Other Questions.
6 Mr. Wall asked the Tánaiste and Minister for Health and Children the action she intends to take arising from the serious concerns expressed by the Medical Council regarding non-resident cosmetic surgeons operating here; and if she will make a statement on the matter. [31577/04]
Amharc ar fhreagraThe Medical Council is the independent authority charged with primary responsibility for the registration and regulation of medical practitioners. The function of the council is to protect the public through implementing appropriate controls on the medical profession. Doctors practising medicine should be registered with it.
Persons who avail of the services of doctors performing cosmetic procedures should endeavour to seek the services of reputable institutions. When invasive procedures are being arranged in so-called cosmetic clinics, persons are strongly advised to check that the services are provided by a medical practitioner appropriately registered with the Medical Council. In addition, before agreeing to undergo any procedure, persons should ascertain the level of follow-up medical support which will be available to them after the surgery has been completed.
It is an offence under the Medical Practitioners Act for a doctor to falsely represent himself or herself to be a registered medical practitioner when he or she is not registered. Registration is required to sign medical certificates and issue prescriptions for certain categories of drugs. In addition, doctors are not entitled to recover in legal proceedings fees charged for the provision of medical or surgical advice or treatment given when they were not registered.
I recently met a delegation from the Medical Council to discuss a number of matters relevant to the current and future system of regulation of the medical profession. Among the issues discussed was that of cosmetic surgical procedures and the requirement for appropriate follow-up medical care for patients who undergo these procedures. The delegation outlined to me its concerns regarding the operation of cosmetic surgery clinics. It is my intention, in the context of upcoming legislation, to actively examine ways to address the issues raised by the Medical Council.
I thank the Minister for her answer. Although she gave some indication of the position, the beginning of her reply reminded me of the advice agony aunts give to those considering cosmetic surgery. Does she agree that when the president of the Medical Council states there is "dangerous stuff going on" the person responsible for the protection of patients, namely, the Minister for Health and Children, must act?
The number of clinics promoting cosmetic surgery and laser treatment has mushroomed. Ireland has become a magnet for companies selling laser equipment in many cases to people who have little or no training in how to use it. The reason is that the market here, unlike that in many other countries, is unregulated. I ask the Minister to examine this issue immediately. The surgery involved can have a negative impact on patients and the clinics in question do not generally provide after-care. In some cases, patients whose operations have gone wrong have found that no after-care is available. This is a serious matter which must be swiftly addressed.
I agree with the Deputy. We do not have legislation on the licensing of private clinics and the Government has no authority in the matter. In addition, the Medical Council does not have power to intervene until it receives a specific complaint. These appear to be two deficiencies in the current regulatory environment. I discussed with the Medical Council the need to address these deficiencies in the new legislation. We must do so effectively and cognisant of our responsibilities under European directives and so forth.
This area relates to vulnerable categories of people who assume, when they see the word "doctor", that the person is a registered practitioner, which is not always the case. Heretofore, the law has been deficient in giving the Medical Council, the regulatory body — I support self-regulation in this area — the necessary powers to intervene on behalf of patients. We will provide for such intervention in the new legislation.
To which legislation is the Minister referring?
The relevant legislation is the Medical Practitioners (Amendment) Bill.
In that case, we could wait for a long time.
No, I hope to have the heads of the Bill soon. Considerable progress has been made on it.
As regards unregistered medical practitioners, of which there are a few, I am aware of two cases which have resulted in deaths and the people concerned have had no comeback. The cases in question concerned a person who stopped taking medication on the advice of the unregistered practitioner in question and another with a cancerous tumour of the neck who stayed away from the medical profession, also on the advice of this practitioner. What steps is the Minister taking to address this matter?
The Deputy is correct that the Medical Council has no role in cases of unregistered medical practitioners. This is the reason we must examine the issue of licensing facilities. It is not acceptable that a person can set up an establishment, advertise cosmetic surgery or laser or other treatment without authorisation or a licence. This could have serious implications for public health or the health of individual patients. We will probably deal with the facilities aspect of the issue through licensing.
