Dáil Éireann díospóireacht -
Wednesday, 23 Oct 1996

Vol. 470 No. 5

Written Answers. - Accident and Emergency Services.

Ivor Callely

Ceist:

66 Mr. Callely asked the Minister for Health the number and details of reviews of the accident and emergency services at Dublin hospitals carried out in each of the years from 1991 to 1996; his views on whether part of the problem is insufficient beds in hospitals; and if he will make a statement on the matter. [19496/96]

Minister for Health (Mr. Noonan,

Limerick East): The acute hospital service in Dublin has encountered problems in the provision of accident and emergency services, particularly over the winter period in the past number of years. The causes of the problems which arise have been well documented. Many elderly patients require acute hospital care initially but much of their recovery period could be spent in step-down sub-acute accommodation. For a number of years now there has been a shortage of sub-acute beds, particularly in Dublin. This 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 hospital.

Since 1991 there have been a number of reviews into the accident and emergency services provided by the six major hospitals in Dublin. In 1990 the Dublin Hospital Initiative Group which was chaired by Professor David Kennedy examined these issues and made wide-ranging recommendations regarding the more efficient use of all acute hospital services in the Dublin area. These recommendations covered aspects which were common to all of the Dublin accident and emergency hospitals, such as the interaction between the accident and emergency department and other departments within the acute hospitals; admission, bed management and discharge policies; and the need for step down facilities for elderly inpatients no longer requiring acute hospital services. 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 David Kennedy, monitored and reviewed progress in relation to the implementation of these reports "good practice" recommendations. This group found that the implementation of the recommendations was broadly satisfactory, although it was recognised that to put them fully into effect would take some time. Earlier this year a study was carried out under the auspices of the Eastern Health Board which analysed bed utilisation within the six major accident and emergency hospitals. This report has been the basis of a review of internal work practices, not only within the six Dublin accident and emergency hospitals but also on a national level.

I have already provided details to the House of the significant improvements which I have put in place to improve the acute and sub-acute sectors since I came into office — see extract from Official Report of 1 May, 1996, vol. 464, cols. 1853-1856 — and I hope to put additional facilities in place for the winter of 1996-97.