When Harney took on the poisoned chalice of the department dubbed 'Angola' in April 2005, she promised action. Within two months, she had produced a 10-point, wide-ranging action plan to improve accident and emergency services.

Five months late, she said every action in that plan was being implemented. "If new actions are needed, there will be new actions.

If new decisions are needed, new decisions there will be, " she promised.

The plan was to abolish trolley queues. A year later, it hasn't worked, and now the minister is rejecting claims that her 10-point plan to tackle A&E overcrowding is a flop.

The man Harney appointed to head up the Health Services Executive, Brendan Drumm, says just providing extra beds is not the solution and partly blames the rigidity of consultants' working hours for the problem. The consultants disagree. Both he and Harney admit the current situation is unacceptable, but seem at a loss to efficiently tackle it, despite many brave promises.

Resources are clearly not the issue. We are spending 12bn on health this year . . . about 7,000 from each taxpayer. In her 2003 report, Niamh Brennan revealed that healthspending in Ireland had increased by 125% from 1997 to 2002. An OECD report recently ranked Ireland 14th in the developed world in terms of money spent on health. And yet the problem seems to be getting worse.

Two weeks ago on the Late Late Show, Gleeson, highlighting the "disgusting" treatment of elderly people in emergency departments, said a monkey could solve the crisis.

Today, our special investigation reveals that there is a solution at the minister and Drumm's fingertips.

At St Luke's Hospital in Kilkenny, they haven't had a patient on a trolley in three years, despite struggling with the same problems as every other A&E department in the country. They have transformed the A&E department with a revolutionary approach. But it has not been a quick fix.

The differences are simple, but strategic, and have necessitated a radical change in culture on the part not just of the A&E department, but also on the part of the entire community. Consultant physician Garry Courtney says the philosophy at the heart of the operation is that nobody knows a patient better then their own GP. In most hospitals, GPs find it impossible to speak to somebody by telephone to discuss whether a patient needs to attend A&E or not. In St Luke's, a designated bed manager liaises directly with GPs. The phone is always answered.

It means that decisions are made about where the patient can best be directed and cared for before they even arrive at the hospital. If a child has a high fever, arrangements are made to go straight to the paediatric department. The GP's knowledge is utilised and patients know they are best attending their GP before going to casualty. It's the polar opposite to practice in other swamped A&E departments.

For more serious cases, the Medical Assessment Unit kicks in and deals with patients in a different department. Five physicians run this section in turns, ensuring that exhaustion does not compound the already demanding job.

Representatives of 28 of the country's 35 A&E departments, as well as Harney and Drumm, have all visited St Luke's to see how they are doing it. It's a stunning success story and it's no secret. The question is why have they not replicated it. How long more do we have to listen to the blame game, the sniping and the soundbites? There is an answer. St Luke's has shown it can work.

What are we waiting for?