I thank the Cathaoirleach for allowing me to raise this matter and I welcome back the Minister of State who was in the House yesterday. I raise this matter to get the Minister of State to outline the reason acute hospitals are penalised for keeping patients for too long without due regard to the medical need of the patients whose interests should be the priority consideration. This has come to light in recent weeks where about ten hospitals have been fined almost £2 million for apparent delays in discharging patients. There is a worrying trend that patients may not be given priority consideration and that hospital administration will take precedence to the point where doctors will be concerned that patients are staying too long.
All of us have been or have had relatives who have been in hospital. Doctors will usually say that one will be discharged within a few days, a week or whatever. However, various factors can delay that, such as the patient not responding quickly, their contracting an infection or the doctor being very busy in theatre and not being able to discharge the patient until the next day. There are various average lengths of stay in hospital for various medical procedures. For pneumonia, the average stay is 15 days, for angina it is seven days, for cataracts it is three days, for hip replacements it is 17 days, for a coronary bypass it is 15 days and for a hysterectomy it is five days. Obviously no two cases are alike so it is important that the signal be sent out that decisions on the length of stay and when a person will be discharged will be made on medical grounds and not on the basis of financial considerations.
I accept that hospitals must be run on an economic basis and that, for administrative purposes, it is important that a bed be cleared after a week or ten days. However, a patient's health must be the priority and doctors must make decisions on medical rather than economic grounds. The health, care and welfare of the patient must always come first. I accept the medical service is sometimes top heavy with administration and that there is room for improvement in the running and operation of health boards and hospitals and the administration of procedures. Part of the problem is that a patient may go to convalesce in a nursing home for post-operative care and a bed in such places may not always be immediately available. That is an area which should be examined.
I hope the Minister of State can reassure us that primary consideration will be given to the health and welfare of patients, that it will the number one priority and that doctors, in consultation with nurses, will make the decision whether it is prudent to discharge the patient or to move them to another place. We are all aware of the chronic situation surrounding the admission people to nursing homes, the operation of the homes and the manner in which beds become available in them. I hope it is not the case that the Department is seeking to penalise hospitals because patients' care and welfare have been put first.
A case in Drogheda attracted a great deal of attention and Professor Jimmy Sheehan, one of the leading orthopaedic surgeons, wrote to the papers saying it is imperative that the doctor or surgeon makes the decision and that, while there is an average length of stay for cases, every case is different and people could have a setback. He also said that people should not be put under unnecessary pressure because they stay longer in hospital than the average for their condition. I remember a case some time ago in my constituency where a seriously ill woman left hospital early, suffered a relapse and died.
Perhaps the Minister of State would take on board what I have said and reassure us that, while she would wish to be prudent, in certain medical cases there is more to it than just balancing the books.
