Vol. 539 No. 3
3 Mr. G. Mitchell asked the Minister for Health and Children if his attention has been drawn to the report on bed capacity review to the Eastern Regional Health Authority; and if he will make a statement on the matter. [19448/01]
As the Deputy is aware, I initiated a national review of bed capacity in both the acute and non-acute sectors, on foot of the commitment by the Government in the PPF. The review is being conducted by my Department in conjunction with the Department of Finance and in consultation with the social partners. The review is at an advanced stage and will be completed shortly. I will bring the findings of the study to Government with a view to agreeing the overall strategy for the health services.
In parallel with the national review of bed capacity, the Eastern Regional Health Authority prepared a comprehensive needs assessment indicating a requirement for 1,276 additional acute beds by 2011 to meet increasing demands. The objective of the ERHA assessment was to determine whether additional acute beds are required within the eastern region based on good standards of efficiency, population characteristics and medical health care developments.
My Department also invited the Eastern Regional Health Authority and the health boards to submit proposals on measures which could be put in place in the short-term to bring additional bed capacity into the acute hospital system. In this regard the ERHA recently submitted proposals to my Department aimed at increasing bed capacity within the eastern region. The proposals identify potential to increase the acute hospital bed complement in the region by 325 beds and ten extra day care places up to 2003.
I have allocated additional revenue funding of £3 million to the ERHA to support the initiatives proposed. This funding is being utilised by the ERHA to fund the early commissioning of 53 additional beds and support a number of initiatives aimed at alleviating pressure on accident and emergency departments and improving patient services. I am satisfied that this investment will allow for the enhancement of acute hospital services in the eastern region. The additional proposals identified by the ERHA are being examined by my Department and will be considered in the context of funding available and other competing demands.
Is the Minister aware that the eastern region accounts for 41% of acute beds and 41% of all activity nationally? Is he ashamed to learn from the ERHA bed capacity review that there has been a decrease of 31% in acute beds in the eastern region since 1980? The number of acute beds in the region has gone from 7,066 to 4,884, or 4,076 when obstetrics and psychiatry beds are excluded. When bed supply per thousand people in the eastern region is adjusted to account for the 20% of patients treated in ERHA hospitals who are from other health board areas, the ratio of beds is lower than both the ratio in the United Kingdom and the OECD average. Why do certain hospitals, such as those dealing with gynaecology, orthopaedics, ophthalmology or ear, nose and throat conditions, have relatively low occupancy rates, even though the specialties concerned have a high demand and long waiting lists?
Is the Minister aware that the report states that long waiting lists and waiting times for elective admissions are adversely affected by down theatre time? The report mentions a recent ERHA survey that showed that about 22% of theatre time is unavailable, equivalent to one week per month. The main reason given for lost theatre time is a shortage of trained theatre nurses. How can that be allowed to happen in a country that has 60,000 registered nurses, even if only half of them are in the hospital system? The Minister is entering his fifth year in government. How can he account for the figures I have cited?
It takes about three years to train a nurse. On the Order of Business some time ago, Deputy Quinn acknowledged that the rainbow Government did not listen to representations made at the time regarding increases in the number of training places in nursing schools. We are reaping the whirlwind as a result of the lack of foresight shown. Nursing unions lobbied for a cap on nurse training places in the early 1990s. Since the Government came to office, it has dramatically increased the number of training places in nursing schools. There are 1,340 places in such schools this year, an increase on last year's record intake. It will take some time for the nurses to come through, as training courses last three years. A range of measures have been introduced in the interim, not least overseas recruitment. About 4,500 nurses came in to the system last year and when resignations and retirements are taken into account, there was an increase of 1,300 nurses, a significant achievement by any objective standard. The Government has introduced a range of incentives for nurses to take specialist courses, especially in theatre nursing. Fees and salaries will be paid while the courses are being undertaken. Flexitime was introduced last November to improve job retention within the profession, following consultation with the Nursing Alliance.
May I ask a brief supplementary question?
The time for Question No. 3 has come to an end and we need to move on to the next question.
May I take some injury time from Question No. 4 as I wish to ask a supplementary question now?
I am happy enough to take time from Question No. 4.
Is the real problem not the fact that of the 60,000 nurses, only half are working in the health system and it is difficult to attract the other 30,000 back into the system because of the cost of housing and the inconvenience of Dublin? Is it not time to give a salary allowance to former nurses to encourage them back into the system in Dublin? Nobody is interested in the issue because it relates to Dublin but 20% of patients in Dublin hospitals come from outside the city. There are nurses available who should be paid and given an incentive.
I am wary of the figure of 60,000 nurses on the register because all those on it are not available. Many left the profession years ago for other jobs.
Only 1,200 are needed for Dublin.
A great deal of research has highlighted that one of the key issues in regard to keeping nurses in the system is that they want a clear career path in the profession and opportunities for advancement. That is a key measure which is being pursued to ensure nurses stay in the system. We are creating a proper career path, educational opportunities and opportunities for specialisation within the system.
