Arthur Morgan (Louth, Sinn Fein)
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Question 20: To ask the Minister for Health and Children if she will make a statement on the recently published Acute Hospital Bed Capacity Review commissioned by the Health Service Executive. [2204/08]

John Perry (Sligo-North Leitrim, Fine Gael)
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Question 46: To ask the Minister for Health and Children if she shares the view of the Health Service Executive acute hospital bed capacity review that the number of acute beds in the system could be reduced by 4,000; and if she will make a statement on the matter. [2696/08]

Seymour Crawford (Cavan-Monaghan, Fine Gael)
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Question 59: To ask the Minister for Health and Children her views on whether services in hospitals or elsewhere should not be removed until as good or better services are available; and if she will make a statement on the matter. [2296/08]

Bernard Durkan (Kildare North, Fine Gael)
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Question 72: To ask the Minister for Health and Children the extent to which adequate provision is expected to be made in terms of sufficient public hospital beds to meet requirements in the future; and if she will make a statement on the matter. [2740/08]

Bernard Durkan (Kildare North, Fine Gael)
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Question 135: To ask the Minister for Health and Children the extend to which she anticipates the number of hospital beds in the public sector to increase or decrease in the next 10 years; the expected increases or decreases in the private sector in the same period, having particular regard to her Departments plans for the future; and if she will make a statement on the matter. [2968/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 20, 46, 59, 72 and 135 together.

The Health Service Executive recently published a Review of Acute Bed Capacity carried out by PA Consulting together with a HSE discussion document which proposes an integrated approach to health service delivery that seeks to achieve the right balance between in-patient, day case and community based care.

The Review found that with future challenges, such as our ageing population and the increase in chronic diseases, we will need to plan for a 60% increase in demand for health care by 2020. It suggests that if current practices and processes continue the demand for public hospital beds would escalate to nearly 20,000 by 2020. To meet this need we would have to provide the equivalent of twelve new 600-bed hospitals over the next thirteen years. It concludes that such reliance on acute hospitals for service delivery is neither sustainable nor in the best interests of patients.

The Review examined alternative approaches to meeting this demand. It recommends an integrated approach to health service delivery involving substantial change in the way care is provided. Among the measures proposed are significant increases in day beds in hospitals, more long-term care beds, more rehabilitation beds and more services in community-based, non-acute hospital settings.

The Review outlines a number of bed demand scenarios. It suggests that if the proposed model of integrated health service delivery was 100% operational by 2020, the number of acute beds required could be reduced to about 8,800. If the model was 75% operational, the number would be about 10,700; at 50% the number is estimated at about 13,000 and at 25% the number is about 16,000. It makes the point that other developed countries, such as Australia, Canada, Denmark and England have achieved results of this kind through their reform programmes. It also points out that some of our hospitals are already achieving the required efficiencies, such as shorter lengths of stay, more day surgery and admission on day of surgery. The challenge is to achieve these standards of service across the entire acute system.

Pending the implementation of such reforms, the Review estimates that 1,100 additional acute hospital beds are needed to meet current demand. The Government has already committed itself to providing 1,500 extra acute beds through a combination of direct capital investment (500 beds) and the co location initiative (1,000 beds).

The Review also advises that services in acute hospitals should not be altered until viable and appropriate community based alternatives are in place.

I believe that the Review forms a basis for discussion with key stakeholders on how best to plan for the provision of public health care delivery to 2020.