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EDITORIAL: Frontload provision of beds

February 4th, 2018 5:00 PM

By Southern Star Team

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THE Review of Health Demand and Capacity Requirements in Ireland to 2031, published last week by the Department of Health, confirmed that 2,600 extra hospital beds will be required in the next decade in order to cope with the pressures being experienced at Emergency Departments. This will only be enough if parallel requirements for an additional 13,000 residential care beds in the community are also met in order that acute hospital beds can be made available on an ongoing basis to cater for patients coming through EDs that need to be admitted for treatment.

At the moment, the number of people waiting on trolleys for longs periods of time, in and near EDs, is still unacceptably high as the peak flu season seems to be lasting longer this winter. The fact that GPs and primary care centres are so badly resourced and struggling to cope means that more and more people are being funnelled through EDs instead of being treated in their own communities.

While it was great to see step-down care beds opened in Clonakilty Community Hospital to relieve the pressure on acute hospitals such as Cork University Hospital, it was a crying shame that the fantastic new state-of-the-art extension to Bandon Community Hospital was left lying idle for several months because of a dispute over staffing issues. The HSE needs to get its act together on staffing levels in order to ensure timely provision of new hospital beds.

In fact, there needs to be a concerted effort to frontload the provision of beds, in acute hospitals especially, in order to break the back of the shortage problem and help relieve some of the suffering of people who will inevitably present at EDs during the winter of 2018/’19. A determined short-term surge of extra bed provision would also relieve pressure on the hard-working staff who have to cope with all the problems that the current vastly under-resourced system inflicts on them.

Fianna Fáil health spokesman, Billy Kelleher, has suggested ‘an urgent audit of all public hospitals in the country to identify quick wins in terms of additional capacity.’ He correctly pointed out that wards that have been closed in the past would require little or no capital investment to re-open. 

While acknowledging that the challenge will be to staff them appropriately, he was adamant that ‘these wards must be the short term, immediate priority for the government’ and that the ability of the HSE and the Department of Health to deliver beds in the immediate future will be the measure of Health Minister Simon Harris’s commitment to end overcrowding in our hospitals.

Because not every patient needs the same level of care and oversight, Mr Kelleher wants better use made of our community hospital network for step-down healthcare for recovering patients who do not need to be taking up a valuable bed in an acute hospital. The same should apply in the case of private nursing homes, especially with a growing aged population that will increase the demand for beds, however Nursing Homes Ireland has criticised the delay in the publication of the Fair Deal pricing review, which was due to have been completed on June 1st last year and the conclusions of which will impact on expansion investment decisions by nursing home owners. 

NHI chief executive Tadhg Daly pointed out, in reaction to last week’s report, that the only new supply of nursing home beds in the past decade has come from private and voluntary operators. Calling for true partnership by government and the HSE if the considerable increase in  capacity required is to come to fruition, he made a valid point that ‘Ireland is too small for public to operate in isolation from private and voluntary providers.’

Some major capital investments will be needed in existing hospitals and, possibly also, in new public hospitals in the medium to long term so that all the extra beds needed can be provided and adequately staffed between now and 2031. In the meantime also, the health service may be hit by extra demands that could lead to delays, so it is vital to hit the ground running and get as many beds as possible opened or re-opened this year for starters.

Actions always speak louder than words. 

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