Jimmy Deenihan (Kerry North, Fine Gael)
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Question 107: To ask the Minister for Health and Children her views on the impact that the closure of 62 beds in Beaumount Hospital, Dublin 9 and 80 beds at the Mater Hospital, Dublin 1 will have on patient care; the consequence that this will have for her and Health Service Executive plans to move from inpatient to day care treatment; and if she will make a statement on the matter. [25792/10]

Mary Harney (Dublin Mid West, Independent)
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The introduction of the Nursing Home Support Scheme has enabled both the Beaumont and Mater hospitals to significantly reduce the number of delayed discharges and therefore reduce the number of inpatient beds that are required. The average number of long-stay patients (excluding patients awaiting rehab) in Beaumont averaged 105 in the first four months of 2009, compared to an average of 78 in the corresponding period this year.

A Medical Short Stay Unit and a Medical Assessment Unit have also been established in Beaumont hospital to improve access to patient care. Furthermore, priority being given to a range of measures to use existing beds more efficiently. These include development of a Surgical Short Stay Unit in AB Clery Ward, Short Stay Elective Orthopaedic & Plastic Surgery admissions in Banks Ward, Surgical Oncology in St Luke's Ward and a Rapid Response Rehab Unit within an existing medical ward.

Currently, the Mater Hospital has 70 delayed discharge patients, which is a reduction from a high of 121 in June 2009. The reduction in the number of beds fluctuates with demand but it is currently at 20. A Rapid Injury Clinic which has been set up at the Mater Smithfield site has improved access to patient care, which has seen over 1,000 people since it opened in April 2010. The Health Service Executive has advised my Department that currently both the Mater and Beaumont Hospitals expect to deliver services in line with the HSE's 2010 National Service Plan.

While public debate tends to focus on bed numbers, it is much more meaningful to measure the actual number of patients treated. In 2009, the combined number of inpatient and day case discharges was 3% greater than the equivalent figure in 2008, despite the difficult situation in relation to resources. The preparation of the HSE's 2010 National Service Plan, which I approved on 5 February, maintains the focus on increased efficiency and targets broadly the same level of overall hospital activity as in 2009. This involves a shift from in-patient to day cases, a reduction in emergency admissions and a further increase in day cases.

While there is no proposal in the Service Plan to close a specific number of beds, the reduction in in-patient treatments will mean that less capacity will be required in this area during 2010. The exact number of beds available at any one time will fluctuate depending on such factors as planned activity levels, maintenance and refurbishment requirements and staff leave arrangements. Beds may also be closed from time to time in order to control expenditure, given the need for every hospital to operate within its allotted budget for the year.

Meeting the agreed efficiency targets will require increased access to the specialist skills and senior clinical decision-making available in Medical Assessment Units, to diagnostics and to other ambulatory care services. The HSE will also focus on minimising length of stay, with a particular focus on reducing the current variation across different hospitals for similar procedures. It will also work to increase same day of surgery admission and to protect inpatient beds for elective surgery in order to reduce waiting times. By reforming the manner in which services are provided, I am confident that the HSE can deliver the volumes of service provided for in the plan, while at the same time continuing to improve service quality and patient outcomes.