Louise O'Reilly (Dublin Fingal, Sinn Fein)
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The submission refers to the available resource data from 2016 and the activity data, which I assume is the hospital in-patient enquiry, HIPE, data, from 2016. We ask the HSE many questions and while I would dearly love to say we get many answers, sometimes we do not. We have had trouble getting information on activities, for example, the number of operations performed in theatres, or basic information such as whether the theatre is open. Where did the witnesses obtain the data? To whom did they speak? Where the resource data come from and to what do they refer?

The 2007 capacity review was undertaken by the witnesses' company. According to that, there were 11,660 beds. By 2016, this number had reduced to 10,500, which is a reduction of 1,160. Where did all the beds go? Are they in the system? Are they on wards that are closed? We did not experience significant hospital closures. Where are those beds? What hospitals are they in? What type of beds are they? When I saw that figure, it threw me.

It is lost on me why workforce planning would not have been included in this review because all the beds in the world could be opened but if the staff members are not available to provide care, they are not much use. I am worried that workforce planning was explicitly excluded because in 2007 it was part of the review. At the time, I was part of the working time directive compliance implementation group and we had an expert group on skills mix which recommended an 80:20 ratio for nurses and healthcare assistants.

I wonder if that has been factored in to some of the witnesses' thinking. It exists already and a lot of work has already been done on skills mix and ratios.

How was the figure of 13,000 residential care beds arrived at? Depending on how one looks at it, different numbers can come up. It strikes me as odd that this will not be included and it is very worrying that workforce, skills mix and future planning are not part of it. We do not just have an issue with recruitment and retention in our acute hospitals but have them across the board. We also have an ageing GP population, which will further complicate matters. I am aware that health service staff have been reformed to death so I hesitate to use the word "reform" but without the workforce the reforms will not happen and we will not enhance bed capacity without an adequate skills mix. How can the increases of which the witnesses spoke be achieved?