Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I thank Senator Power for raising this issue. I wish to assure the House that reducing emergency department, ED, overcrowding is an objective of the Government and the HSE. I convened the emergency department task force in December 2014 to provide focus and momentum in dealing with the challenges presented by ED overcrowding.Significant progress has been made on the implementation of the ED task force plan. Delayed discharges nationally are reducing steadily from 830 in December 2014 to 570 last Tuesday, and this has freed up more than 200 beds every day for acutely ill patients. In October 2014, Beaumont Hospital had between 80 and 90 patients awaiting discharge home with supports or to a nursing home, and this number decreased to between 55 and 65 in October 2015, freeing up a whole ward for acutely ill patients every day. The waiting time for the fair deal nursing homes subvention scheme has decreased from 11 weeks at the beginning of 2015 to between two and four weeks now. By the end of 2015, more than 1,200 additional home care packages will have been provided as well as 149 additional public nursing home beds, 24 nursing home beds contracted for Moorehall in County Louth and 65 beds in Mount Carmel Community Hospital.

Senator Power is correct in identifying services such as D-Doc and convalescent home places as vital parts of a comprehensive solution to the overcrowding which we see in Beaumont all too often. This integrated approach has led the Director General of the HSE to co-chair the ED task force implementation group until March 2016. This will ensure all parts of the health and social care services work together and optimise resources to deal with the particular challenges associated with the winter months.

The rate of increase in the population of older people living in Ireland is greater in north Dublin than in any other part of the country, including other parts of Dublin. In 1997, only 5% of people in Dublin aged over 65 lived in the areas served by Beaumont Hospital. By 2011, this had increased to 24%. With this older population in mind, additional short-stay convalescent beds have opened this year in St. Vincent's Hospital, Fairview, Clontarf orthopaedic hospital and St. Mary's Hospital in the Phoenix Park. Hospitals on the north side of the city were also prioritised for access to the 65 additional beds opened in Mount Carmel Community Hospital. However, given that most people prefer to remain in their own locality, where it is easier for friends and family to visit, a tender inviting private providers to supply additional short-stay and long-term nursing home beds in the area is also in process. It is hoped that it can be agreed in the coming days or weeks. The HSE will continue to target additional short-stay beds as part of its winter planning process for dealing with pressures on acute hospitals.

The HSE is reviewing GP out-of-hours services throughout the country, including D-Doc, which provides an out-of-hours GP service to the population of north Dublin city and county. This review is expected to conclude shortly and will contain recommendations for changes and improvements to the delivery of service in each area. Funding has been provided to Beaumont to extend its day hospital from two days a week to five days a week as an alternative pathway for admission and assessment for elderly people referred to the hospital by their GPs, thus allowing them to avoid the emergency department.

On the question of a new emergency department at Beaumont Hospital, a design team has been appointed, incorporating architects and health care planners, to undertake a feasibility study on the location, size and cost of building a new emergency department at the hospital. This work is at the stakeholder consultation phase and the report is expected to be available in mid-December 2015. When the hospital board approves a design, the project will be submitted for consideration by the Royal College of Surgeons in Ireland hospital group, of which Beaumont Hospital is part, HSE Estates and the Department of Health.