Dáil debates

Tuesday, 18 October 2005

Priority Questions.

Hospital Accommodation.

3:00 pm

Photo of Liam TwomeyLiam Twomey (Wexford, Fine Gael)
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Question 95: To ask the Tánaiste and Minister for Health and Children if the provision of 3,000 acute hospital beds is still Government policy; and if she will make a statement on the matter. [29480/05]

Photo of Mary HarneyMary Harney (Dublin Mid West, Progressive Democrats)
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An Agreed Programme for Government includes a commitment to expand public hospital beds and is in line with the commitment in the health strategy to increase total acute hospital bed capacity by 3,000 by 2011. Substantial investment in additional bed capacity has already taken place in acute hospitals. Funding has been provided to open an additional 900 inpatient beds in public acute hospitals. As of 14 October last, 806 of the beds or day places were in place and the remaining 94 beds or day places will come on stream over the coming months. A further 450 acute beds are at various stages of planning and development under the capital investment programme.

Last July, I announced details of an initiative which will provide up to an additional 1,000 beds for public patients in public hospitals over the next five years. The HSE has been asked to begin to develop an implementation plan and to prioritise proposals with reference to the public hospitals' requirement for additional bed capacity. The additional beds will go most of the way to achieving the commitment in the programme for Government to increase total acute hospital capacity.

The health strategy acknowledges that a significant proportion of additional capacity in the acute hospital system will be supplied in future by private providers. The Department of Health and Children, in conjunction with the HSE, will review public capacity requirements in the acute hospital sector in light of the developments since the health strategy was published and the progress of the initiatives I announced in July.

Photo of Liam TwomeyLiam Twomey (Wexford, Fine Gael)
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I take it from the Tánaiste's response that the answer to my question whether the provision of 3,000 acute hospital beds continues to be Government policy is "Yes". I offer my condolences to the family of the late Mr. Patrick Walsh. The Tánaiste and I know why the intensive care bed available in the Cavan-Monaghan hospital group was not used. She needs to clarify this aspect of the matter at a later stage.

I was tempted to begin my response to the Tánaiste's comments about Government policy by saying that it seems that she disagrees with her boss. Many people are confused about who runs the health services. I would have assumed that they are being run by the Tánaiste, but it seems that Professor Drumm has become the driving force. He has said there is no need for more acute beds in the Irish hospital system. His comments may be seen as a U-turn on Government policy.

Séamus Pattison (Carlow-Kilkenny, Labour)
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The Deputy should ask a question.

Photo of Liam TwomeyLiam Twomey (Wexford, Fine Gael)
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My question is quite clear. The former Minister for Health and Children, Deputy Martin, announced in the health strategy, Quality and Fairness — A Health System For You, that an additional 650 acute hospital beds would be provided in our health care system by the end of 2002. That announcement was made before the previous general election, but in October 2005 we have not yet provided that number of acute hospital beds in the health system. People are being misled. The Tánaiste should make clear whether the Government is committed to delivering the 3,000 acute beds. There seems to be every indication it is not committed to this.

Who decides Government policy? It is misleading for the general public when they hear the chief executive officer of the HSE making announcements like this one. He is responsible for the day-to-day running of our health services. As with the situation in Cavan and Monaghan, the Tánaiste is responsible for the health services. I would like her to clarify whether and when we will have these acute hospital beds. More than one hospital in the country expects acute hospital beds to be delivered. The Tánaiste should outline how committed she is to delivering these beds to the health services.

Photo of Mary HarneyMary Harney (Dublin Mid West, Progressive Democrats)
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Beds will be delivered if they are necessary and not for the sake of it. The analysis done by Dr. Mary Codd, based on demographics, suggested we need 3,000 additional beds by 2011. Over 800 of these were provided up to October of this year.

Professor Drumm made the valid comment that if we had appropriate facilities for the elderly, we would immediately release a substantial number of beds. I stated in an earlier reply to the Deputy that 378 patients in the acute system in the Dublin area could be better placed if alternative facilities, which we are seeking to put in place, were available. This would release a substantial number of beds. With regard to the announcement I made in July on freeing up private beds in public hospitals, the intention is to provide 1,000 beds. There is huge interest in this initiative and I believe it will be successful. That, together with the 450 beds planned for Mullingar Hospital, the Mater Hospital, where 100 beds are planned, and a number of other locations throughout the country, will bring us very close to the target of 3,000 beds. We are optimistic we will achieve that target by 2011.

Professor Drumm's job as chief executive officer of the HSE is to deliver health services. As there is no point making policy that is unnecessary, there must be a close working relationship between the Department and the operational side and policy side of the health service. If it were the case that either more beds or less beds were required, the policy makers would have to bear this in mind and reflect it in any policy decision made. However, as of now, to have a further 3,000 beds by 2011 is the plan.

Photo of Liam TwomeyLiam Twomey (Wexford, Fine Gael)
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Are 1,000 of the 3,000 beds the ones she refers to being developed by the private system?

Photo of Mary HarneyMary Harney (Dublin Mid West, Progressive Democrats)
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Yes.

Photo of Liam TwomeyLiam Twomey (Wexford, Fine Gael)
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That was never announced at any stage of the health strategy. While the Tánaiste came up with the figure of 1,000 beds, she must be quite clear where the beds will be located. Will she indicate where she expects these 1,000 beds to be found in a couple of years or what parts of the country are deemed to require them? It is difficult to work out in which public hospitals the beds will be located.

The role of the HSE is an important factor. To use the term used by the Taoiseach last week, the Tánaiste is almost dumping on the HSE all the problems cropping up in the health services. The Tánaiste, to some degree, and the Taoiseach are not taking personal responsibility for many of the problems arising in the health services.

Photo of Mary HarneyMary Harney (Dublin Mid West, Progressive Democrats)
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I do not accept that. With regard to the question of where the beds will be located, we considered the private activity in public hospitals. For example, last year some 46% of elective surgery at Tallaght Hospital was carried out on private patients. The beds will be located in Waterford, Limerick, where plans are fairly advanced, and in Dublin at St. James's Hospital, Beaumont Hospital and the James Connolly Memorial Hospital, Blanchardstown, which all have plans. The matter is one for the HSE to advance, considering the overall needs of particular hospitals and the situation in each area. We do not want to displace existing private hospitals so the process must make sense at a local level as well.

I do not accept that we are not taking responsibility. There are clear lines of accountability under the new arrangement. There is one Minister for Health and Children, responsible to the Oireachtas for health policy. The chief executive officer of the HSE is the Accounting Officer and he is responsible to the Oireachtas for the expenditure of money on day-to-day health care services.