Limerick East): Elective admissions have had to be cancelled at times due to an upsurge in the numbers of people seeking in-patient beds admitted through the accident and emergency department. This has been a feature of the acute hospital services over the past few years. Casualty admissions by their very nature are unplanned, and while some admissions through the accident and emergency department can be anticipated, it is not possible to predict when the peaks and valleys will occur.
While full figures are not readily available on a national basis, indications are that no more than one to two per cent of admissions to hospitals nationally would have been cancelled because of non-availability of beds in 1995. This figure would be much the same as in 1993 and 1994.
The hospital service has encountered problems in the provision of accident and emergency services, particularly over the winter period, in the past number of years. This is not a problem confined to Ireland but is a feature in other developed countries also. The causes of the problems which arise have been well documented. The ageing of our population has contributed to the difficulties in accident and emergency departments. The winter period brings its own set of problems for our elderly population. This in turn can lead to an upsurge in the number of patients present in accident and emergency departments requiring admission to hospital. Many elderly patients require acute hospital care initially but much of their recovery period could be spent in step-down sub-acute accommodation.
The shortage of sub-acute beds, particularly in Dublin, has caused problems in that acute hospitals have not been able to discharge patients in sufficient numbers, and quickly enough, to cater for new patients seeking the services of the hospital. This in turn has led to the cancellation of elective admissions to hospitals at times, medical priority being the determining factor. There is nothing new in this. This has been the position for quite some time and has faced successive Ministers for Health.
The successful management of the accident and emergency difficulties includes tackling a number of areas including services for the elderly, services for the chronically disabled and services provided by the acute hospitals which, when taken together, provide a comprehensive and integrated response. I have set out in written replies to Deputy Callely on 8 February 1996 and on 13 March 1996 measures which I took to tackle the accident and emergency difficulties during the winter of 1995-96.
I am concerned that any elective admission to acute hospitals should have to be cancelled and I am confident that the measures recently put in place will reduce the need for such cancellations. In cases where elective admissions are cancelled I understand that hospitals endeavour to reschedule these patients for admission as soon as possible.