7 Mr. P. McGrath asked the Tánaiste and Minister for Health and Children if she will report on the provision of services for persons with eating disorders in all health boards or their equivalent; and if she will make a statement on the matter. [31777/04]
Amharc ar fhreagra28 Mr. Deasy asked the Tánaiste and Minister for Health and Children her plans for the improvement and development of services for persons with eating disorders; and if she will make a statement on the matter. [31776/04]
Amharc ar fhreagra55 Mr. Hayes asked the Tánaiste and Minister for Health and Children her views on a report, A Report on Service Provision in the Eastern Region; and if she will make a statement on the matter. [31775/04]
Amharc ar fhreagra68 Mr. Kehoe asked the Tánaiste and Minister for Health and Children her views on whether it is adequate that the tertiary referral service for eating disorders available in St. Vincent’s Hospital, Elm Park, Dublin has three inpatient beds designated for this purpose; if she has plans to increase the number of beds; and if she will make a statement on the matter. [31778/04]
Amharc ar fhreagraI propose to take Questions Nos. 7, 28, 55 and 68 together.
Persons presenting with eating disorders are generally treated through the psychiatric services of their local health board. Outpatient psychiatric services are provided from a network of hospitals, health centres, day hospitals and day centres. Where inpatient treatment is deemed necessary, it is provided in the local acute psychiatric unit or hospital, with beds allocated on the basis of patient need at any particular time.
A tertiary referral service for eating disorders is available to public patients in St. Vincent's Hospital, Elm Park, Dublin at which three inpatient beds are designated for this purpose. A similar service is available privately at St. Patrick's Hospital, James's Street, Dublin and St. John of God Hospital, Stillorgan, County Dublin.
The voluntary organisation Bodywhysprovides advice and support for sufferers of eating disorders, their families and carers. My Department has provided funding of €394,000 for Bodywhys since 2001 to develop its activities in this area.
The report referred to by Deputy Hayes is entitled, A Report on Service Provision in the Eastern Region, and was written by Joy Wall for Bodywhys. The report details the nature of eating disorders, the services available to those suffering from the disorder in the eastern region and makes recommendations for the future development of such services.
As Deputies will be aware, an expert group on mental health policy is preparing a national policy framework for the further modernisation of the mental health services. The provision of services for people with eating disorders is among the issues being considered by the group. I understand a copy of the Bodywhys report has been provided for the group which is expected to report in mid-2005.
As regards the lack of services for adolescents with eating disorders, I was informed recently that young people with eating disorders are literally fading away, both physically and mentally, in institutions totally unsuitable for their condition. Is it acceptable that just three public beds are available to treat adolescents with eating problems? Beds are made available in private hospitals at the discretion of the health boards. I know from experience that difficulties have arisen in accessing such beds and getting the health boards to cover the cost. The idea in all of this is that there is no equality of services for people with eating disorders. This report shows up a glaring inequality, especially when it comes to adolescents, who are often treated inappropriately in psychiatric institutions. Does the Minister not agree that this represents the lack of service to patients in this country?
I thank the Deputy for his response. The report points out inadequacies in the service, glaring inadequacies in the training of general practitioners in this area and a great disparity between the provision of services for public and private patients with anorexia nervosa and bulimia. This is in spite of the fact that the Department has appointed approximately 50 adolescent psychiatrists in recent years. Nonetheless, there are great anomalies in the service. The expert group will examine this report and take into consideration what the author says. Such inadequacies are not acceptable and I look forward to the recommendations of the expert group.
Is the Minister of State aware that the percentage of the overall budget for mental health services has dropped again, from 6.69% to 6.15% of the total budget? This in turn has dropped from 11% in 1997. One of the problems for the child and adolescent psychiatrists is that they have very few support staff. The Department may have appointed extra psychiatrists, but the lack of support staff will cause many problems in certain areas.
That statistic is not correct. The figure is approximately 7% at present, which represents €757 million for mental health services this year. I agree it is not sufficient, but it is not all about money. There are other problems in the area of mental health that are coming to the fore. There is a great disparity between the provision of services for public and private patients. We must examine that because it is not all about money. It is about reforming the practices that have been the norm for several years. I am delighted that there are organisations such as Bodywhys which highlight the inadequacies in the service. In meetings that I have held, many general practitioners have informed me that their undergraduate training in mental health is inadequate. The president of the Irish College of General Practitioners openly admitted in public that the undergraduate training of medical doctors in mental health is inadequate.
