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Dáil Éireann debate -
Thursday, 21 Nov 2002

Vol. 557 No. 6

Written Answers. - Hospital Waiting Lists.

Olivia Mitchell

Question:

11 Ms O. Mitchell asked the Minister for Health and Children the action being taken to ensure that acute hospital beds are not inappropriately occupied; and if he will make a statement on the matter. [22842/02]

Olivia Mitchell

Question:

174 Ms O. Mitchell asked the Minister for Health and Children the action being taken to ensure that acute hospital beds are not inappropriately occupied; and if he will make a statement on the matter. [23087/02]

I propose to take Questions Nos. 11 and 174 together.

The decision to discharge a patient from hospital is a matter for the patient's consultant, based on clinical judgment and assessment of the patient's condition. One of the factors which was identified by the review of acute hospital bed capacity as contributing to pressure on the acute hospital system was the inability to discharge patients who have completed the acute phase of their treatment, but who require further care in a more appropriate setting, such as long-term care, rehabilitation, hospice care, convalescence, etc. A number of initiatives are under way to address the capacity problems affecting the acute hospital system.

In the context of the health strategy, the Government decided 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. Earlier this year I announced the first phase of these additional beds with the commissioning of an extra 709 beds in acute hospitals. Some 272 of these beds have been commissioned under this initiative to date. The latest advice to my Department from the Eastern Regional Health Authority, ERHA, and the health boards indicates that 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 increase in bed capacity will allow the hospital system to significantly increase activity levels for public patients.
Under the winter initiative funding has been provided for contracting of additional places in private nursing homes to help reduce the effect of inappropriately placed patients on the acute hospital system; recruitment of additional accident and emergency consultants and consultant anaesthetists and the provision of a range of supports including walking aids, wheelchairs and special beds.
My Department has plans for a pilot project under the public private partnership initiative in the health sector to provide long stay accommodation for older people in community nursing units, CNUs. The services offered in these units will include assessment/rehabilitation, respite, extended care, elderly mentally infirm and convalescence. Day centres for the elderly will be combined with the community nursing units in each site to help promote the dignity and independence of older people and to support them in living at home. It is anticipated that 17 new community nursing units will be created when the PPP initial plot programme is complete, providing up to a maximum of 850 new beds. The provision of the additional beds to be provided under the pilot PPP programme will free up acute hospital beds where older people may be inappropriately placed and provide a higher quality of care for those people who require the various services provided by community nursing units.
In accordance with the health strategy, strategies are being developed in the areas of primary and community care, services for older people and physical and sensory disability services to increase the capacity of such services to provide the necessary care in the appropriate setting. The range of measures described above will help to alleviate the pressures being experienced by the acute hospital system in terms of capacity. I will continue to work towards increasing capacity to ensure that the ever increasing demand for services can be met.
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