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Dáil Éireann díospóireacht -
Wednesday, 26 Jan 2000

Vol. 513 No. 1

Written Answers. - Hospital Services.

Bernard Allen

Ceist:

409 Mr. Allen asked the Minister for Health and Children the plans, if any, he has to increase the number of mental health rehabilitation beds. [1193/00]

Bernard Allen

Ceist:

410 Mr. Allen asked the Minister for Health and Children the plans, if any, he has to increase the number of physical handicap rehabilitation beds. [1194/00]

Bernard Allen

Ceist:

411 Mr. Allen asked the Minister for Health and Children the plans, if any, he has to increase the number of cardiac rehabilitation beds. [1195/00]

Bernard Allen

Ceist:

412 Mr. Allen asked the Minister for Health and Children the plans, if any, he has to increase the number of stroke victim rehabilitation beds. [1196/00]

Bernard Allen

Ceist:

413 Mr. Allen asked the Minister for Health and Children the plans, if any, he has to increase the number of accident victim rehabilitation beds. [1197/00]

Bernard Allen

Ceist:

414 Mr. Allen asked the Minister for Health and Children the plans, if any, he has to increase the number of extended care beds in each health board area for mental health rehabilitation. [1198/00]

Bernard Allen

Ceist:

415 Mr. Allen asked the Minister for Health and Children the plans, if any, he has to increase the number of extended care beds in each health board area for physical handicap rehabilitation. [1199/00]

Bernard Allen

Ceist:

416 Mr. Allen asked the Minister for Health and Children the plans, if any, he has to increase the number of extended care beds in each health board area for cardiac rehabilitation. [1200/00]

Bernard Allen

Ceist:

417 Mr. Allen asked the Minister for Health and Children the plans, if any, he has to increase the number of extended care beds in each health board area for stroke victim rehabilitation. [1201/00]

Bernard Allen

Ceist:

418 Mr. Allen asked the Minister for Health and Children the plans, if any, he has to increase the number of extended care beds in each health board area for accident victim rehabilitation. [1202/00]

Bernard Allen

Ceist:

419 Mr. Allen asked the Minister for Health and Children the number of mental health rehabilitation beds in each health board area; and the hospitals in which these are located. [1203/00]

Bernard Allen

Ceist:

420 Mr. Allen asked the Minister for Health and Children the number of physical handicap rehabilitation beds in each health board area; and the hospitals in which these are located. [1204/00]

Bernard Allen

Ceist:

421 Mr. Allen asked the Minister for Health and Children the number of cardiac rehabilitation beds in each health board area; and the hospitals in which these are located. [1205/00]

Bernard Allen

Ceist:

422 Mr. Allen asked the Minister for Health and Children the number of accident victim rehabilitation beds in each health board area; and the hospitals in which these are located. [1206/00]

Bernard Allen

Ceist:

423 Mr. Allen asked the Minister for Health and Children the number of stroke victim rehabilitation beds in each health board area; and the hospitals in which these are located. [1207/00]

I propose to take Questions Nos. 409 to 423, inclusive, together.

Effective rehabilitation draws on a broad range of services to meet the particular needs of patients, with the objective of helping patients return to normal life in the community. In the light of this, a large element of rehabilitation services is provided on a day or community care basis. The relevant services range from specialist in-patient medical rehabilitation through such services as physiotherapy, occupational therapy and speech and language therapy. These services are often initiated in the context of in-patient treatment for another underlying illness or condition and subsequently continued on a day care basis or in the community, consistent with patients needs. It is, therefore, more appropriate to focus on ensuring that rehabilitation is provided to patients in the most appropriate setting rather than on the basis of identifying dedicated services for particular categories of patients other than those requiring specialist in-patient medical rehabilitation. A number of important aspects of the role of rehabilitation services are highlighted below and I also have asked the chief executive officer of each health board to write to the Deputy outlining the particular arrangements for the provision of rehabilitation services in each health board area.

In-patient medical rehabilitation services are required by certain types of patients, such as those seriously injured in accidents and stroke patients and a 123 bed facility for such patients is provided at the National Rehabilitation Hospital, Dún Laoghaire, County Dublin, which provides a national medical rehabilitation service. The total cost of this service in 2000 is £9.069 million.

The provision of appropriate rehabilitation care is also an integral element of the service required by many types of patients and proposals for development of additional capacity in the services that contribute to rehabilitation are often presented in the context of proposals for broader service developments. For example, the report of the review group on the waiting list initiative identified that a significant proportion of acute hospital beds were being inappropriately used by patients who did not need, or who 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.
As part of a package of measures to address these problems the Eastern Health Board, in conjunction with the Dublin acute hospitals, which provide accident and emergency services, were asked to examine this particular aspect of the service and to formulate a response. The board submitted a comprehensive action plan which takes into account the complex group of patients who need a mixture of sub-acute care services. This group include young chronic sick, those requiring physical rehabilitation, medical rehabilitation patients and elderly patients. The implementation of the plan, which provides an additional 235 alternative care places to cater for patients across the spectrum, has already been agreed. These 235 places can be broken down as follows: 70 sub-acute-convalescent places, 25 young chronic sick places and 140 long stay contract nursing home places. Some 95 of these beds are to be located on the campuses of acute hospitals with a further 140 sourced from private nursing homes.
Rehabilitation services also have an important role in areas for groups such as people with physical disabilities. Rehabilitation services in this area are provided as part of a comprehensive range of community based services. These services are being developed in line with the recommendations of the review group on health and personal social services for people with physical and sensory disabilities, which published its report, Towards an Independent Future, in December 1996. Priorities for development are respite care, day care, long-term residential care, home support services, including personal assistance, and therapy services. This year, £7 million, equalling a £14 million full-year cost in 2001, has been provided for the development of these services.
I regard the continued development of rehabilitation services as an essential element of providing appropriate care to patients across a wide range of health services. I remain committed to the further development of rehabilitation services and my Department is currently considering the development of a national strategy for the development of rehabilitation services which would take into account the recommendations of the report, Towards an Independent Future and the report of the national advisory committee on medical rehabilitation.
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