Up to 9,000 additional hospital beds needed, review finds

Capacity study says up to 2,500 additional beds required if reformed health system implemented

The review recommends that a number of hospitals should be established to deal exclusively with elective or non-urgent cases. Photograph: Dara Mac Dónaill/The Irish Times
The review recommends that a number of hospitals should be established to deal exclusively with elective or non-urgent cases. Photograph: Dara Mac Dónaill/The Irish Times

Between 7,000 and 9,000 additional hospital beds will be required over the next decade or so if the existing model of healthcare continues, the Government’s long-awaited review of capacity requirements has found.

The review has concluded, however, that the number of additional beds needed could be reduced to 2,000-2,500 in the years up to 2030 if Sláintecare reform proposals, such as investing heavily in healthcare services in the community, are implemented.

In addition, the review recommends that a number of hospitals should be established to deal exclusively with elective or non-urgent cases. It argues this would assist in reducing waiting lists and emergency department overcrowding in acute hospitals.

Health service sources said this could involve a reconfiguration of existing services in some parts of the country including potentially closing some emergency departments.

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Existing reform plans along these lines in Portlaoise have prompted strong criticism from local politicians and campaign groups in the midlands.

The bed capacity review also calls for dramatic increases in long-term residential places. This would assist in reducing the number of delayed discharge patients in hospitals; those whose acute phase of treatment has concluded, but cannot be sent home or transferred to other healthcare facilities.

The Minister for Health Simon Harris has repeatedly pointed to the forthcoming bed capacity review as the way to deal with the overcrowding and trolley crisis in public hospitals.

Trolley count

Nurses on Friday maintained that more than 2,400 patients had to spend time on trolleys in hospitals in the first few days of 2018 while waiting on a bed.

The number of people deemed to require admission to hospital by a doctor and waiting for a bed fell to 483 on Friday, from record levels of 677 experienced early this week. However doctors and health service administrators forecast that the numbers could rise again in the next week or so as the peak of the flu season hits.

The HSE said on Friday it expected non-urgent elective procedures would not take place in hospitals next week but maintained this would be considered on a hospital-by-hospital basis.

However, the HSE stressed hospital groups and individual hospitals were ensuring that cancer and other urgent elective procedures were continuing to be carried out.

“Other non-urgent elective work will be reviewed on a site by site on a clinically prioritised basis during the course of the next week. We expect that non-urgent elective procedures will not proceed but stress that this will be considered on a site by site prioritised basis.”

Community facilities

The bed capacity review is expected to be published within the next three weeks and will feed into the Government’s overall 10-year capital plan.

The provision of additional hospital beds along the lines of the recommendations in the forthcoming capacity review would cost hundreds of millions of euro.

The Department of Health told the Oireachtas committee on the future of healthcare last year that the construction and capital cost of providing an additional hospital bed was about €325,000.

On this basis it would cost in excess of €800 million to provide the 2,500 additional beds proposed by the capacity review as part of a reformed health service.

Mr Harris told The Irish Times in an interview prior to Christmas that thousands of additional beds in acute hospitals and community facilities would be required in the future and that the forthcoming review would set out specific numbers.

He said on Thursday that significant additional funding would have to be provided by Government to meet the cost of opening additional hospital beds.

Martin Wall

Martin Wall

Martin Wall is the Public Policy Correspondent of The Irish Times.