Mr. Tony O'Brien:

It has two effects, but they are not quite linear. Clearly it is better to have patients in the right place for the level of care they need. The typical cost of care in a long-term nursing facility or for the person to stay in their home with home care supports is considerably less that the rolled up cost of a hospital bed. When hospitals are overcrowded in emergency departments and it is necessary to use the full capacity protocol and place extra beds on wards in order to maintain safe care, extra staff must be brought in, and that increases costs in the hospital over and above that factor.

When we spoke earlier about the first two months in one particular hospital, I did at that point indicate that across the hospital system there were particular pressures at play in January and February which were pretty closely correlated with the pressures arising from overcrowding in emergency departments, which was a facet of the delayed discharge situation they experienced.

On the opposite side, it is also the case that patients are typically at their most expensive when they are being admitted for treatment as opposed to when they are in the bed awaiting discharge. A hospital that is more efficient is, generally speaking, in some respects more costly because of the costs of procedures, implants, hip replacements and so on. It is not all one-way traffic in cash terms, but overall it is a very bad situation when hospitals are clogged up to the extent that they were.