The 10-point plan and €80 million in dedicated funding for dealing with A&E units were having an effect, but some hospital units "are not up to scratch", Taoiseach Bertie Ahern said.
As the Irish Nurses' Organisation (INO) began a series of protests yesterday to highlight conditions in A&E units, Mr Ahern said he accepted the "frustration of the nursing staff, particularly in hospitals".
He said 3,300 people were being treated daily in A&E departments, some 1.2 million a year - a significant increase.
Mr Ahern said A&E consultants were now in place, but there was further work to be done.
"A&E consultants leave at 6 o'clock, and really the busiest time is after 6 o'clock. But that's an IR issue that has to be negotiated."
Dublin's northside did not have an out-of-hours service but 150 GPs had agreed to provide a co-op service. "This obviously has a huge impact because on a Friday evening or any night after 5 o'clock or half-five there is no alternative but to go to A&E."
Homecare packages, step-down facilities and additional provision of MRI and CT scans through private hospitals were under discussion.
However, Fine Gael leader Enda Kenny, who raised the issue, said the numbers of people being treated were "very much less than it was seven years ago". The funding had doubled and the problem had worsened.
He said there were repeated incidents where people left their bed or trolley to find it taken when they got back.
"This is truly disgraceful and in a country that is rolling in money. It's a sad situation to see the nurses of Ireland out on the streets again to deal with the problem that the Government committed itself to dealing with over the last eight years."
He questioned the level of confidence they could place in the 10-point plan.
"Can the Taoiseach give any consolation or reason to believe that this plan would work when others hadn't," Mr Kenny said, and he asked what had happened to the agreement drawn up in 2002 "to highlight the overcrowding, which has worsened since then".
Referring to Tánaiste Mary Harney's 10-point plan, Mr Ahern said people were starting to receive the homecare packages, for those who could not leave hospital without additional facilities at home.
The first of the step-down facilities for 500 people were being provided, and nursing home spaces for long-term patients would soon be contracted; site visits for suitable places would be completed this week.
There were discussions with private hospitals to provide access to MRI and CT scans, which would reduce waiting times.
