Dáil Éireann Debate, Wednesday - 3 March 2004
102 Mr. Costello asked the Minister for Health and Children if his attention has been drawn to the comments made by a person (details supplied) who described conditions in the casualty unit of the Mater Hospital as a disgrace, unsafe and inhumane; the steps being taken to address such conditions in that and other accident and emergency departments; and if he will make a statement on the matter. [7010/04]
View answerAt the outset, I should say that both my Department and the Eastern Regional Health Authority accept the need for upgrading of the accident and emergency department at the Mater Hospital. In October 2002, my Department approved a capital grant of €1.355 million for that purpose. That upgrading will, apart from benefiting accident and emergency patients, staff and clinical risk management in general, reduce hospital admissions and expand the available complement of hospital beds.
Due to the nature of the accident and emergency department, it was necessary to phase work on the project, which commenced in April 2003. My Department is advised by the ERHA that a new three-bay resuscitation area and wound care clinic have now been completed, while the final stages of the project, which relate to security and upgrade of the entrance, are expected to be completed within eight weeks. It is acknowledged that, owing to ongoing pressure in the accident and emergency department, programming of the project has been difficult. However, the Deputy will appreciate that clinical priorities have at all times taken precedence over project work.
Pressures on the hospital system arise, inter alia, from demands on emergency departments and difficulties associated with patients who no longer require acute treatment but are still dependent. There are several initiatives under way to deal with those pressures. Planning for the discharge of patients by acute hospitals and liaison with the community services has been prioritised on an ongoing basis by the Eastern Regional Health Authority and the health boards. ERHA initiatives such as Homefirst, Slán Abhaile and home subvention are all contributing to providing alternative care packages for older people so that they can be discharged.
The single most important factor for admission to hospital is bed availability. Acute Hospital Bed Capacity — A National Review, a report published by my Department, identified a requirement for an additional 3,000 acute beds in acute hospitals by 2011. Some 568 of the 709 beds in the first phase have been commissioned, of which 253 are in the eastern region. Revenue funding of approximately €40 million has been made available to the ERHA for those beds. Funding is available to enable the balance of the beds to be brought into operation this year. Also under the acute bed capacity initiative, my Department has allocated an additional €8.8 million to the ERHA and €3.8 million to the Southern Health Board to facilitate the discharge of patients from the acute system to a more appropriate setting, thereby freeing acute beds.
My Department is also advised by the ERHA that it is working closely with the major acute hospitals in Dublin with a view to re-opening beds closed owing to staffing difficulties. An additional 20 accident and emergency consultants have been appointed from the 29 approved. Additional appointments are being worked on by the health boards and the ERHA. Reviews of the bed management function and nurse staffing levels in emergency departments are being progressed by the Health Services Employers Agency in consultation with health service management representatives and the nursing unions.
Emergency medicine departments sometimes deal with injuries and conditions which are more appropriate to a primary care setting. General practitioner out-of-hours co-operatives have been established and are operating in at least part of all the health board areas, with one health board, the North Eastern Health Board, having a region-wide project. A total of €46.5 million was allocated for the development of out-of-hours co-operatives between 1997 and 2003.
A media campaign has been undertaken on radio and television and in the newspapers highlighting the pressures that exist in emergency medicine Departments and encouraging people to attend only if absolutely necessary. This initiative is an attempt to focus on the need for only those in need of emergency care to attend and for others to use the primary care services. I would like to assure the Deputy that I will continue to work with the various health agencies in looking for short-term and longer-term solutions to the current difficulties.
