Madam, – The suggestion in your Editorial (“HSE cuts must be sensitive”, January 15th) is that if we reduce the number of people we admit to our acute hospitals, fewer people will receive the health services they need. This is not the case.
Independent research carried out in 2007 identified that 39 per cent of patients in acute hospital beds did not need to be there – they could have been discharged, either home or to a more suitable facility. Of these, 43 per cent were unnecessarily being kept in hospital simply because they were waiting to see a doctor or other clinician.
These findings confirm that high hospital admission rates do not equal quality effective service.
These practices are being addressed by better co-ordination of all the services admitted patients need, and by reducing non-essential admissions.
This can done by seeing and treating patients in a way that ensures they do not have to be admitted to a ward to access the care they need.
This requires timely access to clinical decision-makers and diagnostic facilities such as X-ray, CT, MRI, blood tests and so on. This is already being achieved by staff every day in many hospitals through specially developed medical assessment units and other similar types of rapid access/diagnostic services.
Since 2007 the number of people waiting more than six months for day case care has come down by almost 50 per cent, and the number of people waiting for inpatient care is down by 40 per cent.
This has been achieved with fewer acute beds, more efficient processes, higher productivity and the essential commitment of staff to developing a modern health service.
Judging the performance of a health service based on the number of people it admits to hospital is unsound. In the interests of patients and clients, we need to move away from these types of measures. Instead, we must concentrate on continually introducing more efficient ways of doing things that will provide better access, quality and value. – Yours, etc,