Vol. 555 No. 2
79 Ms O. Mitchell asked the Minister for Health and Children the number of the additional 709 public beds promised for 2002 which have been provided; the number which will be in place by the end of 2002; the number of public beds available in July 2001; the number available in July 2002; and if he will make a statement on the matter. [17928/02]
The health strategy, Quality and Fairness – A Health System for You, outlines a programme of investment and reform of the health services up to 2011. As part of the preparatory work for the strategy, my Department, in conjunction with the Department of Finance and in consultation with the social partners, conducted a comprehensive review of acute hospital bed capacity needs. On foot of the subsequent report entitled, Acute Hospital Bed Capacity – A National Review, the Government decided in the context of the strategy to provide an additional 3,000 beds in acute hospitals over the next ten years. This represents the largest ever concentrated expansion of acute hospital capacity in Ireland.
In tandem with the publication of the report, I announced the first phase of these additional beds with the commissioning of an extra 709 beds in acute hospitals at a cost of €65 million. I am pleased to inform the Deputy that 258 of these beds have been commissioned under this initiative to date. The latest advice to my Department from the Eastern Regional Health Authority and the health boards indicates in excess of 600 beds will be in place by year end and that the remainder will be commissioned early in the new year.
The average number of public beds available in July 2001 was 10,339. The equivalent figure for July 2002 was 10,574. It is a feature of all acute hospital systems that the number of beds in use in a hospital at any time will fluctuate depending on a number of factors. Examples of such factors include temporary ward closures due to essential maintenance and the periodic provision of additional temporary beds.
It is now clear that the 709 beds cannot be delivered despite the €65 million provided for them. Can the Minister justify spending €65 million, in theory to commission new beds, when 343 beds were closed during the first three months of this year? This equates to the loss of 16,000 bed days. Does it make economic sense that such sums of money should be spent while beds are lying idle?
The Minister stated that the number of beds fluctuates. Everybody understands the need for refurbishment and maintenance. Is he aware, however, that 30% of all bed closures are due to staff shortages and that the equivalent figure for Dublin, where most acute beds are located, is 60%? What measures are planned to retain nurses in the system given that 70% of each cohort of nurses will have left the nursing profession within 18 months of finishing training? This is an enormous attrition rate.
While I welcome the contribution made by Filipino nurses – it has been widely praised – is it wise to depend so heavily on nurses who may leave the system at any time? In the Mater Hospital, for instance, up to 25% of nurses are foreign nationals working on two year contracts who can leave the country at any time.
In the context of the upcoming budget, how will the Minister justify to the Minister for Finance the continued investment in health when it is clear that much of the money going into the health service has been misspent and spent to ill effect to the extent that everybody in the health sector is dissatisfied? There has been a total failure to tackle the underlying structural problems which are causing the waiting lists and dissatisfaction with the service.
It was always understood in terms of commissioning additional beds this year that the bulk of them would come into commission at the latter end of the year because of the obvious logistics involved in putting them into operation, recruiting staff and other such factors. It is on target. I met the boards, including all the chief executive officers, in September. They informed me and my officials that they expect the figure of 600 additional beds will be exceeded and that some of them will enter commission in January and February 2003. This is the first time we have had such a concentrated, deliberate expansion of beds in our acute hospital capacity.
There will always be bed and ward closures due to refurbishment and maintenance. It is an ongoing feature of the hospital sector. Sometimes these figures are opportunistically used to try to create an impression of beds being closed everywhere, which is not the truth.
With regard to nursing, the retention of nurses and turnover have improved significantly as the regular and annual surveys carried out by the Health Service Employers' Agency are beginning to indicate. While there is still a problem in the Dublin area where we are short about 1,000 nurses, the gap is being closed by agency nurses and overtime. I do not hear hospital directors around the country make the same cries about shortages that they made when I took up this position two and a half years ago. We had to go abroad to recruit nurses. They are making a very important contribution to our health service, which should be welcomed.
It has been acknowledged on all sides of the House, including by members of the main Opposition party, that in the late 1980s and early 1990s many interested parties called for the number of places in nursing training colleges to be reduced. This led to the kind of shortages we have experienced in recent years. However, since 1998 alone we have recruited some 5,500 nurses to work in both expanded and existing parts of the health service.
To turn to the Deputy's core point on dependency, we also have a record number of training places. While we cannot tackle issues from the past, such as the then absence of manpower planning, we are providing a record number of training places – 1,640 – this year.
