John Moloney (Laois-Offaly, Fianna Fail)

I thank the Deputy. I will be taking this matter on the Minister's behalf. The HSE accepts that there was a problem in the emergency department at Mullingar hospital on Thursday last week. However, since then all patients in the emergency department were either admitted or discharged within the target of six hours set by the HSE this year.

The hospital's budget for 2009 is in excess of €64 million, increased from €54.8 million in 2006. As Deputy Penrose rightly points out, the hospital has been recognised as being one of the most efficient in the country in the context of the annual case mix adjustment. Last year, the hospital was the highest in the country with a positive case mix adjustment of €1.977 million. It should be noted that inpatient activity at Mullingar to the end of September was 0.2% ahead of last year, whereas day case activity was up by 6.2% year on year. There have been 24,636 emergency attendances to the end of September this year, a reduction of 5.7% on the same period last year.

Mullingar hospital, in common with all other agencies, is required to manage its services within the approved allocation and to run its services within the approved employment ceiling. It is envisaged that the hospital will break even this year and will be within its employment ceiling by end of year. There are no plans to increase the number of nurses employed in the hospital. At the end of October, there were 289.5 whole-time equivalents on the nursing staff, an increase of one whole-time equivalent on the same month last year.

In November, patients were transferred from old accommodation in Mullingar hospital to state-of-the-art accommodation in the newly upgraded wards at the hospital. The new wards are a major improvement in terms of standard of care that can be afforded to patients. Under the new arrangements, the number of inpatient beds has been reduced from 220 to 199, and the number of day beds has increased by 13 from 11 to 24. In addition, there are five extra observation beds.

These changes are very much in line with international practice, which aims to encourage a greater emphasis on the practice of day care medicine. This is a well-established part of the HSE's transformation programme and it will lead to an increase in the overall number of patients treated in the hospital in 2010. The adjustment in beds taking place will help to improve the position, thus making the hospital even more effective in providing care and treatment in the future.

The revised bed complement in place as a result of the move to the new hospital has been fully endorsed by the consultant surgeons and consultant obstetricians at the hospital. In addition, many discussions led by the clinical director have taken place with all relevant consultant staff at the hospital to increase the throughput of surgical and gynaecology work at the hospital. The provision of additional day ward beds as detailed will facilitate this increase in workload.

The hospital is arranging to carry out a bed utilisation study with a view to establishing that all beds within the hospital are being utilised to maximum effect and that all admission and discharge processes are being fully and effectively managed. It is important to note that the current usage of day beds in Mullingar hospital is still behind the international norms for such bed utilisation.

As previously noted, there has also been an increase in the number of observation unit beds from six to 11. These beds are strategically located next to the emergency department to cater for the overflow of patients from that department, which can occur from time to time. The hospital also intends to increase the throughput of patients through the medical assessment unit, which will also alleviate pressure in the emergency department. I am confident that the hospital will continue to provide the best possible quality of care for all its patients.

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