Mary Harney (Dublin Mid West, Progressive Democrats)

I am determined to ensure that all possible measures are taken to facilitate the discharge of patients in a timely manner. At present, there are approximately 750 patients whose discharge is delayed. That represents more than 6% of the total inpatient capacity. There are many reasons for discharges being delayed, including the need for long-stay capacity, community-based supports and, in some instances, a reluctance by families to allow their relative to be discharged until a publicly funded bed becomes available.

The Health Service Executive is addressing the issue of delayed discharges through a combination of increased investment in alternatives to acute hospital stay and improvements in the discharge planning process at hospital level. An additional 273 long-stay beds were made available in 2008, and a further 414 new beds are scheduled in 2009. The HSE has also recently funded 245 additional contract beds to alleviate delayed discharge pressures. Investment in community-based, long-term care supports will be maintained in 2009. This year the HSE will provide 4,700 home care packages, benefiting more than 11,500 people. A total of 6,000 patients were cared for by the community intervention teams that were recently established.

The HSE's funding for long-term residential care services for older people in 2009 is €909 million and it must operate within this resource. This funding currently supports the provision of public and contract beds and the payment of nursing home subventions. It will also be required to support the introduction of the new nursing homes support scheme, a fair deal, later this year. Under the fair deal, long-term care will be more affordable for all who need it.

Hospitals are working to ensure that care is provided in a timely, appropriate and efficient manner. All patients are to be given an expected date of discharge within 24 hours of admission and patients will be discharged at weekends where appropriate. The new consultant contract is key to that. More generally, the HSE's national service plan for 2009 commits to a number of key steps which are designed to improve the efficiency of the hospital system including a reduction in the level of inappropriate admissions, reducing average length of stay, increasing elective surgical admissions on the day of surgery and shifting activity from inpatient to day procedures. The delivery of those measures and targets, combined with the initiatives which I have described, should ensure more efficient use of available capacity.

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