Dáil Éireann Debate, Tuesday - 22 June 2004
3 Mr. S. Ryan asked the Minister for Health and Children if he will report on the waiting lists for public nursing home beds given that it is alleged that in the Dublin area there is a waiting list of up to 12.5 years; if, in light of this situation, he will consider availing of the country’s vacant beds in private nursing homes; and if he will make a statement on the matter. [18626/04]
View answerAs the Deputy is aware, the administration of health services, including the placement of people into long-term care, is, in the first instance, a matter for the Eastern Regional Health Authority, ERHA, and the health boards.
I am aware that the Dublin academic teaching hospitals, DATHs, have been encountering problems with delayed discharges of patients whose acute phase of treatment has been completed and who require to be discharged to more appropriate facilities. However, the claim that people might have to wait for up to 12 and a half years for discharge was, in my view, unjustified.
The Deputy may be interested to know that I have regularly met administrative and medical representatives of the ERHA, the area health boards and the DATHs and, at the most recent meeting, I was advised by the authority that it has commenced a programme to re-open public extended care beds. I am, therefore, fully cognisant of the issues involved. The Minister of State, Deputy Callely, is involved in these meetings.
I understand the ERHA has made strenuous efforts in recent months to recruit staff and that these efforts are beginning to show results. This has allowed for the re-opening of 93 public extended care beds to date.
Additional funding of €13.8 million has been provided to the ERHA this year to facilitate the discharge of patients from the acute system to a more appropriate setting, thereby freeing up acute beds. It allows for funding through the subvention system of additional beds in the private nursing home sector and ongoing support in the community. This funding has already resulted in the discharge of more than 350 patients from acute hospitals in the eastern region to different locations, the majority to private nursing homes.
The ERHA is actively monitoring the situation and working with hospitals, the area health boards and the private nursing home sector to ensure every effort is made to minimise the number of delayed discharges from acute hospitals.
The option of accessing beds in private nursing homes will be considered on an ongoing basis, bearing in mind that, for a variety of reasons, private nursing home beds often may not be suitable for the discharge of heavily dependent older people from acute hospitals.
My Department provides significant funding for the nursing home subvention scheme and more than €443 million has been allocated cumulatively over the past five years. In 2000, the budget available for the scheme was €48.439 million and, this year, €115 million was made available, which is an increase of 137%.
I will continue to monitor the situation to ensure that, to the greatest extent possible, problems encountered by older people in the greater Dublin area in accessing services appropriate to their needs are minimised.
The Minister stated that both he and the Minister of State, Deputy Callely, will monitor the situation but the reality is slightly different. The Minister's response to a recent request is unacceptable and shows a disregard for the needs of older people at a time when community care and home help services have been slashed.
Does the Minister accept that community care areas, especially those in the greater Dublin area, are reporting a 12 and a half year waiting list for long-term public nursing care, especially since the withdrawal of contract beds from the system in September 2003? Arising from that, does the Minister accept that hundreds of acute hospital beds are being inappropriately occupied by older people in acute hospitals, thus leading to ongoing bed shortages and long waiting periods on trolleys in accident and emergency units while, at the same time, more than 2,000 private nursing home beds are unoccupied? Is it not time we examined this area to try to deal with the problem? The Minister's response generally referred to subvention, but the real problem is that the people who cannot afford subvention are being told that they will be dead before they have access to a public nursing home in 12 and a half years' time.
I do not accept the basic content of the Deputy's argument. He is correct in one point in that it requires an overall package of measures which include community and nursing unit beds in the public sector, beds in the private nursing home sector, home care packages, which have been piloted in the Dublin region, and a more innovative approach to the procurement and securing of additional beds in the Dublin region. That is the reason we started out on the first public private partnership in health with a view to securing an additional 450 beds.
That is a long time away.
It is on the way. Unfortunately, due process must be entered into in the context of public private partnerships in that they must be advertised in the Official Journal of the European Communities and go through the entire design phase. That is taking its course, but it is happening and is the most effective way we can significantly increase, within the next two years, the availability of beds in community nursing units on the public side.
Historically, there has been a dearth of such public beds in Dublin because of the closure of many district hospitals in the 1980s and early 1990s. In the interim period, we have provided an increase of up to 137% in the cost of funding private nursing homes. Following discussions last year, additional funding has been given to the Eastern Regional Health Authority for a package of measures designed to free up acute beds and to allow the reasonable referral of patients, who have had acute treatment, to continuing care beds. This is done in a way to maximise allocation of beds and ensure value for money. This funding has resulted in approximately 330 people securing beds. The Department will continue to work with the Eastern Regional Health Authority in monitoring this and see how it can be improved.
The time for this question has concluded. Ceist Uimh. 4 in ainm an Teachta Cowley.
A Cheann Comhairle——
There are only six minutes for questions.
I only had one contribution. The Minister for Health and Children took up most of the time in answering.
The Deputy's contribution took almost two minutes. The Chair has no control over the length of time for questions.
It is unacceptable that the Minister takes up most of the allocated time and still gives no real answer.
I understand, but the way to change it is through Dáil reform. I call on the Minister to reply to Question No. 4.
