Tuesday, 22 November 2005
Question 80: To ask the Tánaiste and Minister for Health and Children the number of the 3,000 promised beds which have been delivered; the time line for the delivery of beds; and if she will make a statement on the matter. [35664/05]
The agreed programme for Government includes a commitment to expand public hospital beds in line with the health strategy commitment to increase total acute hospital bed capacity by 3,000 by 2011.
Substantial investment in additional bed capacity in acute hospitals has already taken place. In 2001, the average number of beds available for treatment of patients in public acute hospitals was 12,144. In August last, this number had risen to 13,244, an increase of 1,100. Some 2,500 acute beds in private hospitals must be added to these figures to give us the full extent of acute hospital capacity in the country, that is, nearly 16,000 beds. Part of this new capacity has been achieved by funding entirely new beds. Funding has been provided for 900, some 806 of which are in place. The remaining 94 will come on stream shortly.
A further 450 acute beds are in various stages of planning and development under the capital investment programme. The recently published Estimates include €60 million to open new acute hospital facilities some of which will provide additional bed capacity. Suggestions that all these should be inpatient beds involving an overnight stay by patients are out of touch with modern practice in hospitals around the world. In the interests of patients and of efficiency many surgical and other procedures are now done on a day basis. In July of this year, I announced an initiative that will provide up to 1,000 additional beds for public patients in public hospitals over the next five years. The HSE has been asked to develop an implementation plan and to prioritise proposals in this area. Public bed numbers are increasing substantially as a result of direct provision and the initiative I have mentioned. It is important to reform the manner in which hospital bed capacity is used. We are doing that in tandem with developments in the primary and community care sectors. Acute care, primary care and community care cannot be viewed in isolation because each impacts on the other. I am determined to ensure the pace of spending increases in the health service matches the pace of reform, in order to achieve a better service for patients.
I thank the Tánaiste for her reply. Does she agree that we face a crisis, given that 80 operations are being cancelled every day, many of them because of bed shortages, and especially as Dr. Séamus O'Reilly has stated in a letter that cancer patients are being left in pain at home because they cannot access beds? Given that the population is increasing — some 120,000 Polish people are living here — does she accept that we need to revise upwards this country's bed capacity, so it is more than 3,000? The root of the problem is that the population has increased by approximately 25% since the 1980s, but the number of beds in our hospitals has decreased by approximately 25% in that time. The Tánaiste seemed to indicate to the House that she agrees with the assessment of Professor Drumm that the number of beds in our acute hospitals is sufficient. Does that continue to be her position, despite all the evidence suggesting that the opposite is the case? Will the 94 beds which were mentioned by the Tánaiste in her reply be delivered before Christmas?
I remind the Deputy that the agreement to provide 3,000 additional public beds was reached separately to any analysis of bed capacity in the private sector. The Deputy is aware that 53% of the population has private health insurance. When we consider the issue of acute bed capacity, we need to examine this country's total bed capacity and ensure that we use all the facilities available to us as effectively and efficiently as possible. The mapping exercise that the National Hospitals Office has completed in respect of ten hospitals is being carried out with a view to ascertaining the efficiency and effectiveness of current hospital practices. It is the case throughout the world that more and more hospital activity is being done on a day case basis. The reality is that Ireland has more hospital beds pro rata than the UK. While 17% of the population of the UK is over the age of 65, just 11% of our population is over that age. We are putting more emphasis on community-based services, particularly for the elderly, which is necessary. On a certain date a couple of weeks ago — I do not have the figures for today or yesterday — up to 400 people who did not need to be in hospital were in hospitals in Dublin. They were medically fit to be discharged, but we were not in a position to put alternative arrangements in place for them. I am determined to resolve this problem over the next number of months. Such people comprise the capacity of a whole hospital, in effect. When we speak about bed numbers, we need to consider the appropriate use of existing beds. In particular, we need to put a greater emphasis on resourcing community-based and home-based services for elderly patients. The Government intends to provide such resources later this year with a view to putting such services in place next year.