Mary Harney (Dublin Mid West, Independent)

The most recent information on bed closures in the acute hospital system refers to the week ended 17 January 2010. At that time, 689 inpatient beds and 37 day beds were closed for reasons of cost-containment, infection control, refurbishment and seasonal closure of facilities.

While public debate tends to focus on bed numbers, it is much more meaningful to measure the number of patients treated. In 2009, the combined number of inpatient and day case discharges was 3% greater than the equivalent figure in 2008, despite the difficult situation in regard to resources.

The preparation of the Health Service Executive's 2010 national service plan, which I approved on 5 February, maintains the focus on increased efficiency and targets broadly the same level of overall hospital activity as in 2009. This involves a shift from inpatient to day cases, a reduction in emergency admissions and a further increase in day cases.

While there is no proposal in the service plan to close a specific number of beds, the reduction in inpatient treatments will mean that less capacity will be required in this area during 2010. The exact number of beds available at any one time will fluctuate depending on such factors as planned activity levels, maintenance and refurbishment requirements and staff leave arrangements. Beds may be also closed from time to time to control expenditure, given the need for every hospital to operate within its allocated budget for the year.

Meeting the agreed efficiency targets will require increased access to the specialist skills and senior clinical decision-making available in medical assessment units, to diagnostics and to other ambulatory care services. The HSE will also focus on minimising length of stay, with a particular focus on reducing the current variation across different hospitals for similar procedures. It will also work to increase same day of surgery admission and to protect inpatient beds for elective surgery to reduce waiting times.

By reforming the manner in which services are provided, I am confident the HSE can deliver the volumes of service provided for in the plan, while at the same time continuing to improve service quality and patient outcomes.

See this speech in context