Dáil Éireann Debate, Thursday - 2 June 2016
8. Deputy Seán Crowe asked the Minister for Health why, as of 29 April 2016, only 234 of 301 new hospital beds were added to support the acute hospital system; the progress being made to date to increase capacity; the funding allocated and used to date for this purpose; and if he will make a statement on the matter. [13697/16]
Amharc ar fhreagraI am very conscious of the impact that long wait times in emergency departments can have on patients and their families, as well as on front-line staff. Last Monday I attended my first meeting of the emergency department, ED, task force implementation group, which is co-chaired by the director general of the HSE and Mr. Liam Doran of the INMO and which is providing focus and momentum in dealing with the challenges presented by emergency department overcrowding. As Minister for Health, I intend to personally attend the monthly meetings in order to keep momentum going.
In June 2015, additional funding of €18 million was made available to the HSE under the winter additional capacity initiative. The initiative identified 301 additional winter capacity beds that could be opened. In some hospitals, beds have proved more challenging to open than envisaged, owing to difficulties in staff recruitment. However, to date, 236 of these 301 new beds have opened. In addition, 116 closed beds have re-opened and a further 14 beds have been opened in Sligo. In total, 366 new or reopened beds have been made available.
This extra capacity has enabled similar emergency department performance to the equivalent period in 2015, despite an average increase of nearly 6% in attendances so far this year.
Furthermore, figures for May show total numbers of patients on trolleys are approximately 18% lower than in May 2015, with numbers waiting over nine hours approximately 24% lower than in May 2015. I do not say this is acceptable but I want to put it into context.
The demand for acute hospital services continues to increase in line with a growing and ageing population. The overall population growth year on year is in the order of 1%, whereas growth in the over-65 age group is of the order of 3% to 4% per year. In addition, in 2014 adults aged 65 years and over accounted for nearly 13% of our population but used 53% of total hospital inpatient care, which demonstrates the demographic pressures on our health service.
Reviews of bed capacity and medical assessment unit hours of service are needed and are key commitments in the programme for a partnership Government, as well as for me, as Minister for Health, so that I can look at ways to address pressures on our emergency departments. I am planning a winter initiative, not just for this year but next year too and this is under way.
Some €18 million was spent last year on the winter initiative. Can the Minister advise if the same amount is being set aside for this year, or will it be more? We are 65 beds short of the target of 301 which was promised. Where did those 65 beds go?
The Minister said it is the intention to undertake a bed capacity review and that is very welcome. When will that start and finish and who will conduct it? Does the Minister have any plans or money set aside to act on the recommendations that will be made? We do not need too much time to know that there are not enough beds in the system. The bed capacity review should be a fairly quick exercise and it would be interesting to know whether the Minister has identified somebody who can carry it out.
I am not in a position to reveal the figure for the winter initiative today but I will be shortly. The Taoiseach and the Minister for Public Expenditure and Reform have made clear in this House that we will present our health Estimate, as well as all other Estimates for departmental Votes, in the next fortnight.
I hope I will be able to provide clarity to Deputy O'Reilly in this regard at that stage. I hope the decision to commence the winter initiative now, at the end of May or start of June, is seen as a signal of my intention and that of the HSE to try to prepare for this in advance and to look at next year as well. As this is a crisis that happens year on year, we need to plan ahead for it.
The Deputy spoke about the closed beds figure and asked where the 65 beds went. As I outlined in my initial response, there have been staff recruitment difficulties in some hospitals and some areas. One cannot open beds without staff. However, some 366 new or reopened beds that were not available in the system are now available in the system. The bed capacity review has to be different this time. I have no interest in carrying out a bed capacity review for acute hospitals only. We cannot keep seeing the acute hospital as the beginning and the end of every conversation. We must look at capacity in the community as well. I refer to nursing homes, long-term stay beds and community hospitals. The bed capacity review must look at the whole continuum of care and beds. I will come back to the Deputy with details of the timeframe. I would like it to take place as quickly as possible, particularly because I am conscious of the review of capital plans that is due to take place next year. I need to know the data so I can deliver in that regard. On the question of how I will have funding to deliver all of these things, the Estimates will be in the House in the next fortnight, as I have said.
We need to know who will conduct the review. I welcome the Minister's statement that it will encompass all beds because there is a serious need for that to be examined. The Minister may already be aware that according to the OECD, the number of beds we have per 1,000 people is below the EU average. We already have a deficit. I am disappointed that the figure for the winter initiative, which the Minister is right to start early, is not being shared with us. As the winter approaches, the pressure on our accident and emergency departments will increase. It used to get particularly bad when there were spikes, but now a level of difficulty is being maintained. I am familiar with this from my previous job. When one talks to the staff one is told that there used to be quieter times, but there are no lulls anymore. The sooner the bed capacity review is undertaken the better, because I believe this will result in all the beds that have been identified being opened. According to our figures, we are still 65 beds short, notwithstanding the other beds.
This is my first outing here, so I do not want to disappoint the Deputy at this early stage of our exchanges. The Deputy will know the figure within the next fortnight. In fact, she will know when I know. Obviously, we have to look at what did and did not work last year and what we did not look at last year that we should look at this year. That is the message I delivered to the emergency department task force on Monday of this week. The important message for the HSE is that the solution to this problem is not one that solely rests in the acute hospitals. It has to involve the primary care divisions of the HSE, social care and the home care packages that were discussed by the Minister of State, Deputy McEntee, with Deputy Kelleher earlier. We will have clarity on this matter for Deputy O'Reilly in the next fortnight or so. I largely agree with what she has said about bed capacity. I stress that we need to identify exactly where the beds are needed. We intend to work with everybody on this. As I have said, we also need to look at delayed discharges because the infrastructure in the community is sometimes inadequate.