Does the Minister think that the lack of investment in the psychiatric services, especially for young people, has contributed to the very high suicide rate among young people?
The doctor might be able to give me statistics on the connection between suicide and eating disorders. Some patients might take their own lives, but it would be a very small number. Anorexia nervosa and bulimia are two medical conditions in their own right and there may be no intention on the part of the patient to take his or her life.
8 Mr. Connolly asked the Tánaiste and Minister for Health and Children if she will give consideration to the possibility of Monaghan General Hospital being used as a location for the delivery of the national treatment purchase fund service; and if she will make a statement on the matter. [31841/04]
Amharc ar fhreagra11 Mr. Healy asked the Tánaiste and Minister for Health and Children if Monaghan General Hospital will be used as a cross-Border centre for the provision of the national treatment purchase fund scheme on an all-Ireland basis; if NTPF funding will be retained in the island of Ireland; and if she will make a statement on the matter. [31855/04]
Amharc ar fhreagra116 Caoimhghín Ó Caoláin asked the Tánaiste and Minister for Health and Children the details of the report she has received arising from the recent visit of her officials to Monaghan General Hospital; the action she proposes to take; and if she will make a statement on the future for acute hospital services at Monaghan General Hospital. [31582/04]
Amharc ar fhreagra142 Dr. Twomey asked the Tánaiste and Minister for Health and Children the timescale for the major revamp of services at Monaghan General Hospital that include a CAT scanner and 24 hours a day, seven days a week medical cover; and if she will make a statement on the matter. [31913/04]
Amharc ar fhreagra143 Dr. Twomey asked the Tánaiste and Minister for Health and Children the emergency cases (details supplied) which will be treated at the enlarged emergency room at Monaghan General Hospital. [31914/04]
Amharc ar fhreagraI propose to take Questions Nos. 8, 11, 116, 142 and 143 together.
I requested my special adviser to visit Monaghan and Cavan on a fact-finding mission on my behalf. She met representatives of the North Eastern Health Board, the medical board of Monaghan General Hospital, the medical board of Cavan General Hospital, representatives of the County Monaghan community alliance and representatives of Monaghan General Hospital development committee. She also met members of the steering group which was established by the board to oversee the reconfiguration of services at Cavan and Monaghan hospitals. The purpose of the visit was to inform me of the position concerning the proposed reconfiguration of services within the group.
I have outlined to the House the range of developments in the hospital group arising from the report of the steering group. My Department has been advised by the board that it has established an implementation group to continue the various developments in the hospital group as a matter of priority. It is my intention to meet Members from Cavan and Monaghan next week. All options will be explored, including the use of Monaghan General Hospital as a location for the delivery of the NTPF services.
I welcome the additional €20 million for the national treatment purchase fund. It is working well, but I would like to see it delivered from Monaghan General Hospital. Has the Tánaiste read the recent report from the Royal College of Surgeons in Ireland? It openly questions the manner in which the health service reforms are being rolled out and states that it is counterproductive to the Hanly report. It further states that the centres of excellence should not be involved in doing elective, intermediate and minor level surgery. It quoted the example of Drogheda hospital and stated that such surgery could be carried out more effectively in Monaghan General Hospital and Cavan General Hospital. Is the Tánaiste concerned about the impact this will have on the training of junior doctors in major hospitals? The report also stated that a senior house officer sent to Monaghan and Cavan on a six-month contract would obtain more experience than in a high-tech Dublin hospital. These matters must be taken into consideration.
Question No. 11 questions the cost-effectiveness of sending people abroad to have non-complex surgery performed, such as intermediate and minor surgery, which could be carried out in our hospitals. The capacity exists and it would increase the volume of work in our hospitals. It would also be welcome as a money earner in our locality.
I am aware of the report by Professor Tanner in the Royal College of Surgeons in Ireland. I have taken advice from the Department and my special adviser has visited Cavan and Monaghan. The situation there is very unsatisfactory. It is not acceptable that a senior sister would almost break down in tears as she showed us the facilities that are not being used. We need to use all the health facilities we have in the most effective way possible and that is not happening.
