John Browne
Question:1 Mr. J. Browne (Carlow-Kilkenny) asked the Minister for Health the plans, if any, he has to relieve the pressure on beds in acute hospitals.
Ceisteanna — Questions. Oral Answers. - Acute Hospital Beds.
Shortly after coming into office, I made arrangements to relieve the pressure on acute hospitals. I provided £500,000 which resulted in the transfer of patients who were inappropriately placed in acute hospitals to more suitable accommodation. This resulted in a reduction in the pressure on the acute hospitals.
From information available to me for the first quarter of 1993, overall activity is broadly in line with the activity for the same period in 1992. I am aware that the pressure of medical admissions continued for a longer period this year than heretofore and, in fact, this pressure only eased quite recently.
The allocation of £4 million in 1993 towards the phased implementation of the Health (Nursing Homes) Act, 1990 will also contribute towards alleviating pressure on the acute hospitals sector by ensuring that people no longer in need of acute hospital care can be nursed in appropriate step-down facilities. I can assure the Deputy that it has been Government policy to maintain 12,000 beds in the acute hospitals sector, thus ensuring the adequacy of patient care.
My Department, in conjunction with the health boards, will continue to monitor the effect of accident and emergency admissions on the hospitals and I can assure the Deputy that appropriate action will be taken to maintain adequate hospital services. I am satisfied that, where urgent treatment is required, it will be provided.
(Carlow-Kilkenny): I would like to approach this issue from a different angle. Would the Minister accept that, in a new trend, people who are dying are being sent home from acute hospitals? I am aware of four cases where the people concerned survived just two days, three days, four days and five days respectively. Their families were put under pressure to take them home. Each of them was admitted to a district hospital. Have we reached the point at which it is no longer possible to die with dignity because of the pressure on beds? I appreciate the difficulties that hospitals face.
I am loath to comment on clinical decision, as it is a matter for the doctor and consultant directly concerned to decide whether a patient should be sent home, but I am anxious to ensure that a range of beds is available. Every patient does not need an acute hospital bed. I hope that whatever is considered to be the most appropriate bed required, be it a less expensive non-acute hospital bed, an acute hospital bed or a hospice bed, will be made available in the health system.
(Carlow-Kilkenny): Would the Minister accept that, because of the pressure on hospitals to make beds available, they are putting too much pressure on families, almost to the point of intimidation, to take the patient home? They are even going so far as to tell the patient that their family should be able to look after them. This is equally true in cases where the patient is dying.
I have no evidence which suggests that there is intimidation and that pressure is being put on families and patients. I have every confidence in the medical profession to take whatever clinical decision is necessary in the best interests of the patient in their charge. I would be interested to hear the details of any particular case that the Deputy would like to bring to my attention.