The chief executive of the Health Executive (HSE), Prof Brendan Drumm, has told hospital consultants it is hard to justify a further increase in acute hospital beds. Minister for Health Mary Harney has supported his view, writes Dr Muiris Houston, Medical Correspondent, in Galway
At the annual meeting of the Irish Hospital Consultants' Association (IHCA) in Galway, at the weekend, Prof Drumm said the Republic already has a higher percentage of acute hospital beds than the United Kingdom, despite having a lower percentage of the population aged over 65.
"We have an age profile that is massively to our advantage. We have 11 per cent of the population greater than 65 while in the UK 17 per cent of people are older than 65.
" If you are suggesting that we need acute care beds of the order of the UK and most of Europe, I would suggest that we cannot justify that," Prof Drumm told consultants.
Warning of a possible "black hole" of extra beds, he advocated the development of primary and community care services instead.
Asked to respond to his statement, Ms Harney said: "There will be no one happier than me if we don't have to have new beds."
Calling for a constant review of bed-need as medical practice changes, she said: "We need to make better use of what we have first before we build more and more . . . It will be a matter for the HSE to decide what we require in each area. But we won't have beds for the sake of it".
Earlier, while acknowledging the Government's plan to provide an additional 1,000 beds over five years through a public/private initiative, president of the IHCA Dr Josh Keavney said: "Delays in admissions, overcrowding and other problems in our hospitals have their root source in the bed shortage".
"Within the developed world, Ireland continues to have one of the lowest ratios of acute beds to population. The EU average is 4.4 acute beds per thousand population while we have 3.05. Had Ireland the EU average, we would have 17,500 beds rather than the present compliment of 12,000 in-patient beds. Additionally, Ireland has amongst the highest bed occupancy rates in the developed world".
Meanwhile, Prof Drumm told consultants of a significant new health service development which he said "raises questions for your contact negotiations".
Referring to the need to integrate more closely the workings of the National Hospitals Office and the Primary and Continuing Care division of the HSE, he said: "At a very central level in this structure we will be bringing in care groups for patient care".
The new patient care groups, would, he said, be both the drivers of policy in specific areas as well as the monitors of policy implementation. They would be set up for specialities such as general medicine, surgery and child health as well as for specific disease areas such as cancer and heart disease.
Promising consultants a senior role in the new groups, which will have between 10 and 15 members including physiotherapists, public-health nurses, social workers as well as patients, Prof Drumm said: "These will be very powerful and influential care groups that will be drivers of policy and monitors of implementation".
"These groups will be capable of saying, why isn't this working in terms of numbers of hips being operated on or whatever. These are your peers. You can pick up the phone and plug directly into the system".
"Is it a challenge to get these into place? It is. But I don't believe this kind of movement should be stopped just because somebody else hasn't done it."