Questions Nos. 194, 205, 808, 812 and 813 together.
Tackling the problems in A & E departments is the Government's top priority in health. Our objectives are to reduce the numbers waiting for admission, the time spent waiting for admission, and the turnaround time for those who can be treated in A & E and do not require admission.
A & E services are improving around the country. Compared to this time last year, the average number of patients in A & E departments awaiting admission is down by approximately 50%. The average time that patients spend waiting for admission has also been reduced.
The HSE established a dedicated Task Force to work with hospitals to improve the efficiency and effectiveness of services in A & E departments. Teams from the Task Force undertook site visits to each of the hospitals identified as experiencing consistent difficulties in A & E services, to discuss individual issues and potential high-impact solutions. The Task Force's conclusions and recommendations will inform the HSE's actions in relation to A & E over the coming months.
A & E departments are not stand-alone services; they are a critical part of a complex healthcare system. Their ability to function efficiently and effectively is heavily dependent on well-functioning practices and processes within the entire acute hospital system, and the availability of integrated primary and community services.
In order that A & E targets and objectives can be achieved over the clinical winter months, the HSE is introducing a broad-based Winter Initiative to build on its existing range of initiatives. The Winter Initiative will be similar to those in place in other health systems internationally. Its purpose is to ensure that the services required to address the particular demands of the winter season are in place and operating optimally. It will focus on a range of measures, including preventative measures, public communications, discharge initiatives, continuing care and home supports. Tackling the issue of care for older people is an important and integral part of the Initiative. The HSE is implementing a number of measures aimed at achieving increases in extended care provision.
I do not accept that the difficulties experienced in managing A & E services relate to inadequate staffing levels. There have been significant increases in staffing levels in A & E departments in recent years and the resources available compare favourably with services internationally.
I believe that the actions and initiatives being taken by the HSE will result in the sustained improvements in A & E services that patients and their families deserve. However, as the Deputy was previously advised, the delivery of clinical training, which is a significant core component of the course, has been the subject of discussions between officials of my Department and the Department of Education and Science in terms of how best it could be facilitated in an integrated fashion with the Health Service Executive (HSE) services.