Seventy-one people waited over six hours for a bed in the emergency departments of hospitals in Dublin, Kildare and Wicklow in the week ended April 15th, according to the Minister for Health and Children.
The largest number of people waiting was at St James's and Tallaght, with 16 each, followed by the Mater with 13, Naas with 12, Beaumont eight, St Columcille's (Loughlinstown) four and James Connolly Memorial (Blanchardstown) two. Nobody waited six hours or more in St Vincent's, according to figures given by the Minister to Mr Noel Ahern TD.
Mr Martin predicted that developments at hospitals around the State would mean fewer patients having to travel to Dublin for services, with benefits both for themselves and for Dubliners, for whom more beds would be freed up.
In particular, he instanced developments at Castlebar, Clonmel, Galway, Limerick, Naas and Portiuncula.
Subventions towards nursing home fees are expected to cost the State 21 per cent more this year than in 2000, according to figures supplied by the Minister for Health and Children to Ms Frances Fitzgerald TD.
The cost is increasing substantially each year, having risen by 15 per cent in 2000. This year's cost is expected to be £46 million, and it is likely to exceed £50 million next year.
With nursing homes becoming an extension of hospital services - and with hospitals placing patients in nursing homes 20 to 30 miles away in some cases - it is clear the cost will go on rising substantially.
But with families paying dearly for nursing-home beds for relatives, the State contribution forms only a tiny part of the overall health budget. This year's £46 million would pay for no more than 600-700 acute hospital beds for a year.
The State saves in other ways as well. According to three geriatricians writing in the Irish Medical Journal, "community therapy services will often not serve patients who are in subvented or contract beds in nursing homes".
Drs Des O'Neill, John Gibbon and Ken Mulpeter of the Irish Society of Physicians in Geriatric Medicine say standards of good practice for these patients should be included in legislation and these standards should apply whether they are in public, private or voluntary institutions.
They point to what they see as a particularly anomalous aspect of how nursing homes are subsidised by health boards. "There is no clearly-stated, consistent and transparent policy among the health boards about meanstesting and the disposal of assets," they write.
"This means that in beds side by side in a nursing home, a patient and family may have gone to considerable distress and disturbance to dispose of assets and pay to make up the difference between subvention and nursing home costs, while in the next bed a patient with similar assets may be paying nothing at all as they are in a contract bed. A similar situation occurs with access to publicly-funded beds."
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