Local hospital committees, made up of those who actually work there, are a welcome response to the A&E dispute, writes Padraig O'Morain, Health and Children Correspondent.
IF committees and forums could solve the problems of the health services, we would be the healthiest and best cared-for people on earth.
We have, currently, no fewer than 117 such bodies earnestly looking into the health services, according to Mr Stephen McMahon, chairman of the Irish Patients' Association, at yesterday's Accident & Emergency Forum.
He wasn't complaining. Mr McMahon believes reviews and analysis are a good thing - so long as they produce plans which are acted upon.
Thanks to the proposals worked out at the Labour Relations Commission to resolve the nurses' dispute, we will soon have more committees - one in every hospital which has an A&E department.
These committees will work out how to manage each hospital's beds in order to cut down on the queues in A&E departments.
There is something astonishing about this. The something astonishing is that it took a work-to-rule by nurses in the INO and SIPTU to bring about the establishment of these committees.
Some of us, in our innocence, would have thought that some such bodies would already have existed in hospitals.
Well, it appears they don't and if the nurses' dispute has helped the hospitals to get their act together in this regard, it was worth it.
What can these committees do? It seems clear that they cannot and will not remove from consultants the right to decide whether patients are ready to leave the hospitals.
Neither can they conjure up beds out of nowhere.
However, Irish Medical Organisation president Dr Mick Molloy believes the committees, by streamlining everyone's work, could shave a day or two off the time particular patients stay in an acute bed.
If that can be replicated in enough hospitals around the country it could have a welcome effect.
But no-one, least of all nurses or doctors, is pretending that these committees will solve the problems which bedevil A&E departments.
A solution to these problems requires more beds, more doctors and more nurses.
This year over 700 such beds will be added to the system. More than 2,000 further beds will be added within the next seven to 10 years.
So increasing bed numbers is a medium- to long-term solution. Are there other things that can be done on a short-term basis?
A clue that perhaps there are came during the nurses' dispute in the fact that many people were able to stay away from A&E departments without any ill effects we know about.
As a result, there was no crisis. That, it should be remembered, was not the whole reason there was no crisis. The cancellation of planned (elective) treatment made more beds available for patients admitted through A&E and that helped enormously.
It meant, however, that the crisis was pushed out of the A&E departments and into the homes of those whose treatment was cancelled.
Nevertheless, the question remains: if many people were able to stay away from A&E during the dispute - which, at time of writing, is still taking place - why can they not stay away at other times?
In some cases, they don't stay away because they are waiting for admission for surgery and other planned treatment. This wait can be so long that they turn up in A&E to bolster their case for admission or because the wait for treatment has brought about a medical emergency.
So a cut in waiting times for planned inpatient or outpatient treatment could keep these particular people out of A&E.
The bad news is that this won't happen today or tomorrow.
The numbers of people waiting (just over 26,000) hardly budged between September and last December, according to figures released by the Minister on the Friday evening of, if you don't mind, St Patrick's weekend.
But are there others who could simply go to their GP? As GP out-of-hours co-operatives become more common it should become possible to divert such people back to their family doctors.
And what of those who go to the A&E to get a second opinion because they don't like that the GP told them? Should they be entertained?
None of this seems very hopeful for the immediate future. Where the hope lies is in the very composition of the new committees which are to be set up under the deal.
On this page we picture an advanced nurse practitioner, Ms Valerie Small, and an A&E consultant, Mr Colman O'Leary of the Irish Association for Emergency Medicine, sitting together at yesterday's A&E forum.
It is precisely these people - the people working together in the A&E departments - who stand the best chance of coming up with solutions that might work.
Such a solution, in some hospitals, might be to designate "protected" beds for emergency cases and "protected" beds for planned admissions. That mightn't work everywhere though it seems to work for Dublin's Mater Hospital - but it is local knowledge that can best address the search for solutions.
So the outcome of the nurses' dispute - if it is over and it isn't as this is written - may not be spectacular.
However, it is likely to put in place local mechanisms in which local doctors, nurses and administrators play to their strengths. That's bound to lead to positive changes - and hopefully we will not have to wait for the distant future to see some of those changes.