Progress in hospitals
When those involved in providing health services start to get things right, they should receive due recognition and commendation. Figures produced by the Economic and Social Research Institute suggest that changing practices within the public hospital system have increased the level of productivity and of patient treatment at a time when official spending has been falling. Achieving more, with less, has been something of a Government mantra and in this instance health professionals are delivering.
Productivity improvements in public acute hospitals have resulted in the number of daycare treatments rising, while the length of stay for inpatient procedures has been reduced. In addition, use of beds by public patients in these hospitals has risen to a level consistent with official policy. In the past, although 80 per cent of beds in public hospitals were nominally reserved for public patients, that requirement was frequently breached by consultants involved in the treatment of private patients.
Prof Miriam Wiley of the ESRI has described the improved performance of these hospitals as “pretty impressive” because more people are being treated faster. Demand for services has, however, also been rising because of an increase in the number of medical cardholders and a reduction in the number of people with private health insurance. As costs continue to rise, insurance companies are likely to scrutinise the performance of the voluntary hospital sector. The average length of inpatient care at a voluntary hospital is now one-third longer than in the public sector.
In terms of an increasing demand, public hospitals may be running to stand still. Efforts to streamline services, along with changes to work practices under the Croke Park agreement, have had an effect. But more is required. Staff numbers are falling and beds have been closed. Many reforms of work practices have not been implemented. Public hospitals are, however, leading the way in providing more streamlined and cost-effective hospital care.