Catherine Murphy (Kildare North, Independent)
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Question 138: To ask the Tánaiste and Minister for Health and Children if she is in agreement with the chief executive officer of the Health Service Executive that it is hard to justify a further increase in acute hospital beds and that the development of primary and community care services should be encouraged instead; the action she proposes to take regarding this approach to health care provision; and if she will make a statement on the matter. [28943/05]

Jan O'Sullivan (Limerick East, Labour)
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Question 211: To ask the Tánaiste and Minister for Health and Children her proposals in respect of comments made recently by Professor Drumm that acute hospitals are over equipped with beds and that the focus needs to be redirected to community care; the measures she will take to develop community beds and the amount of money that is being spent; and if she will make a statement on the matter. [28804/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 138 and 211 together.

The health strategy identified a requirement for additional capacity throughout the health system and a need to reconfigure services to achieve maximum efficiency and effectiveness. The concerns about capacity and the configuration of services underline the need for ongoing investment, expansion of acute hospital services and substantial strengthening of primary care and community services. There is a need to build up primary care, community services and acute hospital capacity and reform the health system to underpin the achievement of this objective.

The decision to increase the number of beds in acute hospitals was taken on foot of a detailed national review of bed capacity. The report recognises that acute hospital care is just one component of the health care delivery system. Hospital services cannot be evaluated in isolation from primary care, community and specialist services. The need for hospital services is influenced by the availability and accessibility of those services.

Following the bed capacity review, the Government's health strategy identified a requirement for 3,000 beds in the acute hospital system. Government policy has tackled this in the following ways. Funding has been provided to open an additional 900 inpatient beds and day places in acute hospitals. To date, 806 beds are in place and the remaining beds are to come on stream over the coming months. A further 450 acute beds/day places are in various stages of planning and development under the Capital Investment Framework 2005-2009. I launched an initiative which will provide up to 1,000 beds for public patients over the next five years. Tax reliefs provided under the Finance Act have been successful in attracting additional private capacity. The national treatment purchase fund has used capacity in the private hospital sector to treat some 35,000 public patients who have been waiting longest for admission to hospital.

On foot of my initiative to provide up to 1,000 beds for public patients over the next five years, I have asked my Department and the Health Service Executive to review public capacity requirements in the acute hospital sector in the light of developments since the health strategy and the progress of this initiative. My Department is in discussion with the Department of Finance regarding the provision of community based capacity for older people. Both Departments in recent times have discussed the possibility of providing 850 beds under a public private initiative and more recently have been looking at an option of providing additional capacity under a service level agreement.

This would take the form of the Health Service Executive working closely with the private sector to provide the extra long-term beds for older people with a high to maximum dependency. The private providers would work to general admission and policy criteria set down by the executive over, for example, a five to seven year contract period. The present position is that the departmental discussions are proceeding around the service level agreement concept.

Up to 90-95% of people's health care needs are capable of being met in the primary care setting and, to enable this to happen, it is necessary to continue to develop and enhance the range of services available in the community. I am committed to doing this in line with the principles set out in the strategy, "Primary Care: A New Direction". Implementation of the strategy will require the development of new ways of working and the reorganisation of resources already in the system, both those in the statutory sector and those contracted to provide services, in line with the service model described in the strategy. It is in that context that additional resources can be deployed to best effect.