Mary Harney (Dublin Mid West, Independent)

I propose to answer Questions Nos. 6 and 23 together.

It is important that the clear focus of the health service is on the number of patients we treat and not on the number of beds. Increasingly, our focus is on measuring and improving patient outcomes and this will continue over the coming years.

There are approximately 11,800 inpatient beds and 1,800 day beds in the public hospital system. The exact number of beds available at any one time fluctuates, depending on such factors as planned activity levels, maintenance and refurbishment requirements and staff leave arrangements. Beds may also be closed from time to time in order to control expenditure, given the need for every hospital to operate within its allocated budget for the year.

HSE data on the number of beds closed at the end of December 2010 indicates that, for the week ending 2 January 2011, some 1,378 inpatient beds and 229 day beds were closed for seasonal reasons or for infection control, refurbishment or cost containment. However, in the week ended 9 January, the number of beds closed had fallen to 997 inpatient and 64 day beds. The reopening of the excess of 500 beds is in line with normal practice, whereby bed capacity is reduced over Christmas and reopened when the seasonal holiday period comes to an end. The HSE 2011 national service plan, which I approved on 22 December, sets out to achieve increased efficiency with broadly the same level of overall hospital activity as in 2010.

For acute hospital services, the focus for 2011 will continue to be on increasing day case rates where appropriate and on key performance improvements in areas such as same-day admission and minimising length of stay. Hospital activity levels have a target of a 2% reduction in inpatient activity, offset by a 3% increase in day cases. There will be a continued and concentrated focus on reducing variations in length of stay for similar treatments.

The HSE is driving efficiency in the acute hospital system by increasing the proportion of surgery undertaken on a day basis, increasing the admission of inpatients on their day of surgery and reducing the lengths of hospital stays consistent with patients' clinical needs. The actions being taken by the HSE in all regions are focused on protecting front line services, particularly emergency services, maintaining the quality and safety of services and delivering to service plan targets.

The HSE's commitment to implementing a number of national programmes, such as the acute medicine and surgical programmes, will support the achievement of these targets in 2011. The HSE is working hard to improve emergency department services and patient experiences across the country. The key to addressing this challenge is integrated, proactive management by all concerned based on implementation of the standards and frameworks of the acute medicine programme and related programmes. The HSE plans to continue the implementation of these measures over the coming years. I am confident this is the correct approach and will allow the HSE to address the impact of planned health service budget changes signalled over the next few years while maintaining the numbers of patients treated and improving patient outcomes.

See this speech in context