Dáil Éireann díospóireacht -
Thursday, 24 Feb 2000

Vol. 515 No. 2

Written Answers. - Hospital Accommodation.

Alan Shatter

Ceist:

125 Mr. Shatter asked the Minister for Health and Children the number of beds closed and the number of bed days consequently lost in 1999 in each hospital; the reason for the closure of beds and loss of bed days in each hospital; and the steps, if any, he will take to ensure that beds in acute hospitals are fully utilised throughout 2000 to effect a reduction in in-patient hospital waiting lists. [4887/00]

Ivor Callely

Ceist:

157 Mr. Callely asked the Minister for Health and Children the consultations, if any, which take place with his Department when the management of a general hospital operating under funding from his Department decides to close a number of beds; and if he will make a statement on the matter. [5630/00]

Minister for Health and Children (Mr. Martin)

I propose to take Questions Nos. 125 and 157 together.

Details of the number of bed closures and resulting bed days lost in 1999 are set out in the table attached. It should be noted that, for the purposes of accurate comparison, the figures exclude closures which occurred as a result of the nurses strike.

Under the Health (Amendment) (No. 3) Act, 1996, each health board is obliged to produce an annual service plan for the year on the basis of the financial determination notified to them. This requirement is also applied to voluntary hospitals on an administrative basis. These service plans are agreed with my Department at the beginning of each year. Responsibility for delivering the plans rests with management in each agency. As part of the process of delivering service plans activity in the acute hospital sector is planned by agencies over a twelve month period having regard to anticipated levels of emergency admissions and the overall resources available.

In considering the delivery of service in the acute hospital sector, it is appropriate to examine the overall level of service provided in the sector rather than to simply focus on the number of beds available at any given time. This reflects major changes that have been taking place in medical practice, resulting in reduced average in-patient lengths of stay, a continuing shift in the delivery of care from an in-patient to day case basis and the increasing provision of treatment at out-patient level. In developing and delivering service plans, the implementation of an appropriate mix between in-patient, day case and out-patient care is a major consideration for local management in seeking to maximise overall activity.

The total discharges, both in-patient and day case, in the acute hospital system for the period January to December 1998 was 809,099. At out-patient level, the figures show that 1,960,126 attendances were recorded in that period. This huge volume of overall activity represented an increase of 3% over 1997 levels. This upward trend in overall activity continued in the first ten months of 1999. Overall discharges, in-patient and day case, were up 2.47% over the same period in 1998, which includes an increase in day cases of 9.87%. The increasing delivery of care at this level reflects trends in modern medical practice and is indicative of a service that is increasingly focusing resources in a manner that is best suited to the needs of the public.

In achieving the activity targets set out in the annual service plan, temporary bed closures would form a part of the normal bed management function performed by local management as part of their efforts to optimise the overall activity delivered within the resources available. They also, of course, facilitate staff annual leave, refurbishment works and the scaling down of elective activity at times of low demand such as the high summer period and at Christmas. In recent times it has also been necessary to close beds, particularly in the Dublin hospitals, due to difficulties recruiting appropriately qualified staff. Within this overall context, I will be asking agencies this year to explore whatever means are available to them to use their overall resources more flexibly in order to achieve reductions in waiting lists and waiting times.