Written Answers. - Hospital Ward Closures.

Seán Ryan

Question:

85 Mr. S. Ryan asked the Minister for Health and Children the number of bed closures per hospital during January 1999; the reason for the closures in each case; and if he will make a statement on the matter. [1951/99]

Bernard J. Durkan

Question:

101 Mr. Durkan asked the Minister for Health and Children if his attention has been drawn to the closure of any wards within hospitals; if this has resulted in the loss of available beds; if he has identified the cause of these bed losses; the proposals, if any, he has to address the issue; and if he will make a statement on the matter. [1875/99]

Alan Shatter

Question:

554 Mr. Shatter asked the Minister for Health and Children if he will give details of the number of beds closed in each hospital in 1998 as a result of the shortfall in the nurses required; the nursing shortages in this regard; the position to which each shortage relates; the number of bed days lost in each hospital as a consequence; and the effect of nursing shortages on each hospital's ability to undertake elective and emergency surgery. [1510/99]

Alan Shatter

Question:

578 Mr. Shatter asked the Minister for Health and Children the number of bed days lost in 1998 as a result of the closure of beds and wards; and if he will provide a breakdown of the information supplied in respect of each hospital. [1668/99]

Bernard J. Durkan

Question:

635 Mr. Durkan asked the Minister for Health and Children the reason for the loss of hospital beds through ward closures; if his attention has been drawn to the concern within the health services regarding shortages of staff and funding; the initiatives, if any, he will take to address these issues in the near future; and if he will make a statement on the matter. [2193/99]

Bernard J. Durkan

Question:

636 Mr. Durkan asked the Minister for Health and Children the number of hospital bed losses through ward closures, shortages of staff or other reasons during December 1998; and if he will make a statement on the matter. [2194/99]

I propose to take Questions Nos. 85, 101, 554, 578, 635 and 636 together.

Details of the number of bed closures and resulting bed days lost in December 1998, for 1998 as a whole, and associated with nursing shortages in 1998 are set out in the following tables.
The corresponding figures for the month of January 1999 are not yet available. In considering the delivery of service in the acute hospital sector, it is appropriate to examine the overall level of service provided in the sector rather than to simply focus on the number of beds available at any given time. This reflects major changes that have been taking place in medical practice, resulting in reduced average in-patients lengths of stay, a continuing shift in the delivery of care from an in-patient to day case basis and the increasing provision of treatment at out-patient level. In developing and delivering service plans, the implementation of an appropriate mix between in-patients, day case and out-patient care is a major consideration for local management in seeking to maximise overall activity. As part of this process, activity in the acute hospital sector is planned over a 12 month period having regard to anticipated levels of emergency admissions and the overall resources available. In achieving the activity targets set out in the annual service plan, temporary bed closures would form a part of the normal bed management function performed by local management as part of their efforts to optimise the overall activity delivered within the resources available. They also, of course, facilitate staff annual leave, refurbishment works and the scaling down of elective activity at times of low demand such as the high summer period and at Christmas. I am confident however that, given the level of increased funds I have made available to the acute hospital sector this year over last year, the level of temporary bed closures will be kept to a minimum.
Total discharges, both in-patient and day case, in the acute hospital system for the period January to October 1998 were 676,635 which represents an increase of 3 per cent over the same period in 1997. In other words, irrespective of any temporary bed closures that occurred during that time, over 3 per cent more patients received treatment in our acute hospitals. Within this overall increase, there was an increase of almost 1 per cent in the number of patients treated at inpatient level and an increase of just over 12 per cent in the number of patients treated on a day case basis. This marked shift towards the increased provision of treatment on a day care basis underlines the inappropriateness of available bed numbers as an accurate measure of what is happening in the acute hospital sector. It is in this context that the performance of acute hospitals in 1998 should be judged. In agreeing service plans for 1999 with agencies in the acute hospital sector, my fundamental concern is to ensure that they will again deliver a level of service to patients commensurate with the funding being provided to them. In relation to bed closures as a direct result of nursing shortages, the figures provided indicate that a total of 4,738 bed days were lost during 1998, representing a monthly average of 22 beds nationally or 0.18 per cent of the total bed complement. It is evident that the impact of nursing shortages is mainly concentrated in the Dublin area and is having some limited impact on the ability to perform elective work in the main hospitals affected. While the recruitment of nurses is primarily a matter for individual employers, in response to the current situation, the Health Service Employers' Agency, HSEA, has established a task force to examine the full nature of the difficulties and to make recommendations on appropriate action.
Hospital Bed Closures During December 1998.

Health Board Area.

BedComplement.

Number of Beds closed in December 1998.

December 1998 bed closures as a % of bed complement.

Number of Bed Days lost in December 1998.

Number of Bed Days lost in December 1998 as a % of number of bed days available.

Number of bed days available December 1998.

