Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

That is worth sharing with us and those across the health service who are trying to deal with the problem.

The bed capacity review and the Economic and Social Research Institute, ESRI, reports indicate that there will be extreme demands on health services in the years ahead and that if we do not enhance the capacity of the health service, as Mr. O'Brien predicted some time ago, we will effectively run the service on an emergency basis only and elective procedures will be a very rare experience. The bed capacity review recommends that there be 2,500 beds - intensive care and step-down beds - across the health service and a substantial increase in the numbers in nursing homes. Has there been any audit or will one be carried out of the 2,500 beds required? It would require approximately five new 500-bed hospitals. With the best will in the world, we will be waiting a long time for five hospitals to be built. Could an audit be carried out of what stock could be available through cheap conversions or upgrades of wards that may have been closed or changed to other types of facility to try to get some capacity into the system quickly? Does the HSE have the capacity to do this or would it need outside assistance?

It is extraordinary that 200 hospital beds were taken by patients with influenza. I assume that many of them were elderly people who are more likely to be badly affected by influenza. We seem to be incapable of dealing with patients in the nursing home setting. Figures, opinions and views vary, but many residents from nursing homes are being transferred or referred through out-of-hours services to an emergency department which is probably the wrong place for them to present. Has any consideration been given to enhancing and increasing community geriatric services in order that residents can be treated in the nursing home setting? Many of them require intravenous treatment. I am sure the competence and expertise are available, but they need to be deployed in the right area, with nurse specialists, geriatric nurse services and geriatricians to provide treatment in the nursing home, rather than transferring residents to an emergency department.

I have spent the past seven years observing the budgetary process for the Department of Health and the HSE and I am very disappointed that we have made no progress on how to assess and articulate the funding required. It seems to be a constant game of chess, draughts or snakes and ladders because there does not seem to be any coherent response to the HSE's requests when it points to the demands that will be placed on it in the years ahead. All of the funding sought will never be given, but I assume most accept that it is sought in good faith and that it is not a number plucked from the sky.