Private submission
Martin Wall
Senior management at the main Dublin teaching hospitals have told the Government that the establishment of 250 places in long-term facilities would lead to the easing of overcrowding in accident and emergency departments.
In a private submission to the Tánaiste and Minister for Health Mary Harney, the chief executives of the main Dublin teaching hospitals said there was a "hard core" of elderly patients who could not be placed in any of the bed facilities currently under development such as step-down, rehab or respite.
The chief executives, in their submission, described the situation in accident and emergency departments in Dublin hospitals as chaotic.
The submission, drawn up by the chief executives of St Vincent's, the Mater, St James's, Tallaght and Beaumont hospitals - which was also signed by the chairs of the medical boards in each - said this group of 250 patients required to be placed in long-term care facilities.
"At the present time, we estimate there are in excess of 250 patients in this category who will not be facilitated within the current arrangements being promoted.
"It is clear to us that if these beds were created as a once-off initiative, the beds [ in the acute hospitals] could be used to create medical assessment units."
A report produced by Comhairle na nOspidéal last year recommended the establishment of such medical assessment units where patients would have fast-track access to diagnostic services.
The report said such units had been shown to reduce substantially the time spent waiting for admission.
The Government announced last year that three additional units would be established in St Vincent's, Tallaght and Beaumont.
However, there have been difficulties about space and regarding how much money would be provided for the establishment of these facilities.
The chief executives' submission to the Tánaiste maintained that using vacated beds in hospitals to create medical assessment units "would certainly ensure that A&E departments are not crowded with patients waiting for admission".
"There are always going to be some patients waiting for admission for one reason or another but this would certainly alleviate the chaos that is currently being experienced," the submission states.
The chief executives said the Government's Bed Capacity Report in 2001 estimated that 5,000 additional beds were required, with 3,000 of these in acute hospitals.
"Since 2001 less than 1,000 beds have been created within the system. The effect of this limited bed capacity is compounded by two significant factors: (a) an increased level and intensity of activity and (b) the requirements of elderly patients admitted to acute hospitals," the submission states.
In a reply to the hospital chiefs, the Tánaiste said funding had been made available already for an additional 900 beds under the Government's health strategy commitments and that an additional 450 were at various stages of planning and development.
She also referred to her recent initiative for developing private facilities on the campus of public hospitals. She said this would free up 1,000 beds, currently designed as private, in the public hospital sector.