Written Answers. - Hospital Delays.
Ivor Callely
Ceist:
13
Mr. Callely
asked the
Minister for Health
if his attention has been drawn to the number of times patients awaiting elective hospital procedures have their appointments cancelled due to the shortage of beds; and if he will make a statement on the matter.
[2612/96]
Matt Brennan
Ceist:
26
Mr. M. Brennan
asked the
Minister for Health
the measures, if any, that have been taken to ease the accident and emergency crisis in hospitals; the cost of these measures; and the agency conducting the current advertising campaign urging the public to use their General Practitioner.
[2696/96]
Limerick East): I propose to take Questions Nos. 13 and 26 together.
The hospital service has encountered problems in the provision of accident and emergency services, particularly over the winter period in the past number of years. This is not a problem confined to Ireland but is a feature in other developed countries also.
The causes of the problems which arise have been well documented. The ageing of our population has contributed to the difficulties in accident and emergency departments. The winter period brings its own set of problems for our elderly population. This in turn can lead to an upsurge in the number of patients who present in accident and emergency departments requiring admission to hospital. Many elderly patients require acute hospital care initially but much of their recovery period could be spent in step down subacute accommodation. The shortage of sub-acute beds, particularly in Dublin, has caused problems in that acute hospitals have not been able to discharge patients in sufficient numbers and quickly enough, to cater for new patients seeking the services of the hospital. This in turn has led to the cancellation of elective admissions to hospitals at times, medical priority being the determining factor. There is nothing new in this. This has been the position for quite some time and has faced different Ministers for Health.
The volume of patients who present at casualty departments for treatment has also increased. For example between 1988 and 1995 the number of new attendances at the six major accident and emergency hospitals in Dublin increased by approximately 39 per cent. The extra volume of patients, in some instances, has necessitated extending the physical facilities in some accident and emergency departments and it is intended to continue refurbishing accident and emergency departments as required.
The accident and emergency problem has been building up, especially in Dublin, for some time. Up to now, difficulties in the accident and emergency services have been dealt with by providing mainly once-off solutions. I was anxious that a more comprehensive and integrated approach be adopted and therefore I asked officials in my Department to examine the situation in Dublin and submit proposals for the winter of 1995-96.
In the first instance there is a need for hospital management to give greater priority to the problems that have emerged in the organisation and delivery of accident and emergency services. Hospitals need to refocus their activities to a greater degree with regard to bed utilisation and in relation to admission and discharge procedures. It is important that each hospital agrees a series of measures that will result in a better and more streamlined response. It is only when the above issues have been tackled that a hospital is in a position to deal with the many day to day logistical problems that arise in the provision of accident and emergency services.
The successful management of the accident and emergency difficulties includes tackling a number of areas including services for the elderly, services for the chronically disabled and services provided by the acute hospitals which, when taken together provide a comprehensive and integrated response. The measures adopted for the winter 1995-96 are are follows: 25 new elderly care beds were opened in Peamount Hospital; 40 additional nursing home places in private nursing homes were made available; 3 new community ward teams for the elderly have been approved; a 25 bed unit for the young chronically disabled is being opened in Cherry Orchard; a 46 bed community unit for the elderly on the Navan Road is due to be opened next week; a health board public education campaign co-ordinated by the Eastern Health Board on the appropriate use of accident and emergency services was launched on 15 January 1996 and is ongoing. The agency involved is Doherty Advertising and the cost of the campaign is approximately £140,000. In the six accident and emergency hospitals in Dublin a number of measures were taken including: (i) the opening of extra beds, (ii) additional staff recruited, (iii) medical equipment grants were approved for accident and emergency departments, (iv) observation facilities were opened.
The cost of the measures outlined above was £534,000 in 1995 and will be approximately £2.5 million in 1996. This is the largest investment ever in the management of accident and emergency services in Dublin.
