Vol. 513 No. 3
193 Mr. Haughey asked the Minister for Health and Children if he has satisfied himself that accident and emergency departments and acute hospitals can deal in a satisfactory and caring way with medical complaints and convalescent care requirements of the very elderly; the measures, if any, he is taking to deal with this situation; and if he will make a statement on the matter. [2294/00]
I am aware that in recent times hospitals providing accident and emergency services have experienced increased activity. However, it is important to note that while patients may experience delays in accident and emergency departments, every effort is made by the staff to keep these delays to a minimum and to ensure that appropriate medical treatment is provided to all patients at all times.
A contributing factor to the delays for patients who are awaiting admission from accident and emergency departments to acute hospitals is the number of patients who are inappropriately occupying acute hospital beds. The report of the review group on the waiting list initiative indicated that a significant proportion of such 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.
As part of a package of measures to address these problems the Eastern Health Board, in conjunction with the Dublin acute hospitals which provide accident and emergency services, were asked to examine this particular aspect of the service and to formulate a response. The board submitted a comprehensive action plan which takes into account the complex group of patients who need a mixture of sub-acute care services. This group include young chronic sick, physical rehabilitation cases, medical rehabilitation patients and elderly patients. The implementation of the plan, which provides an additional 235 alternative care places to cater for patients across the spectrum, has already been agreed and 205 of the places are already in situ. The remaining 30 will be in place by early February 2000. These 235 places can be broken down as follows: 70 sub-acute-convalescent places, 25 young chronic sick places and 140 long stay contract nursing home places.
194 Dr. Upton asked the Minister for Health and Children the number of empty beds in the Meath Hospital, Dublin 8, which could be used for long-term care of the elderly. [2295/00]
As the Deputy will be aware, services provided at the Meath Hospital transferred to the Adelaide and Meath Hospital, incorporating the National Children's Hospital, Tallaght, on the opening of that hospital in June 1998. The Eastern Health Board subsequently negotiated a lease on the Meath Hospital for the purpose of commissioning and opening a much needed 60 bed sub-acute unit for older people. This service development was essential to ensure that St James's Hospital would have additional support to meet demands upon it following the opening of the new hospital at Tallaght.
The Meath Hospital was later purchased by the Eastern Health Board in late 1999 to provide for the development of a range of important services on a permanent basis. This initiative will focus on the provision of critical services to the local elderly population, and in supporting nearby general hospitals.
The proposals for the development on the Meath Hospital campus are as follows:
The 50 bed unit for older people the range of in-patient services in this unit will include: sub-acute-convalescent care for patients who have completed the acute phase of their medical care; respite-intermittent care for patients being cared for at home but who require short-term planned admission for non-acute care-assessment and-or to give "home carers" respite; and long stay care for patients who have been medically assessed as no longer capable of being cared for in their own home environment.
25 bed facility for secondary rehabilitation is for older persons who, having completed the acute phase of their treatment, require continuing intensive rehabilitation over a planned period of time prior to being discharged back into their own home environment with appropriate community support.
The 60 long stay places currently in situation at the Meath Hospital will be redesigned and together with the additional 15 places will enable the ranges of inpatient services as described above to be provided.
The Eastern Health Board is setting up a register for people who would benefit from a regular attendance at a day care unit. It is expected that up to 20 patients a day would attend such a unit. The range of facilities available will be needs based. However, it is expected that physiotherapy will be provided.
On general practitioner's treatment unit, the Eastern Health Board proposal is to provide support services for the south inner city primary care unit – 29 participating general practitioners – and will include a minor injuries unit and wound dressing clinic. The services will be provided out of hours.
195 Dr. Upton asked the Minister for Health and Children the number of elderly people on waiting lists for long-term care in Dublin. [2296/00]
196 Dr. Upton asked the Minister for Health and Children the number of empty beds in Dublin hospitals and institutions which could be used for long-term care of the elderly. [2297/00]
I propose to take Questions Nos. 195 and 196 together.
I wish to advise the Deputy that there is no spare bed capacity in acute hospitals or in hospitals or extended care facilities in the Dublin region for older people who require long-term care.
I have been informed by the Eastern Health Board that 164 older persons were occupying acute hospital beds in the Eastern Health Board region on 23 January 2000. These people have completed the acute phase of their illnesses and have been medically assessed as being in need of long-term care. The Eastern Health Board has also informed me that there would also be approximately 60 older people in a community setting at any one time who have been medically assessed in the various departments of medicine for the elderly as requiring long-term care in the short to medium term. Following their assessment the older people are reviewed on a regular basis in the day hospital attached to the departments of medicine for the elderly to monitor their progress and their priority need for long-term care.
