Jim Mitchell
Question:13 Mr. J. Mitchell asked the Minister for Health and Children if he will provide an additional general hospital for Dublin in view of the pressure on existing general hospitals. [28777/00]
Other Questions. - Hospital Accommodation.
The Deputy will be aware that under the Programme for Prosperity and Fairness, it was agreed to conduct a review of bed capacity in both acute and non-acute settings throughout the areas covered by the Eastern Regional Health Authority and the health boards. The review is being conducted by my Department in conjunction with the Department of Finance and in consultation with the social partners, the Eastern Regional Health Authority and the health boards. It is expected that the review will be conducted next spring. In view of the level of occupancy in the present system and the numbers who are on the waiting list for services, the ERHA decided to carry out an in-depth analysis of the number of beds required in the eastern region as part of the review of bed capacity to deal with the population at present and projected populations. An initial assessment of the needs and analysis would indicate that taking the ten acute hospitals in the eastern region, adjusting for 85% occupancy overall and having regard to the current numbers on in-patient waiting lists, an additional 674 beds are required in the acute hospital system. To maximise the efficiencies of the existing bed capacity, it will also be necessary to provide an infrastructure of hospitals and beds for step-down facilities. The authority is at present analysing the number of beds required for the future on a speciality by speciality basis. While this analysis has not yet been completed it is likely that the overall conclusion will be to provide dedicated elective facilities on a number of sites and additional accommodation at existing hospitals rather than a new acute hospital in the region.
When I raised the issue of the number of beds needed during Priority Questions, the Minister rather testily said it was a silly question to ask. Now we find he knows that the ERHA area alone needs 674 more beds.
No, that is not what the Deputy asked. The Deputy asked—
I asked how many beds the system needed. The record will show I asked that. The Minister did not know the answer and has still not supplied the answer. Given that there is a need for 674 more beds in the ERHA area, has his Department examined the case for an additional hospital for Dublin and if so, who carried out the examination and what was the outcome?
My reply clearly states the options.
Has it been examined?
The Deputy should allow me to make my point. A new acute hospital in Dublin may not solve our problems.
Has it been examined? That is what I am asking.
Can I be allowed to answer the question?
The Minister is in possession.
There are more Members here than just Deputy Mitchell.
I asked the question. The Minister should answer.
I will answer if I get a chance.
The Minister is in possession. I will call Deputy Mitchell for a further supplementary but the Deputy can only ask that supplementary when the Chair names him.
The Minister will not answer any questions.
Will the Deputy allow me three sentences and then he can interrupt me if I have not adequately answered? Regarding the bed review, that option is on the table. As I said, the likely outcome will be that we might be better off looking at a dedicated elective facility to deal with a range of waiting list issues or specific areas like Cappagh, which deals with orthopaedic cases. It may mean providing additional accommodation in the existing acute hospitals, particularly in the area of step-down facilities, rehabilitation and assessment units and so on. I realise that for political and electoral reasons people might like the idea of a new hospital in a particular location, and there are people in my own party who would like that also, but that may not be the best way to approach this issue in terms of needs. That is the reason for the review of bed capacity.
What might be an option is a dedicated elective facility that would not have the pressures of accident and emergency, for example. The one area that is affecting the elective capacity is the fact that accident and emergency major acute hospitals are absorbing huge pressures. Those are the options that people are considering and they are being examined by the process I outlined in my reply.
I am glad to have discovered that the issue of whether Dublin needs another hospital is on the table, as the Minister has put it, but I have not stated whether I want another hospital for Dublin. I am asking the question. That is what I want to find out.
Fair enough.
If the Minister is talking about what he calls another dedicated elective hospital facility, that would mean that if we were to build an additional elective facility at Tallaght Hospital or St. James's Hospital, people would go into that facility ahead of other people on the list, irrespective of the condition of other people. In other words, it would be specifically dedicated to elective cases. That is an important departure from policy heretofore. Will the Minister tell us the philosophy that informs that approach?
It is an option. It is a possibility.
I thought an option was a possibility.
There has been no policy shift yet. It is a possibility that we may be providing a dedicated elective facility. We may have a clearer picture when the review concludes in March. There might be a provision for dedicated elective sites. To a large extent beds that are intended for elective use in acute hospitals are occupied very quickly and hence elective procedures are put back, particularly during the winter months. The backlog then starts again in terms of waiting lists. Equally it could be argued that there may be a need to increase the number of medical beds. Those are the options being considered. Other people will argue that a dedicated site is not the best way forward from a medical perspective. There are people in the medical area who have reservations about that approach.
The Minister is the man to decide that.