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Dáil Éireann debate -
Thursday, 19 Mar 1970

Vol. 245 No. 5

Ceisteanna—Questions. Oral Answers. - Care of Aged.

12.

Dr. Browne

andDr. O'Connell asked the Minister for Health the total number of welfare beds on the basis of approximately 20 beds per 1,000 of the population of 65 years and over which are (a) available and (b) needed.

On the basis suggested in the report the number of places required would be about 6,500. The number of places regarded as being available at present for persons for whom health authorities would have a responsibility is estimated at about 4,900. I have approved of a programme for the provision of some 1,500 new places in purpose-designed small homes for the aged which I hope will be completed by health authorities over the next few years. While some of the existing accommodation may need to be replaced it might be borne in mind that voluntary organisations are also active in this field and the additional places they will be providing will help to meet some of the need.

13.

Dr. Browne

andDr. O'Connell asked the Minister for Health how many long stay hospital units for persons of 65 years and over will be needed on the basis if 15 beds per 1,000 as recommended in the report of the inter-departmental committee; and how many are at present available.

In assessing the number of long stay hospital units required, regard must be had to the facilities available in existing accommodation. A detailed examination of the situation in each health authority area will be necessary before final decisions are made as to the number of new units that must be provided.

On the basis of the recommendations made in the report on the Care of the Aged, some 4,850 beds would be required. It is estimated that about 3,800 beds of an acceptable standard are available at present for long-stay patients.

14.

andDr. Browne asked the Minister for Health if he will state, on the assumption that the planning of geriatric assessment units is on the basis of approximately 4.5 beds per 1,000 of population aged 65 years and over, (a) how many such beds are available at present and (b) how many additional such beds are needed.

On the basis of the suggestions made in the report some 1,450 beds would be required.

The report suggests that geriatric assessment units should be specially equipped and staffed for the full investigation and treatment of elderly patients who are not clearly in need of acute treatment which general hospitals provide. Viewed in this light assessment facilities are available only in some major centres. It will be feasible, however, to provide interim facilities at many other centres throughout the country assuming that appropriate staffing arrangements can be made. In the planning of new general hospitals the provision of special geriatric assessment units will be taken into account.

The Minister did not give me the number of beds available at present.

Special geriatric assessment units are available mainly in Dublin and there are some facilities available at St. Camillus's Hospital, Limerick.

Where in Dublin?

Long stay units are being planned in direct association with county hospitals, for example, at Tullamore, Nenagh, Kilkenny and Lisdown in County Cavan. Some of these beds will be used for assessment assuming that suitable arrangements can be made with the county physicians. Geriatric assessment and rehabilitation units are also being planned in connection with the new Cork Regional Hospital and the new general hospital in Tralee.

Sir, if the Minister was able to give me the answer to the question: "How many are likely to be needed? What is the projected figure?", why can he not give me the answer to the question: "How many are, in fact, available?"

Of course, we have to examine the question of how to do the geriatric assessment and, as the Deputy knows, it is extremely difficult to get geriatricians because it is not a very popular form of discipline.

That is not my question.

We also have to train the physicians in geriatric assessment.

If the Minister can answer one leg of the question why can he not answer the other?

Because I have not studied the question sufficiently.

It is about time the Minister did.

Question No. 15.

My conscience is quite clear. We are making progress on all these matters particularly in relation to some other countries.

Anyone would think Fianna Fáil took over the Government yesterday. Remember they have been in since 1932.

15.

Dr. Browne

andDr. O'Connell asked the Minister for Health whether he has accepted the recommendation that a national body be established to achieve co-operation of all public and voluntary efforts on behalf of the aged.

The views of interested bodies and organisations on the recommendations in the Report on the Care of the Aged, which was published only recently, have been sought. I will take a decision on this particular recommendation when these views have been received and considered.

16.

Dr. Browne

andDr. O'Connell asked the Minister for Health when it is intended that the Dublin Health Authority will have a geriatric assessment unit established and in use.

Geriatric assessment is at present carried out in two of the Dublin Health Authority's institutions, St. Kevin's Hospital and St. Mary's Hospital. In addition, geriatric patients may be visited in their own homes by medical and nursing personnel from these hospitals and preliminary assessment carried out there.

Can the Minister state if the knowledge is available to the public that geriatric patients at home can be visited by doctors from the hospitals?

It is, because the Dublin Health Authority have made very considerable advances in domiciliary visiting by social workers and nurses, considerable advances before the passing of the Health Act. It is prescribed in legislation that they can appoint home helps and engage in these kinds of activities on a more extensive basis. The health authority are to be congratulated on the work they have done in this regard.

Would the Minister be prepared to give us full details of the work they have done in the past year?

That is a separate question.

It would take me ten minutes to read a long supplementary note I have here.

Will the Minister agree that these questions were put down for the purpose of eliciting information?

If the Deputy likes I will send him a statement outlining in further detail what exactly is being done at the moment in Dublin. If the Deputy would like that I can arrange to have it done.

Can the Minister give us any indication as to when the geriatric assessment unit in St. Brendan's Hospital is to be opened and in use?

I have not got that date.

17.

Dr. Browne

andDr. O'Connell asked the Minister for Health the total number of public beds available in the new St. Vincent's Hospital, Dublin for patients of 65 years and over for (a) long stay and (b) geriatric assessment facilities.

The new St. Vincent's Hospital, Dublin, was planned as an acute short stay hospital and while patients in the older age groups will have full access to the hospital, both as out-patients and in-patients, specific accommodation for long stay patients and for geriatric assessment has not been reserved in the proposed allocation of beds.

Does the Minister not think it would be a good idea for a hospital such as this to provide a certain number of beds for geriatric cases?

No; having made an examination of the general principles in regard to hospitals, some hospitals must be established with these kinds of facilities and no others.

Surely in view of the fact that this will be a very important training institution, it is absolutely essential that this type of patient should be available so that the general practitioners and specialists of the future will have experience in the whole problem of geriatric care?

That, again, depends on the question of the rationalisation of medical teaching in Dublin about which I can make no pronouncement. It is also related, as the Deputy very well knows, to the fact that medical students move around the hospitals for their clinical teaching.

This is a teaching hospital.

The Minister admitted a short time ago that there is a shortage of geriatricians. Does he not think that this idea would be of assistance in encouraging more people to specialise in geriatrics where the teaching is carried out? Would he give further consideration to this if there is a shortage of geriatricians?

It requires that certain doctors will have a knowledge of geriatrics as well as other disciplines. I cannot say how far that will be developed.

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