The national treatment purchase fund was established as a last resort to deal with very long waiting lists and to try to find treatment for people in the private health care sector in Ireland or elsewhere. It has worked extraordinarily well. It may well be that there are possibilities for the fund to be used in facilities like those in Monaghan where there are excellent theatres. We need to explore all those options. Several Deputies have come to me with different suggestions and I would like to discuss all these matters together next week.
The report openly states that the smaller hospitals should be used and it questions whether the health service reforms are heading in the right direction.
I think the report suggests that Drogheda be the centre of excellence. We must use all the facilities to their best effect.
We want the regions to have autonomy. Many do not have certain specialist consultants, or only have one. No matter how good a specialist is, he or she cannot provide a service for a region. I strongly support the building of services at regional level. It is not about closing services down but about building them. Cavan-Monaghan Hospital, with hospitals in Drogheda, Dundalk and Navan, must be used in the most effective way possible for patients in each region or from outside, if appropriate. Using a little common sense, we should be able to resolve issues in a more satisfactory manner than has been the case to date.
On the subject of common sense, will there be a rethink on the Hanly report?
Do people understand what the report is about? A lot of people who speak to me about it have not read it.
People are not stupid.
What is happening in Cavan-Monaghan Hospital, before implementation of the Hanly report, is not good enough.
I thank the Tánaiste for sending her adviser and agreeing to meet us next week. I assure her I will enter discussions in a positive and constructive manner. She knows me long enough to know that is the case. However, we have had so many promises. Her predecessor as Minister, Deputy Martin, stood on the steps of Monaghan General Hospital and gave assurances that he would look after the problem. The hospital has been off-call since July two years ago. The Minister is here to discuss a question regarding the national treatment purchase fund. Much work could be done in Monaghan General Hospital under that scheme. The hospital was doing work from Northern Ireland before it was taken off-call. It has an extremely modern theatre——
The Deputy should conclude. He must put a question in a one minute time limit.
Will the Tánaiste do everything in her power to ensure the hospital is put back on-call in coming weeks and that maximum use will be made of the facilities available? It is not common sense to send people to Birmingham. Her predecessor refused to advise me as to how much it would cost, yet the theatre is lying empty in Monaghan General Hospital.
Facilities in Cavan and Monaghan hospitals and elsewhere in the region must be used to greatest effect. Many patients from the region end up in different places because facilities within the region are not used to full effect. This does not make sense from anybody's point of view. I give the Deputy that assurance and look forward to our discussions.
At a recent meeting in Monaghan General Hospital we were told protocols would be in place by the end of January whereby medical admissions by ambulance would be reaccepted. Is this still going ahead? During the course of the debate on our Private Members' motion I was under the impression there was a five day elective and selective surgery service. As the Tánaiste did not contradict me, I thought she had the same assumption. Health board officials in Cavan and Monaghan said there was no such thing, that there was a day surgery service which may extend a little beyond normal hours. When was the Tánaiste made aware that this was the case? This is the impression given to the people of Monaghan in all the discussions we have had in the House since the report was published last April-May. It now comes to light that this is not the case. It is nothing more than an extended day surgery service carried out by an individual surgeon who comes from Cavan General Hospital every day. I do not agree or disagree with the service but the impression given to the House was misleading.
One of the issues which arises is that, depending on who one speaks to, one gets a different answer. This is unsatisfactory with regard to Cavan-Monaghan Hospital and an issue I intend to address. There are badly needed procedures which could be carried out at Monaghan General Hospital. There is capacity to have people stay in overnight. Not all patients would be dealt with on a day case basis. Therefore, we must examine what we can do, how we can do it and how we can use the facility.
The people of Monaghan would prefer——
Most understand that in respect of elective and selective surgery, one deals with particular specialties. It has now emerged these are carried out on a day case basis.
We know the difference between five day surgery and day surgery. I was led to believe it was a five day service, which was misleading.
9 Mr. Howlin asked the Tánaiste and Minister for Health and Children her views on the recent report of the strategic task force on alcohol; if it is intended to implement the recommendations of the report; if she has brought proposals to the Government on this matter; and if she will make a statement on the matter. [31559/04]
Amharc ar fhreagraThe strategic task force on alcohol was established in January 2002. Its remit is to provide specific evidence based measures for Government to prevent and reduce alcohol related harm. The task force published an interim report in May 2002 and has recently published its second report. Together, the two reports provide 100 recommendations framed using the ten strategy areas for alcohol action outlined in the World Health Organisation European Charter on Alcohol. I welcome the publication of the report and intend to bring it to Government shortly.
