Ulick Burke (Galway East, Fine Gael)
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Question 73: To ask the Minister for Health and Children the reason there are only three long-term care beds in Dublin north per 1,000 people over 65 years when the national average is 22; her plans to address this anomaly in view of the fact that two hospitals in the catchment area, Beaumont Hospital and the Mater Hospital, have lost in the region of 57,000 bed days in a single year, which is the equivalent of a 150 bed hospital, as a consequence of this; and if she will make a statement on the matter. [42481/08]

Máire Hoctor (Tipperary North, Fianna Fail)
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Based on the hospitals listed, I understand the Deputy's question to refer to north Dublin, that is, to the area previously covered by the former northern area health board.

The number of long-stay nursing home beds in Dublin North at present is about 2,260. This includes 1,300 beds in private nursing homes, 440 in voluntary nursing homes and 520 in public nursing homes. This equates to 43 long-term care beds per 1,000 people over the age of 65 and compares favourably to the international norm of 45 beds per 1,000 people over the age of 65.

The new 100 bed community nursing unit which was commissioned at St. Mary's Hospital in the Phoenix Park is now fully occupied. Building work has commenced on an additional 100 bed community nursing unit at St. Joseph's Hospital, Raheny, which is scheduled to open in 2009. Planning permission has also been sought for an additional 100 bed community nursing unit at St. Vincent's Hospital, Fairview and for a 50 bed community nursing unit at Oldtown, County Dublin. These developments, when completed, will bring bed numbers in Dublin North into line with, or above, international norms.

James Reilly (Dublin North, Fine Gael)
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Did the Minister of State say that there are 45 beds per 100,000 people aged over 65?

Máire Hoctor (Tipperary North, Fianna Fail)
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No, I said that there were 43 long-term care beds per 1,000 people over the age of 65, which compares favourably to the international norm of 45 beds per 1,000 people over the age of 65.

James Reilly (Dublin North, Fine Gael)
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That statistic applies across the country. The figures I have indicate there are only 22 beds. However, the real point of this question is to demonstrate that the reason we have such a crisis in accident and emergency departments in large urban areas and particularly in north Dublin, with both Beaumont and the Mater Hospitals suffering enormous delays, is the inability of hospitals to discharge patients back into the community. That inability is caused by the fact that an insufficient number of long-term care beds are available to such hospitals.

Information I have received from Nursing Homes Ireland indicates there are 1,810 nursing home beds lying idle around the country as we speak. I am not sure how many of those beds are in Dublin but I understand that it is in the hundreds. We must bear in mind that 130 patients were lying in beds and effectively blocking day-care beds which were earmarked for day-case surgery. This is what is frustrating the entire system. It is penny wise but pound foolish. There are beds available to which hospital patients should be discharged. Given the fact that we have a shortage of such beds in the public system, will the Minister of State give an undertaking to explore, with the private sector, the provision of such beds under contract until new beds have been built, if that is deemed necessary?

Máire Hoctor (Tipperary North, Fianna Fail)
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I remind Deputy Reilly that 200 extra beds, most of them in Dublin, were provided from January of this year.

James Reilly (Dublin North, Fine Gael)
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That is simply not enough.

Máire Hoctor (Tipperary North, Fianna Fail)
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It is very difficult to say when we will have enough beds but that was a new development from 1 January of this year. Funding was provided by transferring fair deal money for both the installation and continued upkeep of those beds. The original fair deal funding figure was €110 million, a portion of which was allocated for the opening and upkeep of those additional beds.

