Dáil Éireann Debate, Tuesday - 13 July 2021
33. Deputy David Cullinane asked the Minister for Health the level of overcrowding in hospitals; his plans to expand hospital capacity in the coming months; and if he will make a statement on the matter. [37545/21]
View answerMy question is about overcrowding in acute hospitals. I am sure the Minister will have seen the repeated warnings from healthcare trade unions over the past number of weeks to the effect that hospital overcrowding is very close to being back at pre-pandemic levels, which is unacceptable.
We know overcrowding in hospitals is a symptom of a wider problem with regard to a lack of capacity. What are the levels of overcrowding in hospitals? What is the Minister going to do to increase capacity in our public systems to reduce overcrowding on one hand but also reduce unacceptably high wait times?
I thank the Deputy for raising this very important issue. I acknowledge that our hospital system is facing challenges and has been close to full capacity in recent weeks.
It is very important to acknowledge this has caused distress for patients, their families, and of course for our frontline healthcare workers who are working in very challenging conditions.
Attendances at emergency departments, EDs, have increased steadily since the beginning of the year and were almost back to 2019 levels, for the same time that year, just before the ransomware attack occurred in May. The last year with which reasonable comparisons can be made is 2019 due to the unusual attendance patterns in 2020. The HSE has estimated that for the week ending 4 July attendances were up 12% on the same time in 2019. There are a number of reasons for this, including the opening up of society as Covid-19 restrictions are lifted and additional GP referrals due to issues accessing diagnostics arising from the ransomware attack. The increased attendances, Covid-19-related patient safety protocols, and manual workarounds and reduced access to diagnostics due to the ransomware attack, have all been contributing to slower progress of patients through the system. The Government has funded significant initiatives across the health service to expand capacity, including, as Deputy Cullinane and I have discussed before, the €600 million invested in the last winter plan. It is worth noting that in spite of all the pressures Covid brought to bear over the winter, thanks to this very significant investment and extraordinary work right across our healthcare system, the ED attendances for the winter, which arguably should have been the highest on record, were the lowest on record. I credit everyone in our healthcare system who contributed to that. I have more I can share with the Deputy in the follow-up.
It is the case that overcrowding is becoming a problem in hospitals again. That was always going to be the case as we came out of a very difficult time for those who work on the front line. I acknowledge that, as the Minister said, it a has been a very difficult year for those on the front line because of Covid on the one hand, which led to the cancellation of much non-essential healthcare and a slowing down at times of essential healthcare and then on the other we had the cyberattack. However, the waiting lists were a problem long before the pandemic and overcrowding was a problem long before the pandemic. While the Government did make substantial additional investment available to the healthcare system last year in the budget, if one tries to find out how many of the beds were delivered, be they acute beds or community ones, it is very difficult to get the answers. Maybe that is down to the cyberattack but I would like it if the Minister was able to share that information with us.
For the Minister's information, next week I will be launching a document myself on how we can reduce waiting lists. The Government often asks where the Opposition's solutions are. I have some of those solutions in the document. I will ensure the Minister gets a copy of this and would like to see him bring forward his plan for how we are going to reduce waiting lists in the time ahead.
I thank the Deputy. I look forward to seeing the document. Nobody has a monopoly on the solutions to this so I very much look forward to seeing the proposals. To respond directly to the Deputy's question, through the winter plan and this year so far, an additional 834 acute beds have been delivered, with another 229 expected this year. In addition, 73 sub-acute beds have been added with 40 more planned for this year. There has also been substantial funding to increase home support hours, as the Deputy will be aware. The strategic plan for critical care is now in place. It aims to increase ICU capacity to 321 by the end of this year and to 446 in the longer term. The €52 million provided for implementation of this plan will allow for an additional 66 beds to be put in place. The HSE has advised that 42 of those 66 beds are now open, bringing our baseline capacity to 297 beds as of right now.
If the Minister could send on all of that information it would be very helpful. However, an awful lot of what was promised has not been delivered. I accept what he outlined is additional capacity and that it is going to make a difference. Any additional beds and any additional staff member in the health services is something I will welcome but as I have said to the Minister on a number of previous occasions, the problems are not just ones of capacity, although that is one part of it. Structural changes must also be made, though capacity is critical. I want to see, for example, the introduction of unique patient identifiers so that we have a system that can actually speak to itself and which is integrated. I want to see an integrated waiting list system. I also want to see hospital consultants having access to diagnostic equipment. We know much of that equipment is antiquated and must be replaced. We also know they struggle and fight to get access to theatre space and we must expand capacity in that area. Last year's budget was light on capital investment. We must also follow through on all the commitments that were made, which were substantial but not all of which were delivered upon, especially in the form of beds and staff, which is the critical part. It is one thing to promise; we must deliver.
I must say I agree with much of what the Deputy has just said. On building up the acute capacity, it is the biggest expansion in a single year ever to have been attempted, as far as I am aware, and the reports back from the HSE are very positive. On the Deputy's point, there are areas where the planned expansion is not on target, largely because of Covid and the cyberattack, and obviously it has been a very difficult year. However, specifically on what we are talking about, there is really good progress and they are doing really well. The Deputy quite rightly referenced access to diagnostics. One area we have invested a lot in this year is access to diagnostics for GPs, which obviously takes some of the pressure off the acute system. The feedback I am getting from GPs, where that has been invested in, is very positive. It is keeping patients in their community for treatment. It is really a matter of doing all this so that the patient pathway the whole way through is increased so people can stay in the community and if they do need to go into hospital, they can get back out to the community as quickly as possible.
