Wednesday, 13 March 2019
Ceisteanna Eile - Other Questions
My question concerns St. Vincent's University Hospital, which is in my constituency. What are the Minister of State's plans to increase capacity at the hospital in the light of the increase in demand for services there?
The Minister for Health recognises that hospitals are increasingly operating at or above capacity, with year-round demand pressures that are further challenged in the winter months.
It is against this background that the health service capacity review of 2018 recommended an increase in acute hospitals beds of more than 2,600 by 2031 to support the projected increase in demand for services in the years ahead. The National Development Plan 2018-2027 provides for the full 2,600 beds over its lifetime.
In the past 18 months, an additional 241 beds have been opened, which included 22 acute beds in St. Vincent’s University Hospital.
In addition, the national service plan provides for the preparation of 202 additional beds, to be operational in the first quarter of 2020, including 12 inpatient beds in St. Michael’s Hospital, Dún Laoghaire, which is part of the St. Vincent’s Healthcare Group.
In addition to capacity, the HSE winter plan seeks to ensure that the health system is as prepared as possible for the increase in demand for services in the winter months, within existing capacity and financial parameters.
St. Vincent’s was identified as one of nine sites requiring additional focus, investment and support as part this year’s winter plan. Important enhanced measures to be provided include additional home support packages, enhanced access to diagnostic testing and additional bed capacity in St. Vincent’s Private Hospital.
The Minister of State is correct that St. Vincent's hospital requires additional focus. When one considers the figures for the hospital, however, one can see that it requires much more focus and attention than the Government has given it to date. According to the Irish Nurses and Midwives Organisation, the number of people on trolleys in St. Vincent's hospital in 2018 was 3,773, which was up by 1,276 in comparison with the figures for 2017, or a jump of more than 50% in one year. Some 3,906 people have waited more than a year for outpatient appointments at St. Vincent's hospital, but when the Minister of State's boss, the Minister for Health, took office, the number was just over 1,400.
The Minister recently published a waiting list plan. When will the 215 people on the inpatient day-case list in St. Vincent's be treated? They have been on the list for more than 18 months. While I acknowledge the provision of the 22 acute beds that the Minister of State outlined, further intervention by the Government is required.
The point I was making was that the need for additional capacity has been recognised and identified and is being addressed, although the speed with which it is being addressed may not satisfy everyone. Capacity is only one aspect of the waiting lists for people in day care and inpatient care, and there are a number of other issues to be addressed. Delayed discharges, for example, is an area on which we must put increased focus and we have recently carried out a report on the matter. As I noted, an implementation team is being established within the HSE to address delayed discharges and ensure that there are more timely discharges. There is also an increase in the focus on the provision of step-down and transitional care, which will free up many beds at the acute hospitals. In addition to that suite of measures, there has been an increase in the National Treatment Purchase Fund this year, rising to €75 million, which should also help to reduce some of the lists. A cross-suite of initiatives and measures is being introduced, rather than capacity alone being addressed, notwithstanding the Deputy's points.
I acknowledge the suite of measures that the Government has introduced but it is clear that it is not sufficient or appropriate for St. Vincent's hospital. The Minister of State referred to 22 acute beds being opened in the past 18 months in St. Vincent's, which is welcome but it does not take into account the extraordinary increase in demand for services at the hospital and the necessity for the Government to ensure that it increases the hospital's capacity.
There are a couple of other points about St. Vincent's that are worthwhile noting. More than 1,000 of people over the age of 75 endured a wait of more than 24 hours in the hospital's emergency department before a decision was taken to admit them. That is not helped by the fact that 11,950 bed days were lost at the hospital owing to heavily delayed discharges. It is important to recognise that there must be an increase in step-down bed capacity at the hospital and throughout south Dublin to deal with capacity. Will the Minister of State do more in respect of St. Vincent's hospital to ensure that the increase in demand is met with an increase in capacity?
I certainly accept the Deputy's points and will ensure that there is an increased focus on what he seeks for St. Vincent's. I was addressing the matter on a more global scale but the measures, vis-à-visstep-down care and transitional care, will also apply to St. Vincent's. I am delighted to hear the Deputy's interest in view of the fact that local Deputies of all parties and none can have a role in ensuring a more proactive approach with their local HSE management teams to provide increases in facilities for step-down care and transitional care beds.