I thank the Ceann Comhairle for the opportunity to speak on the cause of bed shortages in Cavan and Monaghan and the problems caused by the vancomycin resistant enterococcus, VRE, virus in Cavan, where no new patients are being admitted to the critical care unit. These difficulties are replicated nationally and are a major problem in the health service. A number of patients occupy beds without receiving active treatment. There are three categories of such patients — tertiary patients awaiting a nursing home bed whose subvention claim has not been processed, patients awaiting transfer to another hospital for an investigation, such as a CAT scan, and those who are clinically discharged but have nowhere to go because relatives cannot accommodate them. It is not acceptable that patients are occupying hospital beds without receiving treatment. We must examine this. Some 20 people were on trolleys in Cavan-Monaghan General Hospital recently while more than 20 people were occupying beds and not receiving any treatment. A hospital bed costs €651 per day, while for the same amount a patient can stay in a nursing home for a week. It is not logical.
Budget holders of the hospital management and community sections are part of the problem. The hospital budget manager does not care whether patients are receiving treatment once the beds are full. In fact, the less treatment patients are receiving, the more likely he is to keep them because he has no incentive to bring in patients who require treatment. The community manager does not wish to accept another patient full-time because it is a drain on his assets. Two hospital departments are playing with the taxpayers' money. They see it as a budgetary gain, but patients suffer. We must examine how this is allowed to continue.
The same problem exists with regard to clinics. Patients discharged from a hospital who need a taxi to a clinic are encouraged to seek the money from the hospital budget. That department will claim that no money is available for taxis.
I suggest, as I have suggested to the manager of hospital services and others, that we consider vacant floor space in the psychiatric establishment at Cavan-Monaghan General Hospital. A considerable amount of floor space is used at St. Davnet's Hospital to deliver services for Monaghan General Hospital, a practice that is very successful. Adjacent floor space could easily be transformed into hospital step-down facilities for patients receiving no form of treatment. There is already a nursing home on the campus. The additional floor space would not require the same level of high specification, such as oxygen points or nursing care, as the main hospital and this measure would relieve pressure from the general hospitals.
It is ridiculous to keep somebody in a hospital bed at a cost of €651 per day when the same amount would pay for a week's stay in a nursing home. Keeping patients in a hotel with full board would not cost that amount. Playing with budgets is the source of this problem and somebody must crack the whip. The taxpayer, so badly exposed in this situation, must be protected. If the HSE is serious about its task, these minor issues must be addressed. Everyone suggests we need more beds, which is true, but we must examine how we use the beds available to us. We do not make the best use of the available beds even though this problem can be solved.