Written Answers. - Accident and Emergency Services.
Ivor Callely
Ceist:
58
Mr. Callely
asked the
Minister for Health
if his attention has been drawn to long delays that can be experienced in accident and emergency departments in Dublin hospitals; the measures, if any, he intends to introduce to alleviate the situation; and if he will make a statement on the matter.
[8724/96]
, Limerick East): The hospital service has encountered problems in the provision of accident and emergency services, particularly over the winter period, in recent years. This is not a problem confined to Ireland but is a feature in other developed countries also.
The causes of the problems which arise have been well documented. The ageing of our population has contributed to the difficulties in accident and emergency departments. The winter period brings its own set of problems for our elderly population. This in turn can lead to an upsurge in the number of patients who present in accident and emergency departments requiring admission to hospital. Many elderly patients require acute hospital care initially but much of their recovery period could be spent in step down subacute accommodation. The shortage of sub-acute beds, particularly in Dublin, has caused problems in that acute hospitals have not been able to discharge patients in sufficient numbers and quickly enough to cater for new patients seeking the services of the hospitals. This can result in patients having to be placed in temporary accommodation. There is nothing new in this. This has been the position for quite some time and has faced different Ministers for Health.
The volume of patients who present at casualty departments for treatment has also increased. For example between 1988 and 1995 the number of new attendances at the six major accident and emergency hospitals in Dublin increased by approximately 39 per cent. The extra volume of patients in some instances, has necessitated extending the physical facilities in some accident and emergency departments and it is intended to continue refurbishing A & E departments as required.
The accident and emergency problem has been building up, especially in Dublin, for some time. Up to now, difficulties in the accident and emergency services have been dealt with by providing mainly once-off solutions. I was anxious that a more comprehensive and integrated approach be adopted.
In the first instance there is a need for hospital management to give greater priority to the problems that have emerged in the organisation and delivery of accident and emergency services. Hospitals need to refocus their activities to a greater degree with regard to bed utilisation and in relation to admission and discharge procedures. It is important that each hospital agrees a series of measures that will result in a better and more streamlined response. It is only when the above issues have been tackled that a hospital is in a position to deal with the many day-to-day logistical problems that arise in the provision of accident and emergency services.
The successful management of the accident and emergency difficulties includes tackling a number of areas including services for the elderly, services for the chronically disabled and services provided by the acute hospitals which, when taken together, provide a comprehensive and integrated response.
The measures adopted for the winter of 1995-96 are as follows:
—a 25 bed new elderly care unit opened in Peamount Hospital in December 1995,
—40 additional nursing home places in private nursing homes were made available,
—three new community ward teams for the elderly have been approved,
—a 25 bed unit for the young chronically disabled in Cherry Orchard Hospital opened at the start of February 1996.
—a 46 bed community unit for the elderly on the Navan Road opened in the middle of February 1996,
—a health board public education campaign co-ordinated by the Eastern Health Board on the appropriate use of accident and emergency services was launched on 15 January 1996.
—in the six accident and emergency hospitals in Dublin a number of measures were taken including:
(i) the opening of extra beds,
(ii) additional staff recruited,
(iii) medical equipment grants were approved for A & E departments,
(iv) observation facilities were opened,
The cost of the measures outlined above was £534,000 in 1995 and will be approximately £2.5 million in 1996. This is the largest investment ever in the management of accident and emergency services in Dublin.