Jan O'Sullivan (Limerick East, Labour)
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Figures I have for the Dublin North Hospital Group indicate that on 10 November, between Connolly Hospital, Beaumont Hospital and the Mater Hospital, a total of 117 people in acute hospital beds were in a state described as "delayed discharge". This refers to the category of patients or family requesting publicly funded long-term care beds. In the category of patients who required public residential care due to higher care or medical care needs, the equivalent figure was 46. Adding the numbers in these two categories gives a total of 163 people who, on this date, were on delayed discharge in acute hospital beds in north Dublin when they could have been in community beds — whether long-term public beds or private beds. It is crazy that acute hospital beds are being occupied by 163 people who could have been sent either to public beds or private beds. The Minister stated earlier that 110 beds are to be provided in the co-located hospital, if it ever happens, in Beaumont Hospital.

Mary Harney (Dublin Mid West, Progressive Democrats)
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It was 170.

Jan O'Sullivan (Limerick East, Labour)
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Surely it would be much cheaper for the health budget to provide public long-stay beds for these people, who are currently in highly expensive acute hospital beds blocking other patients, who are on trolleys. According to the Irish Examiner, there has been a 40% increase in the numbers waiting on trolleys since 2006, when we had a national emergency. Surely it is a crazy system to have 163 people in this area who are occupying acute beds but who could be in much cheaper community beds. It is the policy to have people out in the community, and they would prefer to be there. The system we have at the moment is totally illogical. Does it not make much more sense to provide cheaper, long-stay public hospital community beds?

Máire Hoctor (Tipperary North, Fianna Fail)
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The fair deal will result in a much more equitable situation. As and from the new year, it will be the same cost regardless of whether people are in public or private beds. This will address the Deputy's point.

Jan O'Sullivan (Limerick East, Labour)
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It will not be in for a while yet if the Minister is allocating €50 million.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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The question refers to the north side of our capital city, but that is part of the Dublin/North-East HSE region, if the questioner will excuse me for making the point. When was the last time an audit of all hospital beds across this region was carried out, and what was the result? Does the Minister of State have the information to hand? If not, will she furnish it to the Deputies representing the various parties here this evening?

Does the Minister of State also note that the HSE's plan for this region is clearly a further reduction in the overall number of hospital beds, adding to the calamitous situation that currently pertains across the Dublin/North-East region? Is she conscious of the HSE claims that bed reductions will be compensated for by the introduction of further home-care packages and long-term residential placements for older people, as the previous questioner mentioned, occupying inpatient hospital beds?

Where will the funding come from? We do not have any of the promised packages in place. Where will the funding come from to compensate for this continual erosion of bed opportunities throughout the Dublin/north-east region?

James Reilly (Dublin North, Fine Gael)
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Tomorrow's plans are no substitute for today's action. The reality is that our hospitals are chock-a-block on the north side. We cannot get people in. Waiting times are getting longer and longer. Beds are available in the community today. All that is required is to put out a tender and ask the operators concerned to provide the beds so we can move people who are finished the acute stage of their treatment, and therefore do not want to be in hospital any more, out of the hospital and into long-term care if that is what is required. I am asking the Minister to do this. Another possibility is a specific tender with rehabilitation associated to allow patients to continue their recovery at home.

I am sorry for raising my voice, a Leas-Cheann Comhairle, but when one hears this stuff and there is a ready remedy there in front of us which is not being availed of, it makes one pull one's hair out, such as is left of it.

Mary Harney (Dublin Mid West, Progressive Democrats)
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There is plenty of it anyway. The Deputy is all right.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Deputy Reilly is welcome to try it. See where it brings the Deputy.

Máire Hoctor (Tipperary North, Fianna Fail)
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Deputy Ó Caoláin asked about an audit. The most recent was the Prospectus audit carried out in January of this year. A total of 68% of beds in the HSE Dublin/north-east region are in private nursing homes, and 32% are public beds. However, that report also notes that there are significant variations across the local health offices regarding the ratio of public to private long-stay beds. For example, in the Dublin north LHO area, 95% of all beds are in private nursing homes, with only 5% in public facilities. Notably, the Dublin north LHO area also has the highest population over 65 in the HSE region. In the Dublin central LHO area, 77% of all beds are in private nursing homes, with 23% in public facilities.