Arthur Morgan (Louth, Sinn Fein)
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Question 106: To ask the Minister for Health and Children the hospital services which have been curtailed or suspended due to end of year cutbacks or budget over-runs; and if she will make a statement on the matter. [42462/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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Operational responsibility for the management and delivery of health and personal social services is a matter for the Health Service Executive and funding for all health services has been provided as part of its overall Vote. Therefore, the Executive is the appropriate body to consider the particular issue raised by the Deputy. My Department has requested the Parliamentary Affairs Division of the Executive to arrange to have the matter investigated and to have a reply issued directly to theDeputy.

Kathleen Lynch (Cork North Central, Labour)
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Question 107: To ask the Minister for Health and Children if she has emergency plans to provide step-down beds in order to enable acute hospitals to discharge the estimated 756 patients who are ready for discharge but have no suitable place to go; and if she will make a statement on the matter. [42438/08]

Máire Hoctor (Tipperary North, Fianna Fail)
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Over the past number of years, my colleague, the Minister for Health and Children, has been working on a number of initiatives to enhance long-stay capacity and, by extension, to facilitate the timely discharge of patients from the acute sector. Firstly, the long-term residential care fast-track initiative, which commenced in 2007 and is continuing until 2010, aims to provide 860 new intermediate and long-term residential care beds. The latest information received from the Health Service Executive indicates that 188 beds were provided in 2007 and that 233 and 422 are to be provided in 2008 and 2009 respectively. The final 17 beds will be provided in 2010. Of the 860 beds, 75 are in the HSE West, 316 are in the HSE South, 242 are in the HSE Dublin North East and 227 are in the HSE Mid-Leinster.

Secondly, the Minister is committed to introducing a new system of financial support for those in need of long-term residential care. The new Nursing Homes Support Scheme will ensure that nursing home care is affordable for those who need it regardless of whether they enter a public or private nursing home. This is significant as information provided by the acute sector indicates that the single biggest reason for delayed discharges from acute settings relates to a patient or their family requesting a publicly-funded bed. The new scheme should ensure that private nursing home care will be affordable and accessible for such patients and their families. The Minister is currently bringing the legislation to provide for the new scheme through the Houses of the Oireachtas with a view to implementing the scheme in 2009. These initiatives are in addition to significant investment since 2006 in community-based long-term care supports.

With regard to the immediate position, the HSE is working to increase long-stay capacity to free up beds in acute hospitals over the winter period. However, the increase will be limited and is being matched by an intensive focus on improved processes and efficiency. Hospitals need to improve their admission and discharge processes, to ensure that people are appropriately admitted and that their care is efficiently managed, both during their hospital stay and their follow up care in the community. Steps are being taken to ensure that patients have an expected date of discharge within 24 hours of admission, that patients can be discharged in a more proactive manner at weekends and that communication between the hospital system and primary care services is improved. Implementation of a new Code of Practice on Discharge Planning has commenced. This should help to deliver further improvements in overall bed utilisation.