Eastern Health Board Area

Beaumont Hospital

627

96

15%

1,658

9%

19,437

Cappagh Hospital

126

0

0%

0

0%

3,906

The Coombe Hospital

237

0

0%

0

0%

7,347

Our Lady's Hospital for Sick

Children, Crumlin

258

n/a

0%

n/a

0%

7,998

National Maternity Hospital,

Holles Street

206

13

6%

403

6%

6,386

Peamount Hospital

60

0

0%

0

0%

1,860

James Connolly Memorial Hospital

257

0

0%

0

0%

7,967

Mater

483

90

19%

2,994

20%

14,973

Naas General

94

0

0%

0

0%

2,914

Rotunda

189

n/a

0%

n/a

0%

5,859

Royal Victoria Eye and Ear

90

43

48%

563

20%

2,790

Hume Street

31

0

0%

0

0%

961

St. Colmcille's

150

12

8%

372

8%

4,650

St. James's

700

115

16%

984

5%

21,700

St. Lukes's

172

0

0%

0

0%

5,332

St. Michael's

95

18

19%

166

6%

2,945

St. Vincent's

472

33

7%

1,023

7%

14,632

Temple Street

144

42

29%

472

11%

4,464

Tallaght

464

n/a

0%

n/a

0%

14,384

Totals

4,855

462

10%

8,635

0%

150,505

Midland Health Board Area

Mullingar

188

17

9%

187

3%

5,828

Portlaoise

140

0

0%

0

0%

4,340

Tullamore

177

38

21%

516

9%

5,487

Totals

505

55

11%

703

4%

15,655

Mid-Western Health Board Area

Croom

99

14

14%

168

5%

3,069

Ennis

94

0

0%

0

0%

2,914

Limerick Regional

397

16

4%

176

1%

12,307

Limerick Regional Maternity

116

0

0%

0

0%

3,596

Nenagh

74

8

11%

24

1%

2,294

St. John's

104

0

0%

0

0%

3,224

Totals

884

38

4%

368

1%

27,404

North-Eastern Health Board Area

Cavan

184

0

0%

0

0%

5,704

Dundalk

143

0

0%

0

0%

4,433

Monaghan

149

13

9%

117

3%

4,619

Navan

190

23

12%

299

5%

5,890

Drogheda

367

44

12%

408

4%

11,377

Totals

1,033

80

8%

824

3%

32,023

North-Western Health Board Area

Letterkenny

317

15

5%

195

2%

9,827

Sligo

340

55

16%

583

6%

10,540

Totals

657

70

11%

778

4%

20,367

Health Board Area.

BedComplement.

Number of Beds closed in December 1998.

December 1998 bed closures as a % of bed complement.

Number of Bed Days lost in December 1998.

Number of Bed Days lost in December 1998 as a % of number of bed days available.

Number of bed days available December 1998.

South-Eastern Health Board

Cashel

81

23

28%

276

11%

2,511

Clonmel

177

0

0%

0

0%

5,487

Kilcreene

91

0

0%

0

0%

2,821

Kilkenny

198

0

0%

0

0%

6,138

Waterford

393

30

8%

330

3%

12,183

Wexford

196

0

0%

0

0%

6,076

Totals

1,136

53

5%

606

2%

35,216

Southern Health Board

Bantry

68

0

0%

0

0%

2,108

Cork University Hospital

566

0

0%

0

0%

17,546

Erinville

56

0

0%

0

0%

1,736

Gurranebraher

126

0

0%

0

0%

3,906

Mallow

69

0

0%

0

0%

2,139

St. Finbarr's

133

0

0%

0

0%

4,123

Tralee

354

0

0%

0

0%

10,974

Mercy

255

19

7%

247

3%

7,905

South Vctoria

186

92

49%

992

17%

5,766

Totals

1,813

111

6%

1,239

2%

56,203

Western Health Board

Mayo General

270

24

9%

264

3%

8,370

Merlin Park

202

32

16%

320

5%

6,262

Roscommon

120

0

0%

0

0%

3,720

UCHG

538

140

26%

2,158

13%

16,678

Portiuncula

212

36

17%

504

8%

6,572

Totals

1,342

232

17%

3,246

8%

41,602

Overall Totals

12,225

1,101

9%

16,399

4%

378,975

Hospital Bed Closures 1998.

Health Board Area.

BedComplement.

Monthly average number of beds closed in 1998.

Monthly average number of beds closed in 1998 as a % of bed complement.

Monthly average number of bed days lost in 1998.

Monthly average number of bed days lost in 1998 as a % of number of bed days available.

Number of bed days available in 1998.

Eastern Health Board Area

Beaumont Hospital

627

20

3%

629

0.27%

228,855

Cappagh Hospital

126

0

0%

0

0.00%

45,990

The Coombe Hospital

237

0

0%

0

0.00%

86,505

Our Lady's Hospital for Sick

Children, Crumlin

258

0

0%

0

0.00%

94,170

National Maternity Hospital,

Holles Street

206

2

1%

109

0.14%

75,190

Peamount Hospital

60

0

0%

0

0.00%

21,900

James Connolly Memorial Hospital

257

0

0%

0

0.00%

93,805

Mater

483

13

3%

891

0.51%

176,295

Naas General

94

0

0%

0

0.00%

34,310

Rotunda

189

4

2%

34

0.05%

68,985

Royal Victoria Eye and Ear

90

7

8%

227

0.69%

32,850

Hume Street

31

0

0%

0

0.00%

11,315

St. Colmcille's

150

4

3%

258

0.47%

54,750

St. James's

700

22

3%

411

0.16%

255,500

St. Luke's

172

0

0%

0

0.00%

62,780

St. Michael's

95

12

13%

103

0.30%

34,675

St. Vincent's

472

6

1%

397

0.23%

172,280

Temple Street

144

8

6%

70

0.13%

52,560

Tallaght

464

0

0%

0

0.00%

169,360

Totals

4,855

97

2%

3,129

0.18%

1,772,075

Health Board Area.

BedComplement.

Monthly average number of beds closed in 1998.

Monthly average number of beds closed in 1998 as a % of bed complement.

Monthly average number of bed days lost in 1998.

Monthly average number of bed days lost in 1998 as a % of number of bed days available.

Number of bed days available in 1998.

Midland Health Board Area

Mullingar

188

1

1%

16

0.02%

68,620

Portlaoise

140

0

0%

0

0.00%

51,100

Tullamore

177

3

2%

43

0.07%

64,605

Totals

505

5

1%

59

0.03%

184,325

Mid-Western Health Board Area

Croom

99

3

3%

733

2.03%

36,135

Ennis

94

0

0%

0

0.00%

34,310

Limerick Regional

397

10

3%

830

0.57%

144,905

Limerick Reg. Maternity

116

0

0%

0

0.00%

42,340

Nenagh

74

2

3%

16

0.06%

27,010

St. John's

104

0

0%

0

0.00%

37,960

Totals

884

15

2%

1,578

0.49%

32,660

North-Eastern Health Board Area

Cavan

184

0

0%

0

0.00%

67,160

Dundalk

143

2

1%

112

0.21%

52,195

Monaghan

149

1

1%

10

0.02%

54,385

Navan

190

3

2%

313

0.45%

69,350

Drogheda

367

16

4%

57

0.04%

133,955

Totals

1,033

22

2%

491

0.13%

377,045

North-Western Health Board Area

Letterkenny

317

5

2%

268

0.23%

115,705

Sligo

340

10

3%

205

0.17%

124,100

Totals

657

15

2%

473

0.20%

239,805

South Eastern Health Board

Cashel

81

2

2%

81

0.27%

29,565

Clonmel

177

0

0%

0

0.00%

64,605

Kilcreene

91

3

3%

54

0.16%

33,215

Kilkenny

198

3

2%

140

0.19%

72,270

Waterford

393

8

2%

140

0.10%

143,445

Wexford

196

7

4%

218

0.30%

71,540

Totals

1,136

23

2%

633

0.15%

414,640

Southern Health Board

Bantry

68

0

0%

0

0.00%

24,820

Cork University Hospital

566

7

1%

158

0.08%

206,590

Erinville

56

0

0%

0

0.00%

20,440

Gurranebraher

126

0

0%

0

0.00%

45,990

Mallow

69

0

0%

0

0.00%

25,185

St. Finbarr's

133

0

0%

0

0.00%

48,545

Tralee

354

3

1%

23

0.02%

129,210

Mercy

255

4

2%

133

0.14%

93,075

South Victoria

186

14

8%

255

0.38%

67,890

Totals

1,813

28

2%

569

0.09%

661,745

Western Health Board

Mayo General

270

5

2%

102

0.10%

98,550

Merlin Park

202

3

1%

27

0.04%

73,730

Roscommon

120

0

0%

0

0.00%

43,800

UCHG

538

32

6%

553

0.28%

196,370

Portiuncula

212

6

3%

90

0.12%

77,380

Totals

1,342

46

3%

772

0.16%

489,830

Overall Totals

12,225

250

2%

7,704

0.17%

4,462,125

Hospital Bed Closures Due to Nursing Shortages in 1998.

Health Board Area.

BedComplement.

Monthly average number of beds closed in 1998 due to nursing shortages.

Monthly average number of beds closed in 1998 due to nursing shortages as a % of bed complement.

Monthly average number of bed days lost in 1998 due to nursing shortages.

Monthly average number of bed days lost in 1998 due to nursing shortages as a % of number of bed days available.

Bed days available in 1998.

Eastern Health Board Area

Beaumont Hospital

627

10

1.59%

215

0.09%

228,855

Cappagh Hospital

126

0

0.00%

0

0.00%

45,990

The Coombe Hospital

237

0

0.00%

0

0.00%

86,505

Our Lady's Hospital for Sick

Children, Crumlin

258

0

0.00%

0

0.00%

94,170

National Maternity Hospital,

Holles Street

206

0

0.00%

0

0.00%

75,190

Peamount Hospital

60

0

0.00%

0

0.00%

21,900

James Connolly Memorial Hospital

257

0

0.00%

0

0.00%

93,805

Mater

483

3

0.62%

0

0.00%

176,295

Naas General

94

0

0.00%

0

0.00%

34,310

Rotunda

189

0

0.00%

0

0.00%

68,985

Royal Victoria Eye and Ear

90

0

0.00%

0

0.00%

32,850

Hume Street

31

0

0.00%

0

0.00%

11,315

St. Colmcille's

150

1

0.67%

107

0.20%

54,750

St. James's

700

1

0.14%

14

0.01%

255,500

St. Luke's

172

0

0.00%

0

0.00%

62,780

St. Michael's

95

5

5.26%

42

0.12%

34,675

St. Vincent's

472

0

0.00%

0

0.00%

172,280

Temple Street

144

0

0.00%

0

0.00%

52,560

Tallaght

464

n/a

0.00%

0

0.00%

169,360

Totals

4,855

20

0.41%

378

0.02%

1,772,075

Midland Health Board Area

Mullingar

188

0

0.00%

0

0.00%

68,620

Portlaoise

140

0

0.00%

0

0.00%

51,100

Tullamore

177

0

0.00%

0

0.00%

64,605

Totals

505

0

0.00%

0

0.00%

184,325

Mid-Western Health Board Area

Croom

99

0

0.00%

0

0.00%

36,135

Ennis

94

0

0.00%

0

0.00%

34,310

Limerick Regional

397

0

0.00%

0

0.00%

144,905

Limerick Reg. Maternity

116

0

0.00%

0

0.00%

42,340

Nenagh

74

0

0.00%

0

0.00%

27,010

St. John's

104

0

0.00%

0

0.00%

37,960

Totals

884

0

0.00%

0

0.00%

322,660

North-Eastern Health Board Area

Cavan

184

0

0.00%

0

0.00%

67,160

Dundalk

143

0

0.00%

0

0.00%

52,195

Monaghan

149

0

0.00%

0

0.00%

54,385

Navan

190

0

0.00%

0

0.00%

69,350

Drogheda

367

2

0.54%

17

0.01%

133,955

Totals

1,033

2

0.19%

17

0.00%

377,045

North-Western Health Board Area

Letterkenny

317

0

0.00%

0

0.00%

115,705

Sligo

340

0

0.00%

0

0.00%

124,100

Totals

657

0

0.00%

0

0.00%

239,805

Health Board Area.

BedComplement.

Monthly average number of beds closed in 1998.

Monthly average number of beds closed in 1998 as a % of bed complement.

Monthly average number of bed days lost in 1998.

Monthly average number of bed days lost in 1998 as a % of number of bed days available.

Number of bed days available in 1998.

South-Eastern Health Board

Cashel

81

0

0.00%

0

0.00%

29,565

Clonmel

177

0

0.00%

0

0.00%

64,605

Kilcreene

91

0

0.00%

0

0.00%

33,215

Kilkenny

198

0

0.00%

0

0.00%

72,270

Waterford

393

0

0.00%

0

0.00%

143,445

Wexford

196

0

0.00%

0

0.00%

71,540

Totals

1,136

0

0.00%

0

0.00%

414,640

Southern Health Board

Bantry

68

0

0.00%

0

0.00%

24,820

Cork University Hospital

566

0

0.00%

0

0.00%

206,590

Erinville

56

0

0.00%

0

0.00%

20,440

Gurranebraher

126

0

0.00%

0

0.00%

45,990

Mallow

69

0

0.00%

0

0.00%

25,185

St. Finbarr's

133

0

0.00%

0

0.00%

48,545

Tralee

354

0

0.00%

0

0.00%

129,210

Mercy

255

0

0.00%

0

0.00%

93,075

South Victoria

186

0

0.00%

0

0.00%

67,890

Totals

1,813

0

0.00%

0

0.00%

661,745

Western Health Board

Mayo General

270

0

0.00%

0

0.00%

98,550

Merlin Park

202

0

0.00%

0

0.00%

73,730

Roscommon

120

0

0.00%

0

0.00%

43,800

UCHG

538

0

0.00%

0

0.00%

196,370

Portiuncula

212

0

0.00%

0

0.00%

77,380

Totals

1,342

0

0.00%

0

0.00%

489,830

Overall Totals

12,225

22

0.18%

395

0.01%

4,462,125

n/a = not available.