Billy Kelleher (Cork North Central, Fianna Fail)
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20. To ask the Minister for Health the status of the hospital bed capacity review; and if he will make a statement on the matter. [12078/17]

Billy Kelleher (Cork North Central, Fianna Fail)
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I wish to ask the Minister for Health about the status of the bed capacity review. I have raised this issue on a number of occasions and I would like to know the status of the review and where we are in the context of the terms of reference. Who will be independently validating the bed capacity review, particularly in view of the fact that for many years it was the policy of the Department of Health to reduce bed capacity? The Department, through the Minister and his predecessors, defended, quite robustly, the policy that bed numbers should be reduced and that beds were not always the answer to the issues of capacity in the hospital system.

Simon Harris (Wicklow, Fine Gael)
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Due to the fact that I am a great champion of new politics, I am not going to get into a debate about bed capacity, closures and the records of various Ministers for Health in various Governments. As the Deputy has correctly pointed out, however, my Department has commenced a capacity review in line with the commitment in A Programme for a Partnership Government. I would like to assure Deputy Kelleher that this is a priority action for me and my Department.

As I have previously advised, my intention is that the review will have a wider scope than previous exercises - I believe there would be agreement in the House on the importance of that - and it will examine key elements of primary and community care infrastructure in addition to hospital facilities. It cannot just be about the hospital beds, it must be about the spectrum of beds across the health service.

Terms of reference for the review have been developed, these are as follows: to consider current capacity in the health system and benchmark with international comparators; to determine drivers of future demand for healthcare including demographic and epidemiological trends; to analyse how reforms to the model of care will impact on future capacity requirements across the system; and to provide an overall assessment of current and future capacity requirements for the period 2017 to 2030.

The review is being led by my Department. The Department of Health develops policy and the HSE is the operational arm of the health service. The review will also be overseen by a steering group, which is now in place. It includes senior officials from my Department and the Departments of the Taoiseach and Public Expenditure and Reform, the HSE and experts with a clinical and academic background. It will hold its first meeting this month. I expect the terms of reference for the review to be adopted and explained in full to the group at the meeting and that the group will begin detailed planning for the review process - including around the external expertise requirements, which I know the Deputy feels strongly about - and in respect of stakeholder consultations. An independent peer group of international health experts will also be established to review and validate the review methodology and findings. There will be an international dimension to this review.

I am keen that this review will be progressed sufficiently to enable it to feed into the mid-term review of the capital programme, which will take place later in the year. I must have a crystallised ask with regard to the number of beds, and I will have that information in time for the review. While the review will consider capacity requirements over the next decade or so, I am also anxious that it have a short-term focus and determine how capital investment over the coming years can be best targeted, given the current pressures being experienced within our hospital services.

The mechanisms for the review are now in place, as is the steering group. I look forward to the emerging findings later in the year.

Billy Kelleher (Cork North Central, Fianna Fail)
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I thank the Minister for his reply. The fact that there is outside oversight in the context of the bed capacity review is welcome. Let us be under no illusions. For the past six years, the policy of the Department of Health, regardless of which Minister was defending it, has been to reduce the capacity of beds in the public hospital system. This policy was robustly defended for a long period and we were told that beds were not necessarily always the answer to increase the capacity to address the issues of waiting lists and other difficulties in the hospital system. If we were just independently evaluating bed capacity, on foot of the Department of Health pursuing a slash-and-burn policy in recent years, then I would have had a concern. I welcome that there will be outside observance of that issue.

Perhaps the Minister could clarify if intensive care unit, ICU, beds and theatre capacity will also be looked at in that context and whether or not there will be a differentiation between paediatric beds and adult beds in the assessment.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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I do not believe there is any degree of urgency on this by the Minister, but there should be. Will he indicate if the report will be ready in time to feed in to the winter initiative? The last winter initiative was not exactly a massive success since everybody got surprised by the flu. I wonder if the report will be ready to feed in to and inform the winter initiative.

Simon Harris (Wicklow, Fine Gael)
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No matter how many times Deputy O'Reilly says that I was surprised by last winter's flu outbreak, I was not. I get this at least once a week from the Deputy. I had been relaying the advice made available to me by doctors and medical experts that the flu in question was a strain we had not seen in the State since 2009. I would hope that the entire report would be ready. Considering that a sufficient amount of material must be ready for the mid-term capital review, I am of the opinion that there will be valuable data and information available in preparation for the winter initiative.

In response to Deputy Kelleher, the position regarding ICU and theatre beds will be examined. I will revert to the Deputy on the issue of paediatric beds because I understand that a paediatric model of care is being developed as part of the new national children's hospital. We are looking at paediatric beds.

I agree with the Deputy about the importance of oversight structures. While overall responsibility will rest with my Department, which has responsibility for making policy for which I am accountable, it is important that the steering group has academic and clinical support and that we also have a degree of independent international oversight. We will identify the members of that international expert advisory group in the near future, and I will share information relating to them with the House. This group of international health experts will be charged with examining and critiquing the draft outputs from the review on the basis of their extensive international experience. The group will look at and validate the review's approach, methodology, conclusions and recommendations.

Billy Kelleher (Cork North Central, Fianna Fail)
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I thank the Minister. While we are asking questions in the context of the bed capacity review, there is not much point, as the Minister stated previously, in having the beds if we do not have blankets and mattresses. More important is the staff for these beds. Will that feed in to the assessment of the manpower requirements, training programmes and all that flows from that report; demographics of population, epidemiology requirements, the beds to support that and the staff to support the bed capacity recommendations?

Simon Harris (Wicklow, Fine Gael)
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I am pleased to hear the Deputy raise that point. I often hear people in radio interviews, for example, referring to the need to open more beds. I am of the view that we need to open more beds. As the Deputy said, however, we cannot do so if we do not have adequate staffing levels. This is part of the very extensive engagement we have had with the Irish Nurses and Midwives Organisation, INMO, SIPTU and the Irish Nurses Organisation, INO, on a range of industrial relations issues in recent times. I am pleased that we have managed to progress with each of those. We had three threatened industrial relations disputes in the health service, one of which I am pleased to have brought to a resolution, another is in a process and the INMO is balloting its members on the other with a set of proposals it is encouraging members to accept. The bed capacity review will also inform the staffing needs for our health service. As Deputy Kelleher knows, we have had closed beds due to a lack of nurses so we must be truthful here, look at staffing levels and open those closed beds, which is what we have been doing in recent weeks. That is why we will hire 1,200 more nurses this year. We must also look at the staffing need for each additional bed. Work is ongoing in that regard.