The practice by hospitals of calling several patients to out-patient clinics at the same time, which results in some patients having to sit around for hours waiting to be seen, has been sharply criticised by Minister for Health Mary Harney.
Pointing out that people were sometimes told to attend at 8.30 am but might not be seen until 12 o'clock, she said this was no way to treat patients. "We have to run our hospital system and our out-patient departments . . . on the basis that we respect the dignity of every single patient, and we respect that time is important to everybody, not just to medical professionals."
Speaking on Today with Pat Kenny on RTÉ Radio 1, she also said that people had to be treated in the community and should see hospitals as places of last resort. "Hospitals can be dangerous places . . . we should only be in them if we need to be," she added.
Ms Harney said that hospital consultants had to be available to discharge patients seven days a week and she reiterated her plan to have some consultants sign up to contracts to do only public work. If this could not be agreed with existing doctors, it would be agreed with new doctors when these were recruited.
"I think about 900 of our current consultants are over the age of 55, so we will be recruiting in any event, just by way of replacement, almost 1,000 in the next decade," she said.
The Minister hit out again at consultant psychiatrists for failing to take part in mental health tribunals which would assess people involuntarily detained in mental institutions. "Can I just appeal to them? 'Please, these are among the sickest people in the country, a very vulnerable group. We want to have those tribunals established next year, and if there is any wish I would make for Christmas to the IHCA and the IMO, it is please co-operate with the establishment of the tribunals'," she said.
On the A&E situation, Ms Harney said that progress had been slower than she would have wished. She claimed that the numbers of patients on trolleys was down 15 per cent on this time last year, something which would be disputed by the Irish Nurses' Organisation, which keeps a daily tally of the number of patients on trolleys.
Ms Harney went on to say that having hospitals on different sites in one region managed as one was an excellent model. "I think that is the most effective way of providing quality-assured healthcare services in the north-east.
"Now, politically it is going to be unpopular, not just party politics, but also medical politics, and I have to say . . . any health minister who intervenes to give a political directive to the HSE is not putting patients first.
"When political directives come first, patients usually come last, and we all have to be prepared to take these tough decisions in the interests of patients because, in my experience, everybody would like to have a state-of-the-art hospital very close to them, but above all else, if you are sick or a loved one is sick, you want to get the best care wherever you can get it. That is more important than where you get it."