Editorials

The Irish Times view on acute hospital beds: shooting at a moving target

The Government plans to add substantially to capacity, but it is unclear whether it is doing enough to address the significant shortages

The Minister for Health Stephen Donnelly and the Minister for Public Expenditure, Paschal Donohoe, at St. Vincent’s University Hospital where they announced the Acute Inpatient Hospital Bed Expansion Plan, (Photograph: Bryan Brophy/1IMAGE Photography) 1IMAGE PHOTOGRAPHY Studio: +353 1 493 9947 | Mob: +353 87 246 9221
The Minister for Health Stephen Donnelly and the Minister for Public Expenditure, Paschal Donohoe, at St. Vincent’s University Hospital where they announced the Acute Inpatient Hospital Bed Expansion Plan, (Photograph: Bryan Brophy/1IMAGE Photography) 1IMAGE PHOTOGRAPHY Studio: +353 1 493 9947 | Mob: +353 87 246 9221
Sun Jun 02 2024 - 20:05

The Government appears to be making a determined effort to get out ahead of the issue of acute hospital bed capacity both politically and substantively. The proximity of the publication of its acute hospital bed targets – complete with figures for every hospital – to the local elections may not be accidental, but that does not detract from their importance.

The report commits the Government to add another 2,997 acute hospital beds to the system by 2031 – bringing the total added since 2020 to 4,656 plus another 929 replacement beds. It is a substantial increase and the cost over three years is put at €245 million. But the question remains as to whether 3,000 new beds is enough.

Even allowing for the additional beds contained in the new plan, the most recent projection of 4,656 is still well below the requirement set out in the 2018 Health Service Capacity Review which called for 7,150 additional acute beds by 2031. That figure came with the caveat that this number could be significantly reduced by reforms in the way the health system operates.

The difference between the two figures is not reconciled in the new plan and we are left to assume that unspecified reforms explain the reduction. The Department of Health says that it has instigated a “refresh” of the 2018 capacity review to take account of “significant developments in the health and wider operating environment”.

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These include demographic and epidemiologic changes since 2018. This work, which will be done in conjunction with the ESRI, will look at demand and associated capacity deficits out to 2040. It is an open question as to whether the refresh will close the gaps between the current and 2018 target.

In the meantime, the HSE has relied on its own modelling and data to allocate beds under the first tranche of funding that has been made available. The department’s view is that the plan “aligns” with the findings of the 2018 capacity review and “considers” interim and longer-term demand modelling. It would be preferable to see a stronger link between evidence and policy.