Hospital consultants and nurses have rejected a report urging a reduction in the number of acute hospital beds, with the main nurses' union claiming this week was "one of the worst in recent years" for patients waiting at A&E on chairs and trolleys.
The Acute Hospital Bed Review published by the Health Service Executive says the number of such beds would have to increase to 20,000 to meet demand by 2020 at a capital cost of some €4 billion.
Irish Nurses' Organisation
It urges a rethink on how health care is provided, suggesting hospitals need to reconsider their admissions and discharge policies and that there should be a move towards more community-based care.
But the Irish Hospital Consultants' Association (IHCA) said the report is a "lone voice" in suggesting that Ireland's hospital services could survive with 4,800 fewer acute hospital beds than at present.
And the Irish Nurses' Organisation (INO) said the system is "at least 1,200 short of the number of acute beds required to properly meet the demands on today's services". The INO said the bed review indicated some "stark" choices must now be faced in funding the health service into the future.
"There is near universal acceptance that the 12,778 beds that we have at present cannot cope with the needs of our population of 4.2 million, of whom 480,000 are over 55 years of age," the IHCA said in a statement.
"Notwithstanding developments in medicine it is impossible to see how we could provide an adequate service for a population of over five million people, one million of whom will be over 55 years of age in 2020, with nearly 5,000 less acute beds."
It said today's review takes an "a la carte" selection of practices in a number of countries where "the dynamics are entirely different from those in Ireland".
"It is highly unlikely that these proposals would necessarily transfer as envisaged by the authors."
The INO said the review "must not be used to divert attention from today's chronic overcrowding".
It said the report !confirms the current shortage of acute beds facing the country and also the need for sustained additional investment in the public health service if it is to meet the needs of this country's growing, and ageing, population by the year 2020".
"This week has been one of the worst in recent years with patients awaiting admission on chairs and ambulances detained at A&E departments because they could not release their trolleys; cystic fibrosis sufferers having to go public on their plight to get safe care and staff in mental health services being assaulted as a direct result of service cutbacks," the INO said in a statement.
The union said it must be "immediately acknowledged, by government and the HSE, that additional significant and sustained investment must be made towards the public health service if we are to have a truly world class service in the years ahead".
"This need was previously identified by the Government when it published the Health Strategy in 2001 but, almost immediately, it declined to commit itself to the necessary additional capital and staffing investment, up to 2011 because of the costs involved," the INO said.
It said today's report should form the backdrop to continued discussions with the social partners.
These talks must address the immediate acute problems facing the health service and result in an "informed debate" about the cost of an integrated model of care, as opposed to developing 20,000 acute beds.
INO General Secretary Liam Doran said: "Today's bed capacity review confirms the starkness of the issues and choices now facing everyone who cares about a quality assured public health service.
"The INO, while welcoming today's review as being an important contribution to the debate about the nature and form of the future of our public health service, will not accept that it becomes a framework for discussions about 2020 in the absence of a concerted effort to deal with today's problems in the interests of today's patients."