Michael McDowell
Ceist:22 Mr. M. McDowell asked the Minister for Health the bed management policies that are in place in hospitals; the way in which they differ from hospital to hospital; and if he will make a statement on the matter. [9458/95]
Written Answers. - Hospital Bed Management Policies.
Limerick East): I would like to stress in the first instance that bed management policy must be a matter for individual hospital management.
On a broader level, the issue was looked at in the recent past by the Dublin Hospital Initiative Group, which was chaired by Professor David Kennedy. The group made wide ranging recommendations regarding the more efficient use of all acute hospital services in the Dublin area, including bed management practices.
Following the publication in September 1991 of the reports of the Dublin Hospital Initiative Group, a second group, the Dublin Hospital Advisory Group, which was also chaired by Professor Kennedy, monitored and reviewed progress in relation to the implementation of these reports "good practice" recommendations. This group found that the implementation of "good practice" recommendations was broadly satisfactory, although it was recognised that to put these fully into effect would take some time.
Specifically in relation to bed management, the advisory group found that the hospitals covered by the initiative group exercise had bed managers in place and that hospitals were agreed that the introduction of these posts had been a welcome and positive development. Accident and emergency consultants in particular, said that they had removed a considerable burden on accident and emergency departments.
The Advisory Group envisaged the bed manager's role as one of facilitating the admission arrangements and policies negotiated and agreed with admitting clinicians, within the constraints of the bed stock available in each hospital. The group's view was that it is a matter for clinicians to agree with management the number of beds required for their practice, to agree Protocols which balance accident and emergency and elective admissions, and to introduce acceptable systems for the audit of bed utilisation.
I should mention that in the context of the recent debate on accident and emergency services my Department has urged hospitals to look again at how they manage their workload, having regard to the level of admission through accident and emergency. Hospitals must accept that they are going to be under pressure at particular times of the year and they must organise themselves to deal with the problem. This is as much part of their role as providing specialist services on an elective basis.
Finally, I recognise that it is necessary that there are sufficient appropriate care facilities available for those patients no longer in need of acute care. This has been a particular problem in Dublin in recent years and one that has faced different governments. The resolution of this problem is now a priority and will be the subject of intensive and sustained attention until we have achieved a satisfactory balance between acute and continuing care provisions.