More beds to close in 2010 - Drumm

Health Minister Mary Harney said a huge effort has been made to minimise the impact on patient care of the HSE's reduced budget allocation for 2010.

However, HSE CEO Prof Brendan Drumm has revealed that 1,100 acute hospital beds will be closed