Mary Harney (Dublin Mid West, Independent)

I wish to explain something to the Deputy because it makes a difference. Many procedures can be done on a day case basis that are currently done on an inpatient basis. I will outline some data. For example, 37% of hernia repairs happen on a day case basis. It varies from Tallaght where 84% of them happen on a day case basis to Mayo where only 16% happen on a day case basis. The length of stay in Mayo is on average three days. In the case of varicose vein procedures, 56% are done on a day case basis, varying from 99% at St. Columcille's Hospital, Loughlinstown, County Dublin, to 57% at Mercy Hospital, Cork. For cataracts, the day case rate varies from 90% in the Mater, Waterford, Sligo and Letterkenny hospitals to 42% in St. Vincent's Hospital. In the case of hip replacements, it goes from seven days in Croom to 18 days in Waterford.

If all facilities could operate to the level of best practice within the country, that in itself would have enormous potential to decrease dependence on inpatient activity. Dr. Barry White has been appointed clinical affairs director of the Health Service Executive and is now appointing clinical leads, particularly in area of chronic illness, to devise and work with clinicians on care pathways. For example, as part of that process, the intention is to ring-fence surgical beds for surgeons so that they are not obliged to have patients admitted one or two days in advance in order to ensure a bed is available. These reforms will generate much increased activity in 2010.

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