Mary Harney (Dublin Mid West, Progressive Democrats)

Although we may be political opponents, I have a great deal of respect for Deputy Reilly, as he knows. As someone who has a lot of knowledge of this area, he knows it is not all gloom and doom and bad news in this respect. Things have vastly improved. In 1980, life expectancy in this country was two years below the EU15 average — it is now 18 months above that average. Sweden is the only country in Europe where men live longer than they do in Ireland. Just one third of the number of people who used to die from circulatory illnesses 30 years ago now die from such illnesses.

While we face challenges and pressures, we should put things in context. I invite Deputy Reilly, as a member of as the Joint Committee on Health and Children, to visit Stockholm, which has twice the population of Dublin but just half the number of acute beds. They do things differently there — they have better discharge policies and they do not keep people in hospital unnecessarily. If one is in a hospital in Dublin on Friday, there is a 99% chance that one will still be there on Monday morning. I hope the new contract will deal with some work practice issues, such as the availability of consultants. I accept that we need more consultants.

I know of a hospital in Dublin that could free up 64 beds if it were to organise its acute beds system differently. Consultants went in there. Experts who have brought about change in other countries made recommendations about the hospital in September. I have seen a letter sent to the hospital by the HSE asking why certain recommendations have not been followed, given that there are people on trolleys. When I looked yesterday at data from another Dublin hospital, I learned that a patient who was fit to be discharged in 2006 is still in the hospital because the person is unwilling to go to a nursing home or a long-term care facility, or to go home on a home care package. Some existing issues in that regard will be dealt with under the fair deal. It is not appropriate for somebody to choose to stay in an acute hospital when alternatives have been put in place. As Deputy Reilly is aware, it is dangerous for a patient to remain in such a hospital if he or she does not need to be there. People should be in such hospitals only if they have to be.

Just under 5% of people in Ireland over the age of 65 are in long-term care, which is in line with the international average. The problem is that one third of those people would not need to be in long-term care if we had better home support systems. Not only are more facilities being put in place, but new home support packages are also being provided. They take a while to put in place because it is expensive to recruit the appropriate staff etc. We have been building them up each year over recent years and they are making an impact. It is a question of doing a number of different things.

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