Fair Deal scheme ‘the Achilles heel of hospital sector’

Fair Deal, the State’s nursing home support scheme, has become the Achilles heel of the acute hospital system, according to HSE director general Tony O’Brien.

Mr O’Brien told the Joint Committee on Health and Children yesterday that, without extra resources, there would be 2,200 people waiting up to 20 weeks for funding by the end of the year.

“When you look at what’s happening in the acute hospital system right now, it could be said that the funding mechanisms and the arrangements for the Fair Deal scheme, as welcome as they are in terms of the benefit it brings to those who gain access, has become the Achilles’ heel of the acute hospital system,” he said.

Mr O’Brien said there was a 15-week waiting period for funding under the scheme last November and a waiting list of 1,937. By January, an action plan had reduced the waiting time to 11 weeks, with the number of people waitingdown 759 to 1,188.

There are 1,234 waiting for funding support but more people that ever before are going on to the list than coming off it.

“The funding that we have applied will sustain the 11-week waiting period until approximately the end of this month. In the absence of additional resources to be applied to that scheme, our concern is that, by the end of the year, we will reach a waiting period of between 18 and 20 weeks and see 2,200 people on that list.”

Earlier, Mr O’Brien said patients attending hospital emergency departments are generally more unwell and more likely to require admission than the past. This is due in part to an increase in the number of frail, elderly patients attending.

He pointed out that, in the last five years, the number of emergency department attendances had increased by 63,123 — more than 5%.

Last year, there were 6,614 more emergency department admissions compared to 2013 — around 550 more admissions each month.

He said the number of delayed discharges — patients whose acute care had ended — remained high and very challenging at 745.

There were 478 patients on trolleys in hospital emergency departments and wards yesterday, according to the Irish Nurses and Midwives Organisation’s Trolley and Ward Watch.

Beaumont Hospital in Dublin had the highest number, at 41, followed by Our Lady of Lourdes Hospital in Drogheda with 36, and University Hospital Limerick where 31 were waiting.

The INMO has secured 88 extra nursing posts and 65 more beds to deal with overcrowding at Our Lady of Lourdes Hospital.

Meanwhile, Mr O’Brien said the review of problem births at Portiuncula Hospital in Ballinasloe, Co Galway, could be extended to include other cases.

The draft terms of reference had been completed. It had been intended that the perinatal care provided to seven women in the hospital would be reviewed but this does not preclude the possibility of extending the review to other families.

Mr O’Brien said it is possible that two of the seven families might not wish to take part in the review.

He said some individuals who had come forward had been involved in losses going back 35 years and it might not be appropriate to include all of the cases in the review.

Warren and Lorraine Reilly, who lost two babies while attending the hospital, had appealed for an extension of the review.