asked the Minister for Health if he will set up an inquiry into the present high hospitalisation costs having regard to the average length of hospitalisation of patients and the fact that patients are admitted on Fridays and Saturdays when treatment may not be commenced until Monday.
Ceisteanna — Questions. Oral Answers. - Hospitalisation Costs.
87.
I am very conscious of the significance of duration of stay in relation to the cost of treating patients, particularly in the case of our high-cost general and special short stay hospitals. While the length of stay in these hospitals has been falling under pressure of the constantly growing demand for in-patient treatment, I am satisfied, on the basis of studies already published in this country and abroad, that substantial further improvement is possible. Better organisation of the total patient load, both at out-patient and in-patient stages, is needed to achieve this. The instance mentioned by the Deputy of wasted in-patient days is only one facet of a many sided problem which calls for much better organisation in which hospital consultants must participate more actively.
Over a year ago I had a report on this question of achieving more effective use of acute hospital facilities circulated to the management authorities and their consultant staffs in all of the acute hospitals and I urged them to take action to solve the problems affecting performance. I am satisfied that there is now a wider understanding of the problems involved and that over a period much greater effectiveness will be achieved. This is something which has to be worked out in each hospital and to facilitate this, more detailed analyses of the work being done must be made available. Last year a study of the working of the consultant out-patient services in the Dublin general hospitals was carried out in association with the Irish Medical Association and the results of this are at present being processed. At my request the Medico-Social Research Board are commencing shortly pilot studies leading on to continuing in-patient studies covering all of our hospitals. The availability to each hospital of this detailed information about its own performance will be a most valuable means of identifying the areas in which improvement is possible.
In view of the information I have given I do not think it appropriate, at this stage, to set up formal machinery of inquiry as suggested by the Deputy.
What is the average length of time spent by a patient in hospital, at the latest available date? That forms part of the question. I know the Minister has provided it for the year 1964 but I should like more up-to-date information.
I have not got it.
When the Minister says no inquiry is needed, would that not be one indication of the need for it?
It is set out in the general report, pages 132 and 133, the average duration of stay, in days, in each hospital.
For what year?
For the year ended 31st December, 1966.
It is in the report, but I have not got it here.
Would the Minister not think there has not been a substantial reduction in the duration of stay of patients in hospital and that there is need for an inquiry as to whether something should be done about it? It has not been reduced effectively having regard to all the facilities at our disposal in hospital. This is an extra factor in the high cost of hospitalisation.
As I said in my reply, the length of stay has been falling. In St. Vincent's Hospital, the duration of stay is something like 17 days.
Was that in 1964?
No.
The average for the country has been 17.1 days for 1964.
I have told the Deputy the situation in my reply, and I do not think a formal inquiry at the moment is needed.
The average is 16.8, but that includes an orthopaedic hospital where the average stay is 100 days.
That is right.
Does the Minister think the average length of stay in hospital compares favourably with that of other countries.
The overall figure?
The 16.8 days for 1966?
Before the Minister answers that, may I direct his attention to the fact that that includes 100 days in an orthopaedic hospital, 231 days in a chest hospital, 349 days in a geriatric hospital, so that average figure is not a very safe one?
May I point out to the Minister that the average stay per patient in a British hospital or an American hospital is ten days.
God help them. Go bhfóiridh Dia orainn.
As Deputy Dillon says, go bhfóiridh Dia orainn if we ever adopt that system here.