That does not tell me anything I did not already know. The whole idea of this process is to elicit information. There are clear recommendations regarding the reduction of availability, health warnings, the protection of children and advertising controls. The task force did not go as far as the Oireachtas committee report, chaired by the Minister of State, Deputy Batt O'Keeffe, which was very specific. It argued for significant change such as a ban on advertising and sponsorship. These measures would make a significant difference with regard to alcohol abuse. There are many ideas. However, the only people who do not seem to have any views or ideas on the matter are the Ministers responsible. Perhaps, as asked in the question, the Minister of State will tell us what is the view of the Department of the recommendations.
Specific responsibility in this area has been delegated to the Minister of State, Deputy Seán Power. The position of the Tánaiste and Minister of Health and Children, Deputy Harney, is that the matter will be brought to Government to seek its view on the recommendations in order that an implementation plan can be developed.
With regard to current trends in alcohol consumption and related harm, in 2003 there was a decline in consumption for the first time in over 16 years. We must assume this is as a result of the increased taxation on alcohol products announced in the December 2002 budget.
We heard a presentation yesterday from Professor Wall who is embarking on a major research project in this area. According to him, the consumption of beer has decreased but the consumption of wine and hard spirits has increased. However, I am not arguing the point. It will be the Minister, not the Minister of State, who will go to the Cabinet on the matter. Can she give us a hint as to what her approach will be? Will it be a case of "Here is another old report from the Department of Health and Children. We do not have to pay it any attention?" or will she state the priorities which are being taken seriously? It would be useful to know. Perhaps she could give us a little hint.
This is not any old report but a matter all Ministers take extremely seriously. There is a suggestion of a difference in approach between Departments. All key Departments are represented on the task force and have signed up to the recommendations, of which there is a wide set in the report which require detailed implementation. A number of recommendations in the interim report, published in 2002, have been implemented such as the increase in taxation on alcohol products which resulted in a decline in alcohol consumption for the first time in over 16 years. In that regard, the Deputy is correct. That resulted in a decline in alcohol consumption in Ireland for the first time in more than 16 years. The Deputy is correct that there has been a secular increase in wine consumption for a number of years but it has not been matched in the case of spirits and beer. The statistics for 2003 are based on overall alcohol consumption. Any product that has alcohol in it is taken into account for the purpose of arriving at that conclusion.
A three-year alcohol awareness campaign proved effective in raising awareness among the public of alcohol as a public health issue. I commend the press and media who have done a good job in recent times in highlighting the dangers of the type of practices in which Irish people have engaged in this area. The Road Traffic Act extends the grounds for breathalysing requests and represents a move towards random breath testing.
The Select Committee on Health Children met today to discuss the new Health Bill. The Joint Oireachtas Committee on Health and Children, chaired by the Minister of State, Deputy Batt O'Keeffe, spent considerable time compiling a report on alcohol. That report is a valuable document which took considerable time to draw up and was the result of many submissions. Will the Minister of State take that report on board? I had hoped he would comment on this valuable report which, if implemented, could make a difference to the situation.
I will draw the attention of officials in the Department to the report and ensure it is taken into consideration in any submissions made.
10 Ms O’Sullivan asked the Tánaiste and Minister for Health and Children the number of nursing posts unfilled at the latest date for which figures are available; if her attention has been drawn to warnings from the INO that the number of vacancies would rise to 2,000 over the next 18 months; the number of vacancies of ICU nurses; and the hospitals in which these exist; the number of nursing vacancies in accident and emergency departments; and the hospitals in which these exist; the steps that are being taken to deal with the shortage of nurses; and if she will make a statement on the matter. [31563/04]
Amharc ar fhreagraThe most recent Health Service Employers Agency report of nursing vacancies reported that recruitment was well ahead of resignations and retirements. Employers reported that 794 vacancies existed at 30 September 2004. The vacancy rate now stands at 2.34%.
