Ms Susan Scally:

As Mr. Bolger said, the capacity proposals we have recently received from the HSE were developed in the context of the health service capacity review. We are looking at 94% occupancy at the moment across the hospital system. We are trying to bring it down to the international norm, which is approximately 85% occupancy. To do that we would need to inject an additional 1,200 beds immediately. The HSE has come forward with proposals which it developed, having consulted intensively with hospitals and carried out rapid analyses of demand and capacity.

I can give the committee a rough number for acute beds. There are potentially 600 beds and just under 300 community beds. The process is under deliberation at the moment and validation is ongoing, meaning the number may change as the process evolves.

The modular programme is a significant element of the capacity plan. The Minister wants to fast-track the delivery of these beds but there is a lead-in time for the construction of modular beds of between 12 and 16 months from the point approval has been given. It is important that all available mechanisms are used to ensure there are no bottlenecks or delays and Clonmel has been mentioned as a good example of where there have been delays.

A number of members referred to additional capacity. There is a need for reform in this area and the HSE is looking at a more integrated approach to patient care, in particular identifying a need to strengthen clinical interventions to improve care pathways, specifically around rolling out the acute floor model, strengthening palliative care in emergency departments, old person's frailty and reablement teams, and measures to support infection control, which was a major issue last winter.

Mr. Gloster spoke about delayed discharges and initiatives to support people returning home, including the winter initiative. The independent expert review of delayed discharges was undertaken under the aegis of the Minister of State at the Department of Health, Deputy Jim Daly. Graham Knowles, the chairperson of the UL hospital group, is chairing the committee, which will focus strongly on the monitoring data we use and the factors that impact on the length of stay for patients, specifically to deal with bottlenecks in care. There will be interim recommendations to the Minister of State at the end of August which will inform winter planning for 2018-19, with final recommendations by the end of September 2018.