Colm Burke (Fine Gael) | Oireachtas source

I thank Mr. Woods for his presentation and apologise to him for the lengthy delay in commencing our discussion. On accident and emergency department overcrowding and hospital overcrowding in general, Nursing Homes Ireland today issued a statement in which it indicated it had understood since July 2016 that the Health Service Executive would engage with the organisation on planning for the winter initiative. This understanding was based on the view that demand for hospital care would increase significantly, leading to significant efforts to discharge patients from hospital at an early stage. The statement notes, however, that no such engagement took place. I ask Mr. Woods to explain the reason for this.

I understand there were 742 vacant nursing home beds nationally at the end of December 2016. In the first two weeks of January 2017, hospitals experienced severe overcrowding. Despite this, the level of engagement with Nursing Homes Ireland has been extremely poor. Why did the HSE not engage with Nursing Homes Ireland before the end of November to plan for a problem that everyone knew was coming down the tracks?

At any one time, between 500 and 600 people are occupying hospital beds as a result of delayed discharges. These are patients who are ready to go home or move to nursing home care. People who transfer from a hospital to a nursing home do not need to stay in nursing home care for 12 months or two years because we also have step-down facilities. However, these facilities do not seem to have been developed as part of the HSE model and there appears to be considerable reluctance to develop them. Surely, plans could be made every year long before winter arrives to use step-down facilities in a much more imaginative way than is currently the case. It does not make sense to have 742 vacant beds in nursing homes when our hospitals are clogged up. It should also be noted that a hospital stay costs between €6,000 and €7,000 per week, whereas the weekly cost of a private nursing home bed is less than €1,200. I do not understand the reason this matter was not addressed before the problem arose.

On the recruitment of nurses, I will cite one case that highlights a problem with flexibility in the recruitment process. I am aware of a woman with a young family who wished to return to nursing and made clear in her interview that she would be available to work on certain days and unavailable on other days due to family commitments because she has young children.

She was told: "We can't take you on, but the best thing you can do is go and apply to an agency and we'll have to take you on in accordance with the hours you're able to work then under the agency." That does not make sense. I am talking about someone who wanted to work in the HSE. I accept she was not able to work from 8 a.m. to 5 p.m. or 9 a.m. to 5 p.m. five days a week, but she was available to come on board in the HSE. However, she was advised to become employed by an agency, which would enable her to get the flexible hours she wanted. That is a huge cost to the HSE. There are serious questions at managerial level on not working to try to facilitate people in order to get them into the system and to ensure we have continuity of care of care for patients and all that.

I need clarification from the HSE on those two points.