This could be considered to be a normal frictional rate given that there will always be some level of movement due to resignations, retirements and nurses availing of opportunities to change employment and location. The recruitment and retention of adequate numbers of nursing staff has been a concern of this Government for some time. A number of substantial measures have been introduced in recent years. The number of nursing training places has been increased by 70% since 1998. In excess of €85 million in revenue funding is being provided in 2005 for undergraduate nurse training. Nursing continues to be regarded as an attractive career. There were 8,300 CAO applications for 1,640 places in 2004.
My Department introduced a scheme of flexible working arrangements for nurses and midwives in February 2001. Under the scheme, individual nurses and midwives may apply to work between eight and 39 hours per week on a permanent, part-time basis. The promotional structure within nursing, including the introduction of a clinical career pathway, has been substantially improved on foot of the recommendations of the Commission on Nursing and the 1999 nurses' pay settlement. I am confident that the extensive range of measures outlined, including the substantial increase in training places, the recruitment of overseas nurses, the more effective utilisation of the professional skills of nurses and midwives in addition to close monitoring and assessment of the situation on an ongoing basis, will continue to prove effective in addressing the nursing workforce needs of the health services.
The lack of graduates will manifest itself towards the end of 2005. My Department is also in discussions with the interim health service executive on this matter. As there will be a cohort of graduates available by early autumn 2006, the problem has a relatively short life span. A working group representing health service employers and officials from my Department was established last April to examine the issue and provide advice to employers on addressing potential shortfalls. Workforce planners in each health board are liaising with directors of nursing and human resource managers to ensure that sufficient staffing resources are available during late 2005 to autumn 2006.
Is the Minister not being complacent about the situation? The vacancy rate is increasing despite all the measures introduced by Government and we are facing into a crisis in 2005. Is the Minister aware that the Irish Nursing Organisation predicts there will be 2,000 vacancies in the coming year as a result of the changes in training?
I have looked at the figures which the Minister kindly provided. Is she not concerned about the key tertiary hospital and its nursing complement? For example, Beaumont Hospital recruited 128.5 new staff and 131.9 resigned or retired from the system resulting in 85 vacancies. The pattern is similar at Our Lady's Children's Hospital in Crumlin where 93 were recruited and 83 retired or resigned leaving 54 vacancies. St. James's Hospital recruited 204 new staff and 359 retired or resigned resulting in more than 81 vacancies. These are the most important hospitals in terms of the role they play, not alone regionally but nationally, and they are experiencing severe nursing shortages. We all know there is no problem filling vacancies in the midlands. What is the Minister going to do about the problem in these particular hospitals where the problem is so acute it affects patient care?
A number of issues arise. A shortfall will arise between the end of autumn next year and 2006 as a result of training. The Government has made available €2 million for the recruitment of overseas nurses. That programme will soon be under way. We need also to examine the nurse-nurse assistant ratio which is 70:30 in Northern Ireland; 60:40 in the UK and is 87:13 in the Republic of Ireland. The ratios needs to be considered, particularly in terms of training for care assistants.
I will have a series of meetings next Monday with An Bord Altranais, the Irish Nursing Organisation and the nurses council on issues which affect nursing. Among the issues raised is the number of nurses emigrating. I recently spoke at a conference held by the INO and was surprised by the figures supplied in that regard. Having checked those figures, of the 2,146 individuals who left Ireland, only 827 were Irish nurses and 1,058 were Filipinos. A person wishing to practise nursing overseas must have verification from An Bord Altranais and it has only provided such verification to 827 people, many of whom have gone to Australia. Like others in the 20 to 35 year age group, many of them go to Australia for at least a year's experience, and that is not unusual. I hope most of them return.
There are many issues involved such as people constantly moving around. We need to use agency nurses. Approximately 1% of all nurses working in hospitals are agency related. We also need to undertake overseas recruitment from places such as the Philippines where nurses have a terrific track record and speak good English. We need to grow the number of people graduating from nursing and in that regard the Government has provided €85 million next year for nurse education.
Will the Minister deal with the issue of a city weighting? While problems are being experienced in Cork, it is particularly a Dublin problem.
Is that in relation to salaries?
Yes, it is in terms of the high cost of living which nurses must endure and which deters them from living in the capital city.
