James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

Question 201: To ask the Minister for Health and Children the progress in regard to the commitment given in the Programme for Government to increase the number of dedicated public only hospital beds by 1,500; and if she will make a statement on the matter. [28059/08]

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

Question 247: To ask the Minister for Health and Children the progress made in relation to the Programme for Government commitment to increase the number of dedicated public only hospital beds by 1,500; and if she will make a statement on the matter. [26765/08]

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

Question 251: To ask the Minister for Health and Children the progress made in relation to the Programme for Government commitment to reform use of beds in hospitals to ensure equity of access; and if she will make a statement on the matter. [26769/08

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

I propose to take Questions Nos. 201, 247 and 251 together.

The Government in 2001 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 Health Service Executive 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 Health Service Executive's (HSE's) capital plan, which is part of the National Development Plan. The co-location initiative aims to deliver approximately 1,000 of these beds for public patients through the development of private hospitals on public sites. The intention is to transfer private activity to those hospitals thereby freeing up capacity for public patients. The Board of the Health Service Executive (HSE) has approved preferred bidders for six co-located hospital sites: Beaumont Hospital, Cork University Hospital, Limerick Regional Hospital, St. James's Hospital, Waterford Regional Hospital, Sligo General Hospital.

The Project Agreements for Limerick Regional Hospital, Beaumont Hospital and Cork University Hospital have been signed. Planning permission has been granted by the local authorities concerned for the co-located hospitals at Beaumont and at Cork University Hospital. Planning permission for the Beaumont and Cork projects has been appealed to an Bord Pleanála. The HSE has advised my Department that a decision to grant planning permission for the Limerick Regional Hospital project was given in mid June and that this decision is scheduled to be made final later this month subject to no planning appeal being lodged.

The HSE advise that the Project Agreements for St. James Hospital and Waterford Regional Hospital are expected to be signed shortly. The HSE expects the Sligo Project Agreement to be concluded by the autumn. Connolly Hospital and Tallaght Hospital, which are also participating in the co-location initiative, are at an earlier stage of the procurement process. Connolly Hospital is at preferred bidder stage and it is expected that the invitation to tender (ITT) for Tallaght Hospital will issue in the near future.

In 2007 the HSE commissioned an independent review of acute bed capacity requirements for Ireland until the year 2020. The report produced reaffirms the case for continuing to increase our focus on a primary and community care model. The review recommended that Ireland develop an Integrated Model of Care system. This overall strategic direction has already been adopted by other developed countries, such as Denmark and Canada. The review forms a basis for discussion with key stakeholders on how best to plan for the provision of public health care to 2020.

A number of measures are being taken in the context of the commitment in the Programme for Government to reform the use of beds in hospitals to ensure equity of access. In addition to increasing the number of acute hospital beds and looking at the optimum configuration of hospital and community services, other measures being undertaken include the negotiation of a new hospital consultant contract and recruitment of additional hospital consultants. Hospital consultants have voted to accept the new contractual arrangements, with members of both the Irish Hospital Consultants Association and the Irish Medical Organisation voting in favour of the new arrangements.

The major changes in working arrangements under the new contract include:

A longer working week (from 33 to 37 hours);

An extended working day (8 am to 8 pm Monday to Friday);

Weekend working (up to 5 hours scheduled attendance, where required, on Saturday, Sunday and Bank Holidays);

Team working under leadership of Clinical Directors; and

Restrictions on private practice rights and robust measurement of individual consultant's clinical throughput, to ensure that the ratio of private to public work is not exceeded.

These arrangements will result in the increased availability of senior clinical decision makers to treat and discharge patients as part of the transition to a consultant-delivered service, from the present consultant-led service. The new private practice provisions, ranging from a total prohibition to an upper limit of 20% of overall clinical throughput, depending on the contract type, are designed to improve the position of public patients in terms of their access to the public health system. The new contract has a target implementation date of 1st September 2008.

In April 2008 the Health Service Executive recommenced the recruitment process for new consultants in a range of specialties and 129 posts have been advertised to date.