Dáil Éireann díospóireacht -
Wednesday, 27 Jan 1999

Vol. 499 No. 1

Written Answers. - Hospital Services.

John Gormley

Ceist:

557 Mr. Gormley asked the Minister for Health and Children the provisions made available to hospitals in the Eastern Health Board region in preparation for the winter months' seasonal increase in patients requiring hospital beds; and if he will make a statement on the matter. [1526/99]

Minister for Health and Children (Mr. Cowen)

A major factor contributing to the increase in demand for acute hospital beds during the winter months in the Eastern Health Board region is the demand for admission as a consequence of increased attendances at accident and emergency departments. To address this problem, I have provided additional funding of £1.65 million this year to enable eastern region hospitals to implement various initiatives aimed at addressing these difficulties particularly during periods of peak demand. These initiatives will include measures to free up beds for emergency admissions through the provision of alternative step-down facilities for patients occupying beds in acute hospitals for lengthy periods. They will allow for the provision of enhanced staffing levels, the development of rapid diagnostic systems for common emergency presentations, continued development of treatment and observation areas in accident and emergency departments and an improved access for general practitioners to urgent specialist opinion.

Part of the additional funding is also being used to fund a public education campaign aimed at increasing general awareness regarding the appropriate use of accident and emergency departments with particular emphasis on persuading persons with minor ailments to attend their general practitioner rather than an accident and emergency department in an acute hospital.

I have also published the report of the review group on the waiting list initiative and am committed to ensuring that its recommended approach is implemented. The report is one of a number of measures which I have taken to address the question of long waiting lists and waiting times. I have provided a total of £20 million for waiting list activity in 1999. This is a 66 per cent increase over the amount provided in 1998 and is two and a half times higher than the sum of £8 million provided by the previous Government in 1997. The report recommended the implementation of a range of steps to free up acute hospital facilities for more elective work. It pointed out that a significant proportion of acute hospital beds were being inappropriately used by patients who did not need, or who no longer needed, acute hospital care. This problem arises due to a shortage of places in the areas of "step-down" or convalescent care, rehabilitation facilities and community based services which reduce the need to use acute hospital care.

Accordingly, I have provided funding in 1999 of £3.83 million for the development of services for older people in the eastern region which will be an important factor in helping to free up acute hospital beds which are currently occupied by patients who could be accommodated in more appropriate convalescent or extended care facilities or discharged home if adequate community supports were available. It will be used,inter alia, to improve the home help service, increase the number of nursing and paramedical staff in the community, provide support for carers, enable a number of new health board convalescent or extended care facilities to open and increase the number of private nursing home places either subvented or contracted by health boards.

There are also a number of chronic sick in acute hospitals who have completed the acute phase of their illness and who are awaiting placement at a level of care more appropriate to their needs. The task of identifying and securing appropriate alternative care facilities for them is under way and this also will have a significant impact on freeing up acute beds in general hospitals over the coming months.