While issues arise in this regard, they apply to other professions such as teachers, gardaí, civil servants and others.
They are not the Minister's responsibility.
Some countries make allowances for those living in the capital but we have not yet explored the issue in terms of public service recruitment policies in Ireland.
Question No. 11 answered with QuestionNo. 8.
12 Mr. Gilmore asked the Tánaiste and Minister for Health and Children the definition of the word “bed” in regard to the commitment given in the national health strategy to provide an additional 3,000 hospital beds; the number provided to date; if she will list the hospitals in each case; the number that have been provided to date in 2004; the projected number that will be provided before the end of 2004; the number of such beds that are recliners, couches and trolleys; the number of beds lost since 1997; and if she will make a statement on the matter. [31555/04]
Amharc ar fhreagraThe commitment in the health strategy to provide an additional 3,000 acute hospital beds was based on the analysis in my Department's national review of acute hospital bed capacity. That report identified a need for 2,840 inpatient beds and 190 day beds. Inpatient beds are essentially overnight beds in which patients are cared for before or following treatment.
The definition of a day bed has evolved in the past number of years. Advances in technology and treatment have altered the way in which day care is provided. In practice, care during day treatment can be provided safely in a variety of appropriate locations such as a bed, recliner or couch. The hospital inpatient inquiry system, HIPE, which records activity in acute hospitals, recently defined a day bed as follows: a day-bed or day-place is the bed, trolley, reclining chair or couch, located in a dedicated, named day-ward-unit, allocated to patients who are admitted as a result of their condition. It is used to allow the patient to rest, recline or recover in the course of an elective day-case admission. Since publication of the health strategy in December 2001, funding has been provided for hospitals to open an additional 900 acute hospital beds. This includes 700 beds announced in 2002 and 200 beds being provided as part of the commissioning of new units. While the majority of these beds are traditional inpatient beds, approximately 20% of the additional capacity are day places.
I thank the Tánaiste for putting the record straight. When this question was asked before, she insisted beds are beds and there was no question of anything else being defined as a bed. The record has finally been put right.
What is the number of beds lost since 1997? The Tánaiste claims that of the beds provided since the 2002 health strategy was announced, 20% are day beds or couches. However, since 1997, how many beds have been taken out of the system?
Since 1997, there have been 915 more beds in the system. In 1997, 12,473 beds were available and at the end of September 2004, 13,388 were available. In that whole complement, 80 were couches. When broken down, 12,325 are inpatient beds and 1,063 are day beds. There has been an increase of 915 beds since 1997.
I officiated at the recent opening of the Beacon Clinic where I inspected the renal facility. It has 35 renal machines and is the most modern state-of-the-art facility in Ireland and the UK, if not the EU. The facilities for patients are extraordinarily comfortable. They are broadly described as "recliners" in the system. Half of the patients treated there are public patients. I spoke to several of them that evening who were full of praise for the facilities and the great convenience it is for those who had to travel longer distances before. In some cases, some had to have their treatment during the night because of the huge demand for existing facilities at Beaumont Hospital.
The question was, how many beds were taken out of the system over the period.
We now have more beds than in 1997.
If the Tánaiste does not have the information, she can forward it to me. Beds were put into the system but others were taken out.
I am giving the figures for publicly funded beds in acute hospitals since 1997.
The Tánaiste is giving the net figure. However, I would like to know how many beds were taken out of the system during the period.
There has been an increase as no beds have been taken out.
Beds would have been taken out. If there is a new development in a hospital, one can end up with fewer beds because standards have been increased. I am looking for statistical information and if the Tánaiste does not have it, she can forward it to me.
I have a list for every hospital, and additional beds, which all hospitals have. I do not know about beds taken out of the system.
Does the Tánaiste foresee a role for the proposed community hospital in Tuam, County Galway, in the provision of additional beds promised under the national health strategy? When will she make a decision to allow the Tuam health campus project to proceed?
In his Budget Statement the Minister for Finance announced a multi-annual capital programme for the health services and other areas. In the context of the moneys available, decisions will have to be made. I intend to discuss with the various authorities at regional and national level the priority areas for funding over the next two years. I am not in a position to say when I will be able to communicate with the Deputy on the matter. I hope it will be shortly.
Written answers follow Adjournment Debate.
