Dáil Éireann díospóireacht -
Wednesday, 5 Dec 2001

Vol. 545 No. 5

Written Answers. - Hospital Services.

Bernard Allen

Ceist:

143 Mr. Allen asked the Minister for Health and Children if he will make a statement on recent comments made by a person (details supplied) that the public hospital system can treat people appallingly due to the fact they have no choice. [31148/01]

Minister for Health and Children (Mr. Martin)

The new health strategy, Quality and Fairness: A Health System for You, which I launched recently provides a framework, inter alia, for a reform of the acute hospital system which will lead to improved access to hospital services for public patients. It also provides for a comprehensive set of actions to be taken to address the issue of waiting lists, and particularly waiting times for public patients.

The strategy places a new focus on waiting times. The targets set out in the strategy are that by the end of 2002, no adult will wait longer than 12 months and no child will wait longer than six months for treatment; that by the end of 2003, no adult will wait longer than six months and no child will wait longer than three months for treatment, and that by the end of 2004 no public patient will wait longer than three months for treatment. Until these targets are achieved, a new dedicated treatment purchase fund will be used for the purpose of purchasing treatment for public patients.

The single most limiting factor for admission to hospital is bed availability. In this context, a comprehensive review of bed capacity needs has been conducted by my Department in conjunction with the Department of Finance and in consultation with the social partners. The review, which has informed the health strategy, has focused primarily on the emerging need to increase bed capacity and to have a strategic framework in place in terms of the number of additional beds required in the short, medium and long-terms. The overall target of the new strategy is that an extra 3,000 beds will be provided over the period to 2011, with 650 beds to be in place by the end of 2002. The next phase of the review will involve an examination and assessment of clinical activity data by specialty.

Measures which I have already taken to improve access to accident and emergency services include the provision of a £32 million, 40.632 million, investment package aimed at alleviating anticipated service pressures and maintaining services to patients, particularly in the acute hospital sector. The investment package has been targeted at a number of key service areas, including the recruitment of 29 accident and emergency consultants. The recruitment of additional consultants to this key area is designed to reduce any unnecessary delays experienced by patients attending A&E departments and to ensure that patients have improved access to a prompt senior clinical decision making service. Additional funding was also provided for the contracting of additional private nursing home places by the Eastern Regional Health Authority, ERHA, and the health boards. These places are for patients whose acute phase of treatment has been completed but who require additional care in an alternative setting. I am pleased to inform the Deputy that the ERHA and the health boards contracted over 700 beds under the initiative which helped to free up acute beds for patients awaiting admission to hospital.

Initiatives identified in the health strategy to further improve the operation of A&E departments include the establishment of 24-hour general practitioner co-operatives as part of the strengthening of primary care which will help reduce demand from, and treat appropriately, patients who would otherwise have to attend at an A&E department; the establishment of minor injury units to ensure appropriate treatment and management of non-urgent cases; the use of chest pain clinics, respiratory clinics and in-house specialist teams to fast-track patients as appropriate; the organisation of diagnostic services to ensure increased access to and availability of services at busy times in A&E departments; the appointment of advanced nurse practitioners, ANPs, in acute hospitals – ANPs diagnose and treat groups of patients independently within agreed protocols; the use of admission protocols to ensure that emergency patients will be the only group of patients admitted to hospital through the A&E department; the appointment of a member of staff to liaise with patients while they await diagnosis and treatment at A&E departments; and the introduction of information systems that record comprehensive, comparable and reliable data on activity in A&E departments. Such information will provide staff with a valuable tool in structuring services to meet the needs of patients.

I have also requested Comhairle na nOspidéal to review the structure, operation and staffing of A&E services and departments with the aim of improving the provision and quality of patient care. Comhairle established an A&E committee to undertake the review. To date, the committee has been engaged in an extensive consultation process, meeting with and receiving submissions from representatives of each health board, relevant voluntary hospitals, appropriate professional bodies and other interested parties. The committee has also obtained information on attendances in each A&E department from each health board and acute general hospital and has also reviewed extensive literature regarding A&E services in Britain, Europe, the US, Canada and Australia. I am informed by Comhairle that it is expected that the committee will complete its report by the end of this year.

Bernard Allen

Ceist:

144 Mr. Allen asked the Minister for Health and Children the reason there is no on-call MRI service at the Mater Public Hospital in Dublin for the past six months. [31149/01]

Minister for Health and Children (Mr. Martin)

Responsibility for the funding of services at the Mater Hospital rests with the Eastern Regional Health Authority. My Department has therefore asked the regional chief executive of the authority to investigate the matter raised by the Deputy and to reply to him directly.