Dáil Éireann debate -
Thursday, 7 Oct 1999

Vol. 508 No. 5

Written Answers. - Hospital Services.

Róisín Shortall

Question:

101 Ms Shortall asked the Minister for Health and Children the discussions, if any, he has had with Beaumont Hospital concerning the persistent lengthy delays in the casualty unit; the reason the hospital is unable to cope with the level of patient demand; the plans, if any, he has to address these problems; and if he will make a statement on the matter. [19436/99]

Minister for Health and Children (Mr. Cowen)

As the Deputy may be aware, the levels of attendance at accident and emergency depart ments 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. This additional funding allowed the Eastern Health Board to run a national public education campaign aimed at persuading people with minor ailments to attend their family doctor rather than a hospital A&E department, and was also used to develop a range of initiatives in major A&E departments. Within this funding, Beaumont Hospital received an allocation of £200,000. The hospital used this funding to provide 24-hour, 7-day-week registrar cover in the department; to introduce a 24-hour triage nursing service, and to appoint a nurse practitioner and improve nurse staffing levels.

This year I provided further funding of £2 million to enable major acute hospitals to implement various initiatives aimed at addressing some of the difficulties being experienced in our accident and emergency departments particularly during periods of peak demand. These initiatives will include measures to free up beds for emergency admissions through the provision of alternative step down facilities for patients occupying beds in acute hospitals for lengthy periods. They will allow for the provision of enhanced staffing levels, the development of rapid diagnostic systems for common emergency presentations, continued development of treatment-observation areas in accident and emergency departments and an improved access for general practitioners to urgent specialist opinion.

As part of this overall funding, a sum of £200,000 was allocated to Beaumont Hospital for the refurbishment of the treatment areas and overall enhancement of the A&E department to create more comfortable conditions for patients.

As is clear from the above, the accommodation of patients in the A&E department at Beaumont Hospital is under constant review and continues to be a main priority for the hospital.

The Deputy will be aware that I have also 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 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. The report recommended 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 inap propriately 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.

In an effort to address these problems, 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. 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 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. 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.