Vol. 522 No. 3
169 Mr. Durkan asked the Minister for Health and Children if all public hospital beds are open and fully utilised at all times; if his attention has been drawn to the closure of any hospital ward due to staff shortages; and if he will make a statement on the matter. [18754/00]
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 12 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 outpatient level.
The total discharges, both in-patient and day case, in the acute hospital system for the period January to December 1999 was 827,197. This huge volume of overall activity represented an increase of nearly 2.5% over 1998 levels. In particular, the level of hospital care being provided on a day case basis showed a very significant increase, up over 9.5% in 1999 over 1998 levels. This upward trend in overall activity continued in the first two months of this year. Overall discharges, in-patient and day case, were up nearly 3.5% over the same period in 1999, which includes an increase in day cases of over 11%. 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 plans, 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 and refurbishment works. In recent times it has also been necessary to close beds, particularly in the greater Dublin area, due to difficulties recruiting appropriately qualified medical and nursing staff.
Notwithstanding this, last month I announced a major £10 million initiative on public hospital waiting lists. In drawing up proposals for this additional waiting list work, the chief executive officers were asked to examine various measures, including utilising facilities during the traditional closure periods in order to maximise overall capacity in the system. The proposals received by agencies following this examination of options by the chief executive officers are to be funded in full.
