Update care ‘or face €4bn bill for beds’

THE Health Service Executive has warned an extra 20,000 beds in public hospitals will be needed by 2020 at a cost of €4 billion unless changes are introduced in the provision of healthcare in Ireland.

HSE chief executive Brendan Drumm said he supported the findings of a report which recommended the development of an integrated health system which would see patients spending less time in acute hospitals than at present.

Prof Drumm claimed the move to treating more patients on a day-release basis and through the greater use of community-based health services, was already under way. He argued the alternative of providing more acute hospital beds, which would require the HSE to build a 600-bed hospital each year for the next 12 years, was unsustainable in dealing with an ageing population.

“To develop a world class health system we have to replace outdated practices with modern ways of doing things that reflect the needs of patients,” said Prof Drumm. “The review tells us that more resources are not the only answer to improving access and reducing waiting times.”

However, he acknowledged such changes would require healthcare staff to engage in more significant and flexible work practices.

The Acute Hospital Bed Capacity Review which was published yesterday, examined how public hospitals admit, treat and discharge patients. It concluded most patients would spend less time in acute hospitals if best international practice was adopted.

However, the Irish Hospital Consultants Association, claimed the HSE-commissioned report was “a lone voice” in suggesting hospital services could survive with 4,800 fewer acute hospital beds than at present. The association pointed out the report’s findings contradicted the conclusions of two other reports which recommended significant increases in acute bed requirements.

It accused the report of adopting an “a la carte” selection of healthcare practices from other countries which could not easily be transferred to Irish hospitals.

“There is near universal acceptance that the 12,778 beds that we have at present cannot cope with the needs of our population of 4.2 million,” said association assistant secretary general Donal Duffy.

But the report by PA Consulting maintains many benefits of an integrated health system, such as the better planning of patient discharges and an increase in the number of patients admitted on the day of actual surgery could be delivered relatively quickly at little cost. It claimed 6,458 public hospital beds — compared with the existing 11,660 beds — would be required to meet current demand if a fully-integrated health system was in place.

Among the report’s main findings is that many patients are unnecessarily admitted or kept in hospital for too long.

The Irish Nurses Organisation said the review was welcome but cautioned it should not be used as an excuse to avoid addressing the current problem of overcrowding in hospitals.