Dáil Éireann - Volume 441 - 14 April, 1994

Written Answers - Dublin Hospitals' Casualty Departments.

33. Mr. R. Bruton asked the Minister for Health if his attention has been drawn to the problems of long waiting periods in the casualty departments of the major hospitals in Dublin; and whether all of the hospitals have adopted the recommendations set out in the interim report of the Kennedy Group dealing with the problems of casualty departments.

Minister for Health (Mr. Howlin): Because of the nature of the work, it is not possible to predict the workload of hospital accident and emergency departments at any particular time. However, at all times, priority is accorded to those patients most in need of immediate medical attention. The situation is exacerbated at times through, for instance, major accidents or epidemics such as influenza. Some accident and emergency departments, particularly in Dublin, have experienced difficulties from time to time because of the number of elderly people requiring attention. The difficulty here has not primarily been the provision of acute hospital beds but of insufficient stepdown facilities for patients in need of a different level of care.

The position regarding the accident and emergency departments is monitored by my Department on an ongoing basis. In this regard, shortly after coming into office I approved a sum of £500,000 to provide an immediate response to a problem of the type to which I have referred. In December 1993 I allocated a further £250,000 to the Eastern Health Board to enable the pressures on the [689] accident and emergency hospitals to be eased. This was achieved through the placing of more than 100 patients from the six major accident and emergency hospitals in Dublin, who were no longer in need of acute hospital care, in stepdown accommodation more appropriate to their condition. This action helped significantly to relieve the seasonal pressures on the hospitals.

The change which I have recently announced in relation to the charge for attendance at accident and emergency departments is intended to create an incentive for patients to attend their general practitioner in the first instance, in cases where their condition would be most appropriately treated at this level. I am hopeful that this change will help to ease the pressure on hospital accident and emergency departments.

Following the publication in September 1991 of the reports of the Dublin Hospital Initiative Group, a second group, the Dublin Hospital Advisory Group, which was also chaired by Professor David Kennedy, monitored and reviewed progress in relation to the implementation of these reports' “good practice” recommendations. This group found that the implementation of the “good practice” recommendations was broadly satisfactory, although it was recognised that to put these fully into effect would take some time.

Certain recommendations required the provision of additional resources and, as such, must be considered in the context of individual hospital's development priorities and the funds available for improvements throughout the health services as a whole.

I would like to assure the Deputy of my continuing concern that the accident and emergency hospitals in Dublin are enabled to respond effectively to the demands placed upon them and that I will continue to monitor the situation with a view to taking further action if required.