Seymour Crawford (Cavan-Monaghan, Fine Gael)
Link to this: Individually | In context

Question 226: To ask the Minister for Health and Children the number of private hospitals in use here; the location and bed capacity of each hospital; the number of public hospitals in use and on call; the number of beds being used in each of them; her views on whether bed capacity is still a major problem in view of the fact that there is a scarcity of step down beds and a serious lack of home support; and if she will make a statement on the matter. [20715/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
Link to this: Individually | In context

Neither my Department nor the Health Service Executive has a direct responsibility for the operation and management of private hospitals. I am not therefore in a position to provide the information sought by the Deputy in that regard. My Department has requested the Health Service Executive to forward directly to the Deputy the detailed information sought by him in respect of public hospitals.

In 2001 the Government made a commitment, in the context of the Health Strategy Quality and Fairness, to increase public acute hospital bed numbers by 3,000 over ten years. This commitment included both acute in-patient beds and day places. The Government is substantially on target to reach this objective.

In 2001 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 number of acute hospital beds recorded by the HSE for 2006 was 13,771 (12,574 in-patient beds and 1,197 day places) based on a total bed complement.

This represents an increase of over 1,600, an average of some 325 new bed and day places per year, a very high level of annual increase by historic standards.

The Programme for Government includes a commitment to provide an additional 1,500 public acute hospital beds. About 1,000 of these will be provided through the co-location initiative and the balance through the HSE's capital plan, which is part of the National Development Plan.

With regard to the important area of home supports, a key-stone of the Government's policy in relation to older people is to support them to live in dignity and independence in their own homes and communities for as long as possible.

In this context, over €190 million additional funding was provided in Budgets 2006 and 2007 to expand a wide range of existing community-based services. These include Home Care Packages, Home Helps, Meals-on-Wheels, and Day/Respite Care. This has significantly enhanced the capacity of the HSE to meet increasing service demands in the last two years. In 2007, for example, the Executive:

had in place some 4,300 Home Care Packages, benefitting in the region of 11,500 clients;

provided around 11.7 million Home Help hours;

supported in excess of 21,000 Day Care places.

In addition to these community based developments, the HSE's Fast Track Beds Initiative is due to provide 860 public beds over the period 2007-2009 under the Executive's capital programme.

The HSE earlier this year 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. The Review considered that taking account of such factors 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 were to 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 period to 2020. 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 for example, 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. As outlined the Government has already committed itself to providing 1,500 extra acute beds through a combination of direct capital investment and the co location initiative.

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.