I propose to take Questions Nos. 165, 174, 187 and 328, together.
The Health Service Executive is advancing the implementation of a series of measures to improve the delivery of accident and emergency services. These measures take a wide ranging approach and are aimed at improving access to accident and emergency services, improving patient flows through accident and emergency departments, freeing up of acute beds and providing appropriate longer term care for patients outside of the acute hospital setting.
A particular focus has been placed on those patients in acute hospitals who have completed their acute phase of treatment and are ready for discharge to a more appropriate setting. The HSE is making sustained efforts to arrange for the discharge of these patients in order to have more acute beds available in hospital for emergency patients. The number of delayed discharges in the major Dublin hospitals now stands at 378. This is the lowest number since January 2005 and has been achieved as a result of the various measures being implemented to improve the delivery of accident and emergency services.
The following is the current position regarding the implementation of these measures. In the care of the elderly area, 48 high dependency beds have been contracted in private nursing homes for those patients with more demanding care needs. A total of 318 patients have been discharged to 95 intermediate care beds for six to eight week stays since contracts with private providers commenced in May. Seventy long-term patients in St. Mary's in the Phoenix Park are being identified in consultation with clinicians and families for transfer to private nursing homes. These beds will allow for the discharge of 35 patients each from the Mater and Beaumont Hospitals. A further 65 patients have been transferred to private nursing homes pending the re-opening of 65 public long-stay beds which were closed in nursing facilities on the southside of Dublin. Additional homecare packages and enhanced subventions have facilitated the discharge of 246 and 94 patients respectively in the Dublin area. It is recognised that a range of short-term, medium-term and long-term measures are needed which transcend the immediate operational issues in accident and emergency departments and which are integrally linked to the development of primary care services and support services for the elderly. My Department and the Health Service Executive will continue to work closely to maintain a focus on the implementation of system-wide measures to improve the delivery of accident and emergency services.