asked the Minister for Health if he has satisfied himself regarding the present position whereby only accident and emergency cases can now be dealt with by most Dublin hospitals; and if he will make a statement on the matter.
Ceisteanna—Questions. Oral Answers. - Dublin Hospital Services.
7.
I am satisfied that hospitals in Dublin are capable of fulfilling their obligations to the accident and emergency system and of providing a satisfactory level of service to others who need access to an acute hospital. Admissions from accident and emergency departments account for only half of admissions to acute hospitals in Dublin. However, I have asked the Eastern Health Board to establish a steering group representing the hospitals on the Dublin accident and emergency roster and work has already commenced on an examination of how the system might be improved.
I should also point out to the Deputy that only a very small proportion of those who attend A & E departments need admission to a hospital bed. The Deputy should also be aware that increasingly many of those requiring acute hospital treatment are dealt with in outpatient departments or on a day basis and those are unaffected by the A & E system.
Finally I should say that I am concerned that hospital accident and emergency departments, especially in urban areas, are used by those who may not really need the services of an acute hospital. I am examining how general practitioners could relieve the burden placed on hospitals. I intend also to highlight the extent to which accidents which could be avoided contribute to the workload of hospitals.
If the Minister is satisfied that there is no problem why is it that he asked the health board to establish a committee? Has the Minister given the committee a time limit by which they must bring their deliberations to a conclusion? Is the Minister aware that the Mater Hospital in Dublin have put 390 of their 450 beds at the disposal of the accident and emergency services?
If the Deputy was listening to me she would have heard me say that I was concerned about how accident and emergency departments are being used. Obviously, I am concerned at the numbers who have been attending accident and emergency departments and the impact that accidents and emergencies are having on the admission policies in hospitals. However, I am satisfied that there are sufficient beds available to deal with essential cases that do not enter hospital through accident and emergency departments. In fact, marginally more than 50 per cent of the beds in the six major Dublin hospitals are available for patients who do not enter through accident and emergency departments.
Will the Minister ask the committee to bring their deliberations to a conclusion by the end of December?
Obviously, I will be monitoring what is going on and I will be receiving reports. I am anxious that the committee come forward with a satisfactory solution. Certainly, I am anxious that they expedite their work but it is more important that they do their job efficiently and if that takes more time, then so be it. I should like to add that since January I received regular reports on what is happening in the six major hospitals, the three on the north side, Beaumont, the Mater and the James Connolly Memorial Hospital, and the three on the south side, the Meath, St. Vincent's and St. James's. I am looking at various improvements that might be made to increase the efficiency of the accident and emergency services and to ensure that more people can be treated as outpatients.
Is the Minister aware that a number of consultants and GPs have been obliged to send patients through A & E departments because they have no hope of getting an elective admission to the general surgical areas of the hospitals? Is the Minister aware that this is the only way they have of getting a bed?
While I am aware that that is happening I do not accept that it is the only resort they have. I have indicated that more than 50 per cent of the beds are available for normal inpatient admissions.
Will the Minister indicate the number of hospitals available at any given time to deal with accident and emergency cases in the Dublin area? Is the Minister satisfied that the number available is sufficient to meet emergencies should they arise?
That seems like a separate question.
There is one hospital available on the south side and one on the north side from 5 p.m. each evening until the following morning to cater for the catchment areas on the north and south side. That has the effect of relieving pressure on the other two hospitals because of the high workload through their accident and emergency departments. I have an open mind on whether all the hospitals should be open to cater for their own catchment areas or not and I hope the committee investigating the accident and emergency services will look at that. I am satisfied that the service is sufficient to cater for the catchment areas but I am a little concerned that patients may find themselves in different hospitals; for example that a person suffering from bronchial asthma might find himself or herself in three different hospitals over the course of a short period of time.