Shane McEntee (Meath East, Fine Gael)
Link to this: Individually | In context

Question 43: To ask the Minister for Health and Children the number of hospital beds closed nationally for which most recent information is available; the reason these beds are closed; the details of Health Service Executive plans to close an additional 1,100 inpatient hospital beds in 2010; the location of these beds; her views on the impact that this will have on patient services; and if she will make a statement on the matter. [25820/10]

Arthur Morgan (Louth, Sinn Fein)
Link to this: Individually | In context

Question 46: To ask the Minister for Health and Children the number of acute hospital beds which are closed here; and if she will make a statement on the matter. [25964/10]

Charles Flanagan (Laois-Offaly, Fine Gael)
Link to this: Individually | In context

Question 52: To ask the Minister for Health and Children the total number of beds closed to date regarding Health Service Executive plans to close 1,100 inpatient hospital beds in 2010; if she will list the hospitals affected by these closures; her views on the impact that this will have on patient services; and if she will make a statement on the matter. [25804/10]

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

I propose to take Questions Nos. 43, 46 and 52 together.

Service delivery is about access to appropriate care for patients, not the number of beds in the hospital system or the number of consultants employed. The focus of the health service must be on the quality of service outputs and the patient outcomes being achieved for the resources available. This approach mirrors that being taken in health systems throughout the world. The 2010 National Service Plan commits the HSE to treating people more effectively by reducing costs and reforming the way services are provided, without reducing access to appropriate services.

The most recent validated information on bed closures in the acute hospital system relates to the week ending 17 January 2010. At that time, 689 inpatient beds and 37 day beds were closed for cost containment, infection control, refurbishment or seasonal closure of facilities. In 2009, the combined number of inpatient and day case discharges was 3% greater than in 2008, despite the difficult situation in relation to resources. The HSE's 2010 National Service Plan, which I approved earlier this year, maintains the focus from previous years on increased efficiency and commits to delivering broadly the same level of overall hospital activity that took place in 2009. Analysis of performance data from the hospital system has shown that, although many improvements have already been implemented, there is still substantial scope in many hospitals for more efficient and appropriate care processes, informed by best practice both in Ireland and internationally.

This involves moving treatment, where feasible, from inpatient to day cases, a reduction in emergency admissions and a further increase in day cases. The continued shift to day case care is intended to deliver an increase of 6.5% over the day case target in the 2009 Service Plan. For conditions requiring inpatient admission, there is also a particular emphasis on reducing the significant length-of-stay variation between hospitals for similar procedures. Hospitals are also working to reduce admissions through active demand management, primarily targeting cases requiring diagnostics only and those where patient needs can be addressed other than by inpatient admission, including on a day basis or in the primary care setting. The HSE is also working closely with the NTPF to facilitate treatment for patients who have been waiting longest for admission.

While there is no proposal in the Service Plan to close a specific number of beds, these more efficient processes, together with some planned reduction in inpatient treatments, mean that less inpatient bed capacity will be required during 2010. Hospitals must manage their bed complement in line with planned activity levels and the requirement to remain within their allotted budget for the year. The exact number of beds available will vary from time to time depending on such factors as planned activity levels, maintenance and refurbishment requirements and staff leave arrangements at any particular time of the year.

Further developments which are enabling more efficient and appropriate care involve the establishment of acute medical and surgical assessment units and using medical admission units for emergency admissions. Hospitals are also achieving improvements through better bed utilisation strategies, proactive discharge planning and improved access to senior clinical decision-making. As well as the significant measures being taken to increase efficiency within hospitals, the HSE is implementing initiatives, such as access to post-acute care to manage delayed discharges, which enable a greater proportion of people's care needs to be met in the community setting, closer to where they live.

The delivery of planned activity in 2010 also requires a renewed focus on appropriate use of resources and control of costs across the pay and non-pay areas. Staff redeployment and greater flexibility on the movement of resources to follow the patient will also be required. With the recent ratification by the Public Services Committee of the ICTU of the terms of the Croke Park Agreement, I look forward to a productive engagement between health service employers and staff interests to implement an agreed agenda for change within the health sector. This will further support the more efficient and appropriate provision of health services, while providing a basis for confidence about pay levels and security of employment in the Public Service for the future.

I am confident that the range of measures I have described will continue to achieve significantly more efficient and appropriate use of resources, without compromising on the standard or levels of patient services.