Michael Harty (Clare, Independent) | Oireachtas source

With regard to hospital emergency department overcrowding, it is a given that every witness who has appeared at this meeting and the meetings on the future of health care accepts there is a bed capacity issue. That cannot be addressed in the immediate term. The bed capacity review will undoubtedly outline that there is a shortage of beds. The number of beds needed may be debatable but there is certainly a shortage in the system. Given that, the only option left is to try to make the system we have more efficient. That is what we are trying to do. There are many components to trying to make the system more efficient. To put it simply, the hospital system cannot cope with the number of people coming in. Are there strategies we can devise that reduce the number of people who require acute hospital care, be it through increased resources or bolstering staff in the community to look after patients? There is capacity in that regard to reduce demand. We have to balance that with the demographics. The population is getting older and people have multiple chronic morbidities. Certainly, they should be looked after within the community. There needs to be an examination of how we can prevent people ending up in casualty departments. How can we stop that?

The other aspect is the question of how we can get people who have completed their acute care back out into the community. Senator Colm Burke has mentioned that the nursing homes association has identified it has capacity to take people out of hospitals once they have completed their acute care. That is another aspect of efficiency.

The third aspect of efficiency concerns the fact that, within the hospital system itself, there are inefficiencies in regard to patient flow and the way in which patients are managed within hospitals. I refer also to access to diagnostics, staffing and the recruitment necessary if people are to be looked after in hospital. All these aspects of care can be managed within the constraints of our bed capacity. The delegation is saying that we will not have a substantial increase in capacity for three to five years so all the other factors need to be addressed to make the system more efficient.

With regard to recruitment and retention of staff, how can we make our system more attractive? Obviously, it is not attractive. That is why people are not taking up the posts and why our nurses and doctors are emigrating. The system is so inefficient that there is no job satisfaction and a very high stress level. Bearing in mind the efficiencies I have outlined, is there capacity to improve the service?