John Gormley
Question:131 Mr. Gormley asked the Minister for Health and Children the measures he intends to take to deal with the ongoing accident and emergency crisis; and if he will make a statement on the matter. [27588/03]
Written Answers. - Accident and Emergency Services.
The single most important factor for admission to hospital is bed availability. A report entitled Acute Hospital Bed Capacity – A National Review, carried out by my Department, iden tified a requirement for an additional 3,000 acute beds in acute hospitals by 2011 and this requirement is reflected in the Government's health strategy, Quality and Fairness – A Health System for You. Some 568 of these beds have been commissioned to date.
In order to address the current increase in demand for acute beds I have provided additional funding of €5.5 million in 2003 by way of €3.8 million to the Eastern Regional Health Authority and €1.7 million to the Southern Health Board to facilitate the discharge of patients from acute hospitals to a more appropriate setting thus freeing up acute beds.
Following the accident and emergency nurses strike in March 2002 the Labour Relations Commission put forward a number of proposals in the area of accident and emergency management. It was agreed that the bed management function was fundamental to the consistent application of admission and discharge policy. In May 2002, CAPITA consulting were commissioned by the Health Service Employers Agency, HSEA, to carry out a national review of the bed management function. This review made specific recommendations that will assist hospitals to structure more effective and integrated bed management departments. The implementation of the recommendations contained in the CAPITA report are now being progressed by a combined management and nursing union steering group under the chairmanship of the HSEA.
The HSEA also commissioned a detailed two stage staffing review of nurse staffing levels required in 36 dedicated emergency departments around the country. The staffing review examined existing structures and staffing levels in emergency medicine departments and included an assessment of the appropriate support, professional nursing role, skills and structures required. The second stage of the review has just been completed and the draft final report has been presented. As part of the process of considering the final report it is expected that the consultants will make a presentation on their findings to management and nursing unions in the near future.
As part of the winter initiative package in 2000-01, additional funding of some €40 million aimed at alleviating service pressures and maintaining services to patients was provided. Part of this investment package was aimed at the recruitment of an additional 29 emergency medicine consultants, of which 20 have been recruited to date.
I launched the influenza vaccination campaign 2003-04 in September 2003. The influenza vaccine is available free of charge from general practitioners to medical card holders who are deemed to be at risk of contracting the disease. The at risk groups include persons aged 65 years or older, those with specific chronic illness such as chronic heart, lung or kidney disease, and those with a suppressed immune system. The immunisation advisory committee of the Royal College of Physicians of Ireland advises that influenza vaccine should be considered for all health care workers who have direct patient contact in both the community and health care institutions such as hospitals and nursing homes. I have asked that the health boards encourage health care workers, particularly those on the frontline, to be immunised annually against influenza.
Emergency medicine departments sometimes have to deal with injuries and conditions which are more appropriate to a primary care setting. There are out of hours co-operatives in all health board areas at present and Government support for the development of general practitioner out of hours co-operatives nationally for the period 1997 to 2003 amounted to €46.5 million. In time, these co-ops can be developed further to ensure that communities, irrespective of size and distance from major urban centres, enjoy appropriate access to primary care services.
I also understand that in the coming months, the ERHA has initiated a media campaign highlighting the pressures that exist in emergency medicine departments and encouraging appropriate attendances at accident and emergency departments.