Written answers

Wednesday, 5 March 2008

Department of Health and Children

Hospital Accommodation

9:00 pm

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
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Question 146: To ask the Minister for Health and Children the extent and the role she intends public and private hospital beds to play in the delivery of services to the public with particular reference to bed complement requirements in the future; if a diminution in public beds is the objective; the extent to which this is expected to affect the delivery of services; if privatisation of services is anticipated in such circumstances; the way this is expected to affect the quality and extent of services available to public patients; and if she will make a statement on the matter. [9234/08]

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
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Question 221: To ask the Minister for Health and Children the number of public and private hospital beds available in each of the past 10 years; the projected numbers for the next 10 year period; and if she will make a statement on the matter. [9751/08]

Photo of Mary HarneyMary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 146 and 221 together.

In 2001, the year of the publication of the Health Strategy, the average number of in-patient beds and day places available in the 53 public acute hospitals was 12,145, based on returns to the Department (11,374 in-patient beds and 771 day places). The provisional number of acute hospital beds recorded by the Health Service Executive for 2006 was 13,771 (12,574 in-patient beds and 1,197 day places) based on a total bed complement. The Programme for Government includes a commitment to provide an additional 1,500 public acute hospital beds. In this context the co-location initiative which was announced in July 2005, aims to make available approximately 1000 additional acute beds for public patients through the transfer of private activity from public hospitals to co-located private hospitals. Additional acute beds, which are at various stages of planning, will be made available through the Health Service Executive's capital plan.

The provision of private care in public acute hospitals is a long standing feature of the Irish healthcare system. Over 2,500 beds in public hospitals are designated as private and semi-private. There is an 80:20 public/private ratio average across the entire acute system. The percentage of beds designated as private varies between individual hospitals; for example, there is a higher ratio of private beds in maternity and paediatric hospitals and a lower ratio in other hospitals.

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 ranging from partial to full delivery of an integrated health service. It makes the point that other developed countries, such as Australia, Canada, Denmark and England have achieved significant results 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 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.

My Department has asked the Health Service Executive to provide the detailed information sought on acute public hospital beds directly to the Deputy.

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