Fine Gael's A&E proposals

Madam, - Fintan O'Toole's particularly ill-informed comment on one aspect of Fine Gael's health proposals (Opinion, May 9th) …

Madam, - Fintan O'Toole's particularly ill-informed comment on one aspect of Fine Gael's health proposals (Opinion, May 9th) exposes the vacuity of his own analysis and, in particular, his failure to recognise the reality of some of the problems facing Accident and Emergency units.

One in three A&E attendances now involves alcohol - fact. Many of those presenting drunk in A&E are also accompanied by "hangers-on", adding to the level of disorder, intimidation and abuse of staff and other patients. In a recent survey of a major Dublin hospital, 79 per cent of respondents said that they felt threatened while in A&E. Fine Gael's solution is about protecting patients and staff from a dangerous and frightening situation and the detail of the proposal explains how.

To be clear, those found to be drunk and not requiring further treatment would be put into a secure area to sleep off the alcohol. I personally experienced the use of "wet rooms" in the old Meath Hospital where those found by a medical assessment to be drunk, but not ill or injured, were allowed to sleep it off on easily cleaned plastic mattresses under the supervision of nursing and security staff. It worked.

With an overall increase in attendances at A&E, an inordinate number of which are drink-fuelled, and with overcrowding which is causing patients to spend unacceptably long periods in waiting areas, it is clear that deterrent measures are also needed. Our proposal to fine those who are found to be simply drunk but not ill or injured will be effective in reducing the numbers of such people presenting at A&E.

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Of course, these measures cannot work on their own and Mr O'Toole's article did not mention our proposals for urgent care centres which will improve the delivery of primary care health services.

It failed to point to our commitment to community care units, providing 600 new step-down beds for respite and rehabilitation for elderly patients.

In the wider context, it missed the fact that Fine Gael is the only political party that has published a fully costed screening programme for diabetes, blood pressure and cholesterol as part of our plan to keep people healthy and out of hospital. The nation's clear problems with alcohol abuse must form an important part of that wider aim.

But right now we must tackle the A&E overcrowding crisis which has seen as many as 500 patients lying on trolleys, has seen hospital staff being injured and abused in the execution of their duties and is estimated to be the cause of three deaths a week in hospitals. Without doubt, removing drunk and disorderly patients and their companions from the mix, where appropriate, will ease the pressure. Mr O'Toole might have done well to consider someone's 16-year-old daughter presenting at A&E with a legitimate medical complaint and being exposed to drunken, intimidating and abusive behaviour for hours in a confined space.

Instead of that he produced a skewed rant, containing precious little accurate reporting and devoid of sympathy for the patients Fine Gael's proposals would seek to protect.

- Yours, etc,

Dr LIAM TWOMEY TD, Fine Gael Health and Children Spokesperson, Dáil Éireann, Dublin 2.