Dáil Éireann debate -
Tuesday, 1 Jun 1999

Vol. 505 No. 6

Written Answers. - Hospital Services.

Róisín Shortall

Question:

179 Ms Shortall asked the Minister for Health and Children if his attention has been drawn to the critical shortage of places for the young chronic sick in Dublin's health services; if his attention has further been drawn to the absence of long-term care facilities for persons under the age of 65 who have been diagnosed as having progressive Alzheimer's disease; the steps, if any, he will take to address this problem as a matter of urgency; and if he will make a statement on the matter. [14577/99]

Minister for Health and Children (Mr. Cowen)

The need for further places for the young chronic sick is part of the overall picture in relation to pressures on acute hospital beds and the service needs of people with severe physical disabilities. This need has been adverted to in the report of the review group on health and personal social services for people with physical and sensory disabilities, Towards an Independent Future, published in December 1996. The Government is committed to the implementation of the report's recommendations as funding becomes available.

With the exception of one private institution in the Dublin area, there are no specialised residential facilities for people with Alzheimer's disease. Because of the wide range in the effects of the disease, people with Alzheimer's disease avail of a variety of health services, from supports in the community to residential care. I have no proposals before me to develop a specialised unit for people with the disease.

Róisín Shortall

Question:

180 Ms Shortall asked the Minister for Health and Children if his attention has been drawn to the persistently long queues at the casualty unit at Beaumont Hospital; the reason in this regard; the steps, if any, he is taking to deal with this problem; if he will intervene in the case of a person (details supplied) in Dublin 11 who has had to endure this problem three times in 1999; and if he will make a statement on the matter. [14578/99]

Minister for Health and Children (Mr. Cowen)

The levels of attendance at accident and emergency departments are complex and difficult to predict and in this regard all accident and emergency departments experience periods of exceptional demand which can result in delays for patients. However, it is important to note that appropriate medical treatment is provided at all times and that waiting periods are kept to an absolute minimum.

In 1998, I made an additional £2.3 million available for the development of accident and emergency services across the acute sector and in 1999, a further sum of £2 million was provided for this purpose. Included in this was the provision of funding to the Eastern Health Board for a national public education campaign aimed at persuading people with minor ailments to attend their family doctor rather than a hospital accident and emergency department, and also the development of a range of initiatives in major accident and emergency departments.

As part of this overall funding, £200,000 was allocated to Beaumont Hospital in 1998 and a further £200,000 was made available to the hospital in 1999 for accident and emergency improvements. Within this funding, the hospital has undertaken a number of measures to improve systems for dealing with patients attending the accident and emergency department. A 24 hour triage system has been introduced to ensure that patients are seen in order of clinical need rather than in order of attendance. A GP liaison sister has been appointed to ensure a good quality integrated hospital-community service to patients who present in the accident and emergency department.

I have also published the report of the review group on the waiting list initiative. The report makes a number of recommendations aimed at freeing up acute facilities for more elective work and I am committed to ensuring that its recommended approach is implemented. The report is one of a number of measures which I have taken to address the question of long waiting lists and waiting times. I have provided a total of £20 million for waiting list activity in 1999. This is a 66 per cent increase over the amount provided in 1998 and is two and a half times higher than the sum of £8 million provided by the previous Government in 1997.

I have provided extra funding in 1999 of £9 million for services for older people. This funding will help 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. I am confident that the measures I have outlined will contribute to improvements in availability of beds in the acute sector and ease pressures in accident and emergency departments in Dublin.

With regard to this patient, I have asked the chief executive officer of Beaumont Hospital to investigate the position in this case and, given the particular circumstances, I have requested that he reply to the Deputy directly as a matter of urgency.

Róisín Shortall

Question:

181 Ms Shortall asked the Minister for Health and Children his views regarding the discharge policies of health boards and voluntary hospitals, particularly in relation to elderly patients; if he will introduce procedures to ensure that vulnerable elderly patients are not discharged without first contacting a family member; and if he will make a statement on the matter. [14579/99]

Minister for Health and Children (Mr. Cowen)

I am conscious of the importance of ensuring an effective, patient friendly approach to arranging the discharge of people who have received treatment in hospital. In the case of older or vulnerable people, I would regard it as standard good practice for hospitals to contact an appropriate relative in advance of the patient's discharge.

My Department issued a policy circular and guidelines on 7 January 1999 in relation to waiting lists, in which the importance of making proper arrangements for post-hospital care was emphasised to all agencies. This included ensuring that acute hospitals would arrange for the provision of convalescent care for older persons, and for other patients who require it, following discharge from an acute hospital.

I have allocated a total of £9 million this year to services for older persons to enable acute hospitals to discharge older patients to appropriate step-down and other sub-acute facilities where these are needed.