Is there a doctor in the house?

Dail Sketch/Frank McNally: The Health and Safety Authority's damning report on A&E departments (they're an accident waiting…

Dail Sketch/Frank McNally: The Health and Safety Authority's damning report on A&E departments (they're an accident waiting to happen, apparently) dominated Leaders' Questions. The latter can be a rowdy event at the best of times. But the authority's findings on what Enda Kenny called "violence, frustration, and carry on" in overcrowded A&Es only inflamed the situation.

Although violence among TDs is rare, frustration and carry on are both common, especially on Wednesdays when the Dáil is televised live. TV coverage does to Leaders' Questions what alcohol does to A&E departments. So on Wednesdays, everyone in the House feels an emergency need to contribute to the debate. The Ceann Comhairle sometimes resembles a harassed triage nurse as he tries to sort out the genuine cases from the rest, while keeping a lid on people's emotions. Assessed for priority treatment, Enda Kenny asked the Taoiseach what he was doing about "the risk of injury, infection and violence from frustrated patients" exposed by the HSA report. Mr Ahern calmly explained that the pressures on A&Es were caused by bed shortages elsewhere in the system. The Government was tackling this by means that included the purchase of beds from the private sector for "step-down" care, he explained.

Meanwhile, back in the waiting room, an ugly situation was developing. It began with an exchange of heckles between Pat Rabbitte and Willie O'Dea: the former suggesting the latter had "beat the Tánaiste in the punch-up" to claim credit for the St Bricin's hospital initiative, and the latter responding: "Nobody likes a smart ass!". From there, the situation quickly deteriorated.

Fine Gael's Jim O'Keefe weighed into the row, calling the Limerick TD "Wee Willie Winkle". But the bitterest exchanges occurred when the former minister for health Brendan Howlin became involved. Mr O'Dea suggested the Labour man "didn't do a whole pile when he was in charge". Whereupon Mr Howlin riposted that Mr O'Dea had been his junior minister, but "he barely ever turned up - he was too busy knocking on doors in Limerick".

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And Mr O'Dea in turn suggested that Mr Howlin had been "in the department all the time, doing nothing".

The Ceann Comhairle restored order eventually, but not before having to add 12 minutes to the question time schedule. "Injury time," he called it. It surely can't be much longer before the Health and Safety Authority investigates.

With the Dáil's resources already stretched, the former secretary general of the Department of Health was wheeled in to give his formal response to the Travers Report. Michael Kelly's appearance before an Oireachtas committee caused an unfortunate clash of schedules, coinciding as it did with ministerial questions in the Dáil involving his former boss Micheál Martin.

But perhaps Mr Martin was grateful for an excuse to avoid reliving his time in Hawkins House, as he continues his recovery at a step-down facility known as Enterprise, Trade and Employment.