Mr Donal O'Shea, the chief executive of the Eastern Regional Health Authority, has strongly criticised the current situation in accident and emergency (A&E) units, where seriously ill patients have to wait for long periods for hospital admission.
In a report adopted by the board of the ERHA, he said that "while problems with A&E departments are not confined to the eastern region, there are aspects of the existing emergency service which are not acceptable, and which must be tackled as a priority by the authority".
The report specifically criticises the length of time patients had to wait for diagnosis and treatment, the practice of "admitted" patients spending long periods on trolleys while waiting for a bed to become available, and the lack of information for patients on how to access specific and appropriate medical treatment.
Major contributors to the A&E crisis include the level of out-of-hours GP cover, the capacity of hospitals to free up beds, a lack of long-stay beds and of experienced staff to assess and treat patients at all times, according to Mr O' Shea.
ERHA Chairman Mr Ivor Callely, TD, and other board members plan to visit A&E departments within the region to see the situation at first hand. They will find an average of 169 cancelled admissions per week in the nine adult hospitals with accident and emergency departments, most due to pressure from emergency cases, which now account for 70 per cent of admissions.
The ERHA document rejects the belief that many A&E attendances are "inappropriate". Instead it argues that the way the current system responds to these patients is "inappropriate".
Specific issues to be addressed by a forthcoming review of A&E services by the ERHA will include the possible restructuring of A&E departments to meet the varying needs of patients.
The development of satellite and community-based units for minor injuries and illnesses will, if implemented, represent a significant reversal of previous acute hospital policy. The provision of out-of-hours GP services at these centres will be welcomed by both patients and doctors alike.
A proposal by the ERHA to start call centres to provide patient information and assessment of the most appropriate choice of treatment reflects similar initiatives within the United Kingdom's NHS.
The ERHA has established a dedicated team to progress the A&E review.