A new target for the maximum length of time patients should have to wait on trolleys in A&E once a decision to admit them has been made has been set by the Health Service Executive for the first quarter of this year.
It said yesterday that no patient should now have to wait more than 12 hours on a trolley once a doctor decides they need to be admitted to a bed.
Up to this it has warned hospitals no patients should have to wait more than 24 hours in A&E for a bed and while in reality many hospitals were complying, a number were still unable to reach this target.
Figures provided by the HSE, for example, show that in two hospitals yesterday five patients were waiting more than 24 hours for a bed, while in nine hospitals 34 patients were waiting more than 12 hours for a bed.
The HSE has stressed, however, that over time it plans to reduce its target waiting times further. It says it hopes to move to a six-hour target from the time patients present to an emergency department to the time they are discharged or admitted. This is the target set for hospitals in the A&E taskforce report which is due to be published shortly.
Angela Fitzgerald, chairwoman of the taskforce, said she believed the six-hour target could be achieved but not immediately.
"The HSE is on record as saying the ultimate target for waiting time is six hours but we accept that that is not something we can do today," she said. "It would be unfair to hospitals because there are a number of things we have to work with hospitals to deliver on."
Ms Fitzgerald added that she believed the six-hour target could be realistically set for all hospitals later this year. The targets had to date focused hospitals on the problem.
Meanwhile the HSE, in a statement, said a number of initiatives had helped to reduce overcrowding in A&E units in recent months, including the provision of admissions lounges, more long-stay beds and better community services. However, it acknowledged, as the does taskforce report, that the infrastructure in a number of A&E departments needed urgent attention.
"Within the HSE capital plan, there is provision for new A&E departments on a number of sites including Letterkenny, Sligo, Mercy Cork, Wexford, Our Lady of Lourdes, Drogheda, and the Mater hospital, Dublin. There is also provision for significant refurbishment work to be carried out at a number of other sites," it said.
Liam Doran, general secretary of the Irish Nurses Organisation, said the six-hour target was a desirable aspiration but not achievable given the current infrastructure of many hospitals. More acute and long-stay beds were required, as well as massive investment in primary-care services, if the targets were to be met, he believed.
Finbar Fitzpatrick, secretary general of the Irish Hospital Consultants Association, also said hospitals had to be provided with more beds to meet these new targets.
"They have not set out how these targets are going to be met," he added.
Fine Gael's health spokesman Dr Liam Twomey said he was greatly concerned by the health executive's determination to measure waiting times of patients in A&E from the time a decision had been made to admit them in the first quarter of the new year.
This was dismissive of the experience of patients during the period they were awaiting assessment in A&E, he said, and smacked of an effort "to cosmetically reduce the numbers instead of aiming to make a real difference to patients".
The INO claimed last night that 266 patients were on trolleys in A&E units yesterday. The HSE claimed the number was 120.