Dáil Éireann debate -
Wednesday, 5 Dec 2001

Vol. 545 No. 5

Written Answers. - Hospital Accommodation.

Róisín Shortall

Question:

92 Ms Shortall asked the Minister for Health and Children if his attention has been drawn to concerns expressed by the Irish Association of Emergency Medicine that the shortage of beds has become so acute that some patients who are recommended for admission by accident and emergency consultants never get beds; the steps being taken to deal with this situation; and if he will make a statement on the matter. [30910/01]

Minister for Health and Children (Mr. Martin)

The Deputy will be aware that attendance patterns at A&E departments are difficult to predict accurately in advance. Periods of exceptional demand can be experienced. I can assure her that every effort is made to keep waiting times to a minimum and that appropriate medical care is provided at all times.

Hospitals providing A&E services operate a triage system whereby each patient attending an A&E department is assessed and treated in accordance with his-her medical priority. The objective is to ensure that people requiring treatment are treated without undue delay.

Measures which I have already taken to improve A&E services include the provision of a £32 million or 40.632 million investment package aimed at alleviating anticipated service pressures and maintaining services to patients, particularly in the acute hospital sector. The investment package has been targeted at a number of key service areas, including the recruitment of 29 A&E consultants. The recruitment of additional consultants to this key area is designed to reduce any unnecessary delays experienced by patients attending A&E departments and to ensure that patients have improved access to a prompt senior clinical decision-making service.

Additional funding was also provided for the contracting of additional private nursing home places by the ERHA and the health boards. These places are for patients whose acute phase of treatment has been completed but who require additional care in an alternative setting. The ERHA and the health boards contracted over 700 beds under the initiative and this helped to free up acute beds for patients awaiting admission to hospital.

A comprehensive review of acute hospital bed capacity needs has been conducted by my Department in conjunction with the Department of Finance and in consultation with the social partners. On foot of that review the Government has decided in the context of the new health strategy entitled, Quality and Fairness: A Health System for You, to provide an additional 3,000 beds in acute hospitals over the next ten years. A total of 650 of these beds will be in place by the end of 2002. This additional bed capacity will contribute significantly to a reduction in waiting times in A&E departments for patients deemed to require admission for further care and treatment. The next phase of the review will involve an examination and assessment of clinical activity data by specialty.

Other initiatives identified in the strategy to improve the operation of A&E departments include: the establishment of 24 hour GP co-operatives as part of the strengthening of primary care which will help reduce demand from, and treat appropriately, patients who would otherwise have to go to an A&E department; the establishment of minor injury units to ensure appropriate treatment and management of non-urgent cases; the use of chest pain clinics, respiratory clinics and in-house specialist teams to fast track patients as appropriate; the organisation of diagnostic services to ensure increased access to and availability of services at busy times in A&E departments; the appointment of advanced nurse practitioners for emergencies in acute hospitals – ANPs diagnose and treat groups of patients independently within agreed protocols; the use of admission protocols to ensure that emergency patients will be the only group of patients admitted to hospital through the A&E department; the appointment of a member of staff to liaise with patients while they await diagnosis and treatment at A&E departments; and the introduction of information systems that record comprehensive, comparable and reliable data on activity in A&E departments. Such information will provide staff with a valuable tool in structuring services to meet the needs of patients.

I have also requested Comhairle na nOspidéal to review the structure, operation and staffing of A&E services and departments with the aim of improving the provision and quality of patient care. Comhairle established an A&E committee to undertake the review. To date the committee has been engaged in an extensive consultation process, meeting and receiving submissions from representatives of each health board, relevant voluntary hospitals, appropriate professional bodies and other interested parties. The committee has also obtained information on attendances in each A&E department from each health board and acute general hospital. It has also reviewed extensive literature regarding A&E services in Britain, Europe, the US, Canada and Australia. I am informed by Comhairle that it is expected that the committee will complete its report by the end of this year.