Tuesday, 18 October 2005
Accident and Emergency Services.
The Health Service Executive is advancing the implementation of a series of measures to improve the delivery of accident and emergency services. These measures take a wide ranging approach and are aimed at improving access to accident and emergency services, improving patient flows through accident and emergency departments, freeing up acute beds and providing appropriate longer term care for patients outside of the acute hospital setting.
A particular focus has been placed on those patients in acute hospitals who have completed their acute phase of treatment and are ready for discharge to a more appropriate setting. The HSE is making sustained efforts to arrange for the discharge of these patients to have more acute beds available in hospital for emergency patients. High dependency beds and intermediate care beds in private nursing homes along with home care packages are being used to ensure that patients are appropriately placed. The number of delayed discharges in the major Dublin hospitals now stands at 378. This is the lowest number since January 2005 and has been achieved as a result of the various measures implemented to improve the delivery of accident and emergency services.
The HSE has also advised me that there was a reduction of 22% in the total numbers waiting on trolleys in accident and emergency departments between April 2005 and September 2005. The reduction in Dublin hospitals has been 25%.
My Department and the HSE will continue to work closely to maintain a focus on the implementation of system-wide measures to improve the delivery of accident and emergency services.
There was a danger for some time that the Tánaiste's ten point accident and emergency plan would turn into a ten year plan. I am glad she has focused her attentions on the nub of the problem in the accident and emergency departments in the greater Dublin region.
Her reply did not refer to MRI scanners and everything else that went into this ten point plan, but mentioned that she has focused on the problem, that is, looking after those 400 patients who are taking up beds inappropriately in the acute hospitals.
I want more detail on what she means because this looks at long-term care, both low and high-dependency level care for these patients. What plans has she for a community care nursing home setting, hopefully run in the public sector in the greater Dublin region and how will she look at that problem in the future? There may be 400 patients in these Dublin hospitals now — the figure has always been between 400 and 500 — but what is the Tánaiste's plan for the future, especially when we have an older population? The matter of how badly this job has been done by Government has cropped up in many parliamentary questions in recent times. For example, the health strategy promised community care support and extended care beds at a rate of 800 per year. To date, since 2001, only 531 of these beds have been delivered — less than 10%. During those years, the former Minister for Health and Children and the Ministers of State, Deputies Martin and Callely, continued to answer questions on the issue by saying what a great job they were doing in delivering these beds. However, less than 10% of the expected beds have been delivered. I ask the Tánaiste for a clear answer on how we will develop community care nursing home beds in the public system for the greater Dublin region, both now and into the future.
Question No. 92 mainly concerns the issue of accident and emergency units, a matter that has been a priority for me. We have worked successfully on initiatives that will have a lasting and not just a temporary impact. That is the reason the number of patients on trolleys is down by 25% in Dublin and 22% nationally since last April.
With regard to the elderly — on which a parliamentary question arises later — there have been significant initiatives. I will announce further initiatives later this year, many of which will support people to remain in their homes. Families with support are more inclined to support their elderly in the community than is the case if there is no support. Elderly people prefer this. International research shows that people live two years longer on average and have a higher quality of life if they can live at home. I will deal with the Deputy's question by way of the later question.
One of the big issues in the Dublin area is the lack of out-of-hours services for general practitioners. We have gone to tender on the north side of Dublin in this regard. I understand four companies have submitted tenders to provide these services. This initiative will have a major impact, in particular on Beaumont and the Mater Hospitals.