Dáil Éireann díospóireacht -
Thursday, 30 Apr 1998

Vol. 490 No. 4

Written Answers. - Accident and Emergency Services.

Ivor Callely

Ceist:

42 Mr. Callely asked the Minister for Health and Children if he has satisfied himself that the Dublin hospitals can adequately respond to accident and emergency demands and that required admittance beds are available; and if he will make a statement on the matter. [10193/98]

Minister for Health and Children (Mr. Cowen)

The hospital service has encountered problems in the provision of accident and emergency services over the past number of years. This is not a phenomenon confined to Ireland but is a feature in other developed countries also.

My Department has been funding a national public education campaign aimed at persuading people with minor ailments to go to their family doctor rather than a hospital accident and emergency department. A considerable element of the overcrowding in accident and emergency departments could be relieved by diverting those cases which are neither accidents nor emergencies and which could be appropriately dealt with by a general practitioner.

For patients who require admission to hospital, the shortage of sub-acute beds 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. This problem is linked to the ageing of our population. Many elderly patients require acute hospital care initially but much of their recovery period could be spent in step down or sub-acute accommodation.

Figures indicate that in the six Dublin accident and emergency hospitals a total of about 160 acute beds are occupied by elderly patients who have been medically assessed as being in need of long-term care and awaiting placement.

In addition, about 90 beds are occupied by patients who have completed the acute phase of their hospital care and are awaiting placement at a level of care more appropriate to their needs.

I recently approved an additional allocation of £2,250,000 to fund a wide range of measures aimed at tackling the problem on a number of fronts. There is the continuing need for public education regarding the appropriateness of attending the accident and emergency department. The advent of extra long-stay places should provide some relief to the bed situation in acute hospitals. In this regard funding was specifically allocated for the following initiatives: 20 additional acute beds for three months at James Connolly Memorial Hospital at a cost of £300,000; 40 elderly places at St. Monica's Home at a cost of £600,000 and 20 day care-step-down places at Crinken Lane and Crooksling at a cost of £200,000.

In addition, various staffing and organisational initiatives in the accident and emergency departments themselves are expected to contribute to a better service for patients requiring the services. These initiatives include the provision of triage nurses, new nurse practitioners and additional medical support. The Eastern Health Board's steering group for Dublin accident and emergency services provides my Department with a weekly activity report. Each of the Dublin hospitals provides the steering group with a weekly return of its accident and emergency activity. This gives the group an overview of the situation throughout the city on a week to week basis, so that appropriate action can be agreed between the hospitals in order to relieve areas of particular pressure.

My Department will keep the services under review, in consultation with the Eastern Health Board and the hospitals concerned, in order to assess the outcome of the various initiatives taken.

I am confident that the restructuring of the Eastern Health Board will contribute further to the effectiveness of the approach to the "continuity of care" issues which affect the provision of acute hospital services at present.