Dáil Éireann debate -
Thursday, 22 Apr 1999

Vol. 503 No. 5

Written Answers. - Hospital Waiting Lists.

Ivor Callely

Question:

39 Mr. Callely asked the Minister for Health and Children if his attention has been drawn to the views of the chief executive officers of the Dublin general hospitals regarding the difficulties being experienced for hospital beds; the number of general hospital beds available in the city in 1999; the population it serves; the comparison figure for 1979; the catchment area for Beaumont Hospital; the population growth in the Fingal area over the past decade; if he will consider the feasibility and the need for a new general hospital to cover the growing Fingal area; and if he will make a statement on the matter. [10427/99]

Minister for Health and Children (Mr. Cowen)

The total number of acute hospital beds in public hospitals in the Eastern Health Board area is 4,855, comprising 4,548 in-patient beds and 307 day beds. The most recent census of population (1996) showed that the population of the Eastern Health Board area was 1.3 million. This compares with a figure of 1.17 million in 1979. The 1996 census of population also showed that the Fingal area had a population of 167,683 compared with a population of 138,479 in the 1986 census.

Each of the major Dublin acute hospitals provides a local service to its immediate hinterland. However, referral is a matter for the general practitioner in the first instance, exercising his or her clinical judgment on the hospital of choice. In addition, many of the hospitals in the Dublin area provide both regional and national specialities and referrals to these specialities from outside the Dublin area are a significant feature of their activities.

There are no plans for the development of a new hospital in the Fingal area in the immediate future. The Deputy will be aware however, that I recently announced the level of capital investment in the health services for the next three years. Exchequer capital spending on the health service infrastructure which will total £525 million over the next three years, includes provision for a number of major hospital developments in the North Dublin region. In this context, it is worth mentioning one major development in particular which is under way in North Dublin.

I recently gave approval to the appointment of a design team for a major capital development at James Connolly Memorial Hospital. This development will include the provision of new acute wards and the refurbishment of existing wards, new intensive care and coronary care units, a new accident & emergency department and a new department of physical medicine. I am unable to give a precise timetable for this development because, like all major capital projects, the timing for planning, tendering and construction depends on several variable factors which are extremely difficult to assess accurately in advance. However, I would be hopeful that Phase 1 of the development will be completed in 2001.

I am of course, aware of the difficulties being experienced in relation to access to hospital beds. I have recently published the report of the review group on the waiting list initiative and am committed to ensuring that its recommended approach is implemented. The report recom mended the implementation of a range of steps to free up acute hospital facilities for more elective work. It pointed out that a significant proportion of acute hospital beds were being inappropriately used by patients who did not need, or who no longer needed, acute hospital care. This problem arises due to a shortage of places in the areas of "step-down" or convalescent care, rehabilitation facilities and community based services which reduce the need to use acute hospital care.

Accordingly, I have provided funding in 1999 of £3.83 million for the development of Services for Older People in the Eastern Region which will be an important factor in helping to free up acute hospital beds which are currently occupied by patients who could be accommodated in more appropriate convalescent or extended care facilities or discharged home if adequate community supports were available. It will be used,inter alia, to improve the home help service, increase the number of nursing and paramedical staff in the community, provide support for carers, enable a number of new health board convalescent or extended care facilities to open and increase the number of private nursing home places either subvented or contracted by health boards.

There are also a number of chronic sick in acute hospitals who have completed the acute phase of their illness and who are awaiting placement at a level of care more appropriate to their needs. The task of identifying and securing appropriate alternative care facilities for them is under way and this also will have a significant impact on freeing up acute beds in general hospitals over the coming months.