Tuesday, 26 November 2019

Ceisteanna (50)

Michael McGrath


50. Deputy Michael McGrath asked the Minister for Health the reason to date in 2019 more than 1,500 persons over 75 years of age have endured emergency department waiting times of more than 24 hours at Cork University Hospital, CUH. [48768/19]

Amharc ar fhreagra

Freagraí ó Béal (8 píosaí cainte) (Ceist ar Health)

Why is it that to date in 2019 more than 1,500 people in the over 75 age group have endured emergency department waiting times of more than 24 hours at CUH?

I thank the Deputy for turning up to ask this question. So far today, three Opposition Members who tabled questions have not turned up to ask them, which is interesting. In fairness, I am not criticising the Deputy, who is ably deputising for her colleague but there were three other questions that the Opposition never bothered to turn up to ask me.

Deputy Michael McGrath has a genuine reason for being absent.

There must be something important happening to which I was not invited.

The number of patients attending emergency departments has increased this year with the result that the hospital system is currently operating at close to full capacity. HSE figures show that for the first ten months of 2019 the number of patients attending Cork University Hospital increased by 3.5% and the number of attendances of patients over the age of 75 increased by 6.9% compared to the same period in 2018. This reflects increasing demand for unscheduled care, especially by patients in the 75 years and over age group. A number of factors may affect the waiting times for older patients. In particular, people in the older age category presenting to emergency departments are more likely to have complex needs and to be admitted than the population generally.

In preparation for the anticipated increase in demand over the winter period the HSE's winter plan was launched on Thursday, 14 November. The Government provided an additional €26 million to fund the implementation of the plan. Nine winter action teams, each aligned to a CHO and associated acute hospitals and hospital groups, have prepared integrated winter plans. These plans focus on demand management and reduction, staffing availability, timely access to the most appropriate care pathway for patients and appropriate timely discharge from acute hospitals. Each action team has now set out a range of initiatives it will undertake within its area to implement the plan. I am confident that with the immediate measures being undertaken under the winter plan and the strategic approach being taken by the Government, we will make progress in addressing the difficulties in emergency departments.

I share the Deputy's view that far too many people over the age of 75 are waiting far too long on hospital trolleys. I have conveyed clearly to the HSE that it must prioritise the care of older people in our emergency departments. The action teams must put in place the necessary care pathways for frail, elderly patients. We have allocated €26 million in this regard.

I reiterate that my opening comments were not related to this question, which is being covered ably by the Deputy, but to three other questions for which there was no Member in the Chamber.

I am glad that the Minister clarified that because Deputy Michael McGrath has a genuine reason for being absent. He left this question in my capable hands, I hope. Between January and the end of October this year, a total of 1,508 people aged over 75 endured emergency department waits of longer than 24 hours in CUH. These are some of our most vulnerable patients. The Mercy Hospital in Cork was not as bad as CUH but still another 450 patients aged over 75 had to suffer waits of more than 24 hours. This is not acceptable. What exactly is being done to address this? I seek more details from the Minister. He has explained a number of issues but I ask him to go into more detail. Does he believe it is acceptable to treat vulnerable older people in this manner? Is it not a form of elder abuse? Does he believe it is acceptable that this is happening? What communication has he had with the HSE on this matter? I seek specific details of his contact with the HSE.

I am in daily contact, often several times a day, with the most senior members of the HSE, including the CEO and the chief operating officer, as well as with the CEOs of the hospital groups on occasion, the director of the acute hospitals and many others, along with senior members of my own management team. We engage several times a day on the situation in the acute hospitals, as one would expect at this time of year. That will continue and intensify through the Christmas and new year period. The Deputy asked a fair question as to what is happening now. We have provided €26 million to the Minister of State, Deputy Daly, for the nursing home support scheme to ensure a quick turnaround time of four weeks. We have also put in place more home care packages and more funding for transitional care. Regarding structural change, from January next under the new GP arrangement, there will be a structured chronic disease management programme for patients over the age of 70 for the first time. This means that older people who are currently being treated in hospital for a number of chronic conditions, including asthma and heart conditions, will be treated in the community instead.

I accept that the Minister is trying hard but something is very wrong when the most vulnerable in our society have to wait so long in emergency departments. Many older people do not want to go into hospital because of the long waiting times. That is not good enough. Is he aware that the numbers are twice as bad as for the same period last year? This is not acceptable, particularly as there is no major flu epidemic at the moment. What will it be like if there is a major outbreak or crisis? With respect, what is being done is not working. There are too many people aged over 75 and too many people in general waiting on trolleys in Cork hospitals. I often raise the issue of Bantry Hospital with the Minister because I believe that providing more funding for that hospital would help to alleviate the long waiting times and the overcrowding in the city hospitals.

I agree with the Deputy regarding Bantry Hospital. The Minister of State, Deputy Daly, is due to meet management of the hospital on 2 December. The Deputy is correct that we need to continue to make that hospital busier and to invest more in it, which is our intention. She is also correct that there is a need for more capacity in Cork generally. That is why we are funding a new elective hospital for Cork. I have received correspondence from the hospital group on a proposed site for that hospital and I hope to be in a position to make an announcement on it early in the new year so we can get on with delivering this new hospital.

I do not find this situation acceptable. Nobody finds it acceptable that mothers, fathers, grannies and grandads or any other loved ones, but particularly frail older people, have to wait around in emergency departments on trolleys. We need to do everything we can to create alternatives to our emergency departments. That is why we are investing more in general practice. In the interim, while we are trying to implement Sláintecare, the ten-year strategic plan agreed by all parties in this House, we will invest more in social care supports to get people out of hospital quicker and back into their communities, something about which the Deputy is passionate. We will continue to focus on that.

Question No. 51 replied to with Written Answers.