Richard Bruton (Dublin North Central, Fine Gael)
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Question 216: To ask the Minister for Health and Children if her attention has been drawn to the delayed discharge recorded at 18% at a hospital (details supplied) in April 2009; the steps she will take to reduce this rate; her views on whether there is a lack of convalescent facilities in north Dublin for patients who have completed their acute phase of care; and if she will make a statement on the matter. [28914/09]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The HSE is addressing the issue of delayed discharges through a combination of increased investment in alternatives to acute hospital stay and improvements in the discharge planning process at hospital level. There are many reasons for discharges being delayed including the need for long stay capacity, community based supports and, in some instances, a reluctance by families to allow their relative to be discharged until a publicly funded bed becomes available.

Hospitals are working to ensure that care is provided in a timely, appropriate and efficient manner. All patients are to be given an expected date of discharge within 24 hours of admission and patients will be discharged at weekends where appropriate.

The HSE National Service Plan for 2009 commits to a number of key steps which are designed to improve the efficiency of the hospital system including a reduction in the level of inappropriate admissions, reducing average length of stay, increasing elective surgical admissions on the day of surgery and shifting activity from in-patient to day procedures. The delivery of these measures and targets should ensure more efficient use of available capacity.

Following on from the launch of the Code of Practice for Integrated Discharge Planning last year, the HSE has initiated an "early transfer" pilot programme across 4 sites including Beaumont, Tallaght, Drogheda and Cork University Hospitals, which started on July 1st. Under the programme, patients can be transferred from the ED to a ward earlier than would normally be the case. The decision to transfer patients will be based on a prior analysis of the number of planned discharges each day. It is hoped that this will drive efficiencies in the wider hospital system, especially at ward level, and result in earlier access to in-patient beds.

The HSE's funding for long-term residential care services for older people in 2009 is €909 million and it must operate within this resource. This funding currently supports the provision of public and contract beds and the payment of nursing home subventions. I understand that at the end of March 2009 there were a total of 29,000 beds in nursing homes. Of these approximately 25,985 are long stay beds. There are currently in the region of 23,000 people in long stay residential care in Ireland.(7,500 public,15,500 private). A monthly average of 9,161 beds were reported as subvented at the end of April 2009.

It will also be required to support the introduction of the new Nursing Homes Support Scheme, A Fair Deal, later this year. Under the Fair Deal, care will be more affordable for all who need it. Earlier this year, the HSE provided 235 additional contract beds, including 90 for HSE Dublin North East, to alleviate pressure on the acute hospital system by the numbers of patients whose discharges are delayed.