Dáil Éireann debate -
Thursday, 24 Feb 2000

Vol. 515 No. 2

Other Questions. - Hospital Bed Capacity.

Ivor Callely

Question:

7 Mr. Callely asked the Minister for Health and Children if, further to Parliamentary Question No. 131 of 15 December 1999, he will review the Beaumont and Mater hospitals' catchment areas in view of the pressure on the hospitals which have indicated they cannot cater for the demands of the population they serve, particularly the accident and emergency departments where there are unacceptable delays and lack of bed accommodation; his views on the need for a new hospital based in Swords to accommodate the growing population trends in the area and reduce pressure on existing hospitals; and if he will make a statement on the matter. [5196/00]

Mr. Martin

The Deputy will be aware that under the Programme for Prosperity and Fairness it was agreed to conduct a review of bed capacity in both acute and non-acute settings. Integral components of this review of capacity will be examinations of the day work carried out in hospitals with a view to establishing the adequacy and appropriateness of day care facilities, given the 9-10% per annum increase in day activity in recent years, and the organisation and use of operating theatre facilities with a view to possible increased efficiency in the area.

Both the Beaumont and Mater hospitals and their respective catchment areas will be examined in the course of the reviews and the outcome will facilitate the Eastern Regional Health Authority, within whose functional area both hospitals operate, in determining future policy for the planning of acute hospitals services in the entire region.

Mr. Shatter

I thank Deputy Callely for tabling the question which I am sure the Minister found most helpful. Does the Minister accept that we are not properly using existing resources within either the Mater or Beaumont hospitals? Our failure to properly use existing resources within each of those hospitals is to the detriment of patients and is contributing to a substantial escalation in the in-patient hospital list. Would he agree that it is entirely unacceptable that 8,536 bed days were lost in Beaumont Hospital last year as a result of beds being closed? Last year also, some 21,000 bed days were lost in the Mater Hospital. Does the Minister acknowledge that these hospitals would be better staffed and resourced if the Government confronted the reality of nursing shortages in Dublin so that these beds could be properly utilised and the waiting list difficulties would be substantially tackled?

Mr. Martin

In the first instance, the responsibility for organising services within the region lies with the Eastern Health Board – now the Eastern Regional Health Authority. Seasonal bed closures have been a feature of the health service for a long time. There has been a significant increase in the volume of activity in all the acute hospitals throughout the country, but particularly in the Dublin region. A number of strands are involved if we are to make progress in resolving both the waiting list and the accident and emergency issues. Those strands include increased capacity and more effective and efficient organisational structures in hospitals, particularly for the accident and emergency services. The Programme for Prosperity and Fairness provides for a review of bed capacity with our acute hospital services, which is under way.

Ms McManus

Does the Minister accept that there is a very serious shortage of hospital beds? Ireland has the lowest per capita figure of any OECD country. In terms of planning to meet the crisis that now exists, he is not helping by not knowing, or not telling us, what is the current waiting list. We do not have information for December 1999. It is extraordinary that information needed for proper planning is not being provided by his Department.

Also, does the Minister accept that it is the Department of Health and Children that is responsible for planning, budgeting and funding hospitals to ensure there is patient care? In terms of growth in patient care and numbers, does the Minister accept that day patients are getting more treatment, not overnight patients? That is a critical matter when it comes to serious procedures such as cardiac surgery or cancer treatment.

Mr. Martin

International trends as well as trends here reflect the significant increase in day cases. That is a factor in the issues raised by Deputy Shatter. There is an ongoing drive in terms of efficiency, turnover and so on. We are setting up the Eastern Regional Health Authority which will have statutory authority for the delivery of services in the region. We either decide to have a proper regional statutory authority to deliver health services in accordance with service plans, proper planning, initiatives and so on, or we do not. We cannot have it both ways.

Ms McManus

The Minister does not even have information on the waiting lists?

Mr. Martin

We do. We will make the information available. This is ongoing – the last one, December 1999, is not 100 years ago. It is less than two months ago.

Ms McManus

I asked about September 1999.

Mr. Martin

I thought the Deputy said December. I apologise.

An Ceann Comhairle

I did not call the Deputy. The Minister is still in possession.

Mr. Martin

We could go back over the last ten years but the bottom line, and the Deputy knows it as well as I do, is that there are issues as to how hospitals and manpower within them are organised. That has an impact on waiting lists and, in particular, in how accident and emergency departments are organised. Bed capacity is certainly an issue and the Programme for Prosperity and Fairness presents an opportunity to deal with that.