Mary Harney (Dublin Mid West, Progressive Democrats)

I believe what I said and I believe the matter is being addressed. A number of factors must be taken into account and I have instanced some of them. If one takes the example of one hospital in Dublin where because of the performance in the hospital in regard to accident and emergency services and other matters, the Health Service Executive employed consultants to go to that hospital. The recommendations which were produced last September, if implemented, would lead to the freeing up of 64 acute beds. The Health Service Executive had to write to that hospital only last week to remind it of the measures it was to put in place by the end of March. I hope that hospital implements these changes because, if not, the Health Service Executive has stated in its letter it will have to make alternative arrangements for those patients with private providers and use the funding that would otherwise go to the hospital.

I got a report about another hospital in this city which has a patient there since 2006 who was fit to be discharged at the end of that year. There are issues there around long-term care which the new legislation setting up the fair deal scheme will address. A number of factors in particular influence late discharges. The affordability and availability of long-term care, particularly around the greater Dublin area, is a factor. With the new legislative process in regard to those matters we will certainly make enormous progress.

There are some places in the country like the north east where the rate of admission into the acute system is twice what it is in other parts of the country. Deputy O'Sullivan's area of Limerick, for example, rarely has a problem. I do not say it does not have pressures but in fairness to the hospital in the area it never has the kind of pressures experienced in some big hospitals because that hospital adopts a very good integrated approach with community primary care in the area. It also has better discharge policies and practices than others. We can learn from hospitals like that and Waterford Regional Hospital and other good performers such as St. Luke's in Kilkenny. It is not rocket science, it is already happening in this country and we want it to happen in more places.

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