One of the key components of the Minister for Health's 10-point plan to solve the A&E crisis will not be delivered on this year, it has emerged.
The €70 million plan announced by Mary Harney in November promised "10 wide-ranging actions to improve A&E services, including fully staffed acute medical units in major hospitals". The actions were due to be implemented in 2005, the Department of Health has confirmed.
However Pat McLoughlin, head of the Health Service Executive's new National Hospitals Office, told the Dáil health committee yesterday that none of the new acute medical assessment units would be built this year.
He said the three hospitals where the units were to be provided - Tallaght, St Vincent's and Beaumont - had been asked to "reorganise services internally" instead to ensure people were assessed more quickly.
Aidan Gleeson, secretary of the Irish Association of Emergency Medicine and an A&E consultant at Dublin's Beaumont Hospital, said his hospital drew up and costed plans for the unit after it was announced. It would cost €17.5 million but the hospital was only being offered €4 million by the HSE.
"The reality here is that the Government and the Department of Health keep saying they want a world-class service, a Rolls-Royce service, but they are only prepared to pay for the Morris Minor version," he told RTÉ's Morning Ireland.
Again yesterday there were 291 patients on trolleys, according to the Irish Nurses Organisation (INO).
Dr Gleeson said there had been no improvements since Ms Harney's 10-point plan was announced. "In fact, we have seen the situation get worse and unfortunately it's going to continue to get worse before it gets better," he said.
Mr McLoughlin told the committee that other parts of the plan were being acted on and improvements in A&E conditions could be expected in coming months. It took time, he said, to seek tenders for step-down beds because set procedures had to be followed. Contracts were now being signed for these beds, to which patients inappropriately placed in acute hospital beds could be discharged, he said.
He added that 150 GPs in north Dublin had agreed in principle to participate in an out-of-hours GP service and a national audit of cleanliness in hospitals would be conducted during the summer.
Discussions, he said, were also taking place around the setting up of minor injury units. They would, he emphasised, be provided in areas of greatest need.
Meanwhile hundreds of nurses, former patients, public representatives and union officials protested outside A&E units at Tallaght, Cavan and Mayo general hospitals yesterday as part of the INO's ongoing campaign for action on the A&E crisis. The lunchtime protests continue next week outside a number of other hospitals.