A consultant-led acute medical assessment unit (AMAU) pilot project ran on Saturdays in Co Donegal was “not a real test” of the system as it had to be used to address surging inpatient numbers, Minister for Health Jennifer Carroll MacNeill has said.

The Irish Times on Monday reported how consultants rostered to work on Saturdays under new contracts with the State, a key healthcare reform championed by the Minister, saw just five patients over the course of the 12-week trial at Letterkenny University Hospital.

An AMAU is a facility aimed at providing immediate evaluation, diagnosis and treatment for patients presenting with various conditions or referred by GPs.

The HSE West and North West region, which runs the hospital, said that as a result of capacity pressures in Letterkenny during the pilot period, the AMAU facility had to be used for inpatient surge capacity on a number of weekends.

“We’re talking about senior decision-makers in on Saturday and over the weekend to help with patient flow,” Carroll MacNeill told reporters in Dublin on Monday.

“That’s helping with discharge, but it’s also helping to treat people earlier and make a plan for them either to be admitted and treated or to come back at a later stage.”

Carroll MacNeill said this approach reduced “possibly not unnecessary admissions, but maybe more conservative admissions”. She said about a quarter of people who attended an emergency department would, in general, be admitted.

“If you see a hospital with like a 35 per cent admission rate or 39 per cent admission rate, it often speaks to possibly not enough senior decision-makers there to support the more junior staff in the decisions that they’re making.”

The Minister said this was “quite different” to people being rostered to do “clinics and so on”.

“We’re beginning to see clinics … on a whole range of different things in the maternity hospitals and some of the acute hospitals … that’s about dealing with, doing outpatient clinics.”

She said the move to a “fully six-day system” would happen “piece by piece by piece”.

HSE chief clinical officer Colm Henry said the use of the AMAU for inpatient surge capacity “is what we’re seeing in recent months because of the unprecedented pressures during a summer in terms of unscheduled care demands”.

He said in this report “there was a marked underutilisation of those beds because they were used in surge”.

“That doesn’t equate to no requirement for senior decision-makers to be in. In fact, that’s all the more compelling that senior decision-makers should be in at times when unscheduled care is very busy,” Henry said.

Regarding Budget 2027, which is to be announced next month, Carroll MacNeill said her department was “not in a cost-cutting phase of any kind”.

“There are about seven or eight hospitals that are consistently not getting it into grip in relation to patient flow and there are others that have come an enormous journey in the last 12 months,” she said.

“There are regions that have done that, that have stayed within budget and there are other regions that have not done that and have not stayed within budget and there is not a correlation between the budget and the effectiveness of patient flow. It is something very different.”

On the long-delayed national children’s hospital, she said a number of issues were reported to her last month including one about the number of staff working on the site being “very considerably down on what it should be” for August. Others issues were in relation to surgical theatre floors and ventilation.

Carroll MacNeill also said there were issues around the bathroom pods in the hospital and said it was up to contractor Bam “to fix them and bring them to the appropriate standard to get the fire certification”.

She said she was refusing to name a date for when the hospital might open, saying that “Bam need to turn up and do the work”.