Enda Kenny (Mayo, Fine Gael) | Oireachtas source

The Cabinet sub-committee on health is not the Government. The opportunity presents itself during the course of Cabinet sub-committee meetings to receive updates and progress reports from the Ministers involved and request details on an issue from the HSE person involved.

The Deputy has asked a number of relevant questions. In dealing with beds, a new modular ward is to come on stream this summer in Our Lady of Lourdes Hospital which will have 20 beds. GP care services for those aged under six years and over 70 will be introduced this summer, as planned, and people are signing up. Fair deal scheme waiting times are down to four weeks and will be maintained at this level for the rest of the year. As the Deputy is aware, they have been reduced from 18 weeks, which was unacceptable. The numbers of patients on trolleys are still high. It is a problem, but it is easing. Although the position is much better than it was, it is not yet acceptable to us.

The private sector is being employed, where possible, to reduce the very long waiting lists. I can give some details of the emergency department action plan which was published in April. It details a range of time-defined actions to make the best use of existing hospital and community service capacity; to develop internal capability and seek process improvement; and to improve oversight, planning, governance and leadership. In view of the experience to date, it was decided to allocate €74 million for the action plan on a strictly ring-fenced basis. I have referred to this previously. Some €44 million is being allocated for the nursing homes support scheme, NHSS, in providing an additional 1,600 places and reducing waiting times from 11 weeks to four. Coupled with the normal weekly release, this funding allocation has seen the number on the national placement list fall to 476 as of 15 May, with waiting times reduced to three or four weeks from that date. Since 2 April, more than 1,800 people have been approved for funding under the NHSS.

Some €13 million was provided to cover the cost of additional transitional care beds and home supports, both of which can provide people with viable alternatives to acute hospital care. The temporary transitional beds in use to address emergency department overcrowding will be replaced with sustainable, more effective beds under the fair deal scheme. A further 173 community care beds will be made available around the country, which can be opened on a short or longer term basis and as part of a mix of short-stay rehab or long-term care beds. Of these, 110 have been opened in district hospitals, with a further 24 opened at Moorhall, County Louth. Some 65 beds are being opened in Mount Carmel Hospital, of which 15 are available, while the remainder will become available on a phased basis from now until the end of June. This will provide more flexibility and improve the flow of patients out of hospital at an earlier point.

The additional funding comes on top of measures already taken in last year's budget, when the Government provided €25 million to support services that provided alternatives to and relieved pressure on acute hospitals. This will enable the HSE to deliver on the Minister's stated objective of reducing the number of patients subject to delayed discharges by one third to less than 500 and the number of patients on trolleys in emergency departments awaiting admission for over nine hours to fewer than 70. The benefits should have an impact within a relatively short space of time across acute hospitals and social care services.

The HSE commenced work immediately on these objectives. On the direction of the Minister, it has the capacity to recruit, where necessary to deliver front-line services. Arrangements are in place to allow the recruitment of such staff where it has been established that there is an urgent service requirement. Figures show that on 19 May there were 668 delayed discharges nationally, a fall of 100 since March.

For the Deputy's information, I will outline a number of additional measures. All hospitals open overflow areas on an ongoing basis, with up to 300 additional beds open, and such areas include day surgery cases, with a curtailment of day surgery activity levels as a consequence. Patients with private insurance are being diverted to private hospitals where consultants have admitting rights. Weekend discharges are being optimised, while level two hospitals are being optimised to decongest emergency departments. This was particularly effective in the Louth-Meath hospital group. Non-urgent elective cases have been curtailed, where necessary. The community intervention team services in Naas and at Our Lady of Lourdes Hospital have been expanded. These escalation measures will remain in place and the daily oversight arrangements in national hospital groups and individual hospitals will continue.

The Minister has given the HSE a very clear understanding of the necessity to control costs and have management exert its responsibility in managing these costs in hospitals. It is not always possible to do so. It is an opportunity for the Cabinet sub-committee on health to receive reports and updates on the progress being made in all of the different areas. There is good news to report in some cases, although not in all. The Department, the HSE and Ministers are working very hard in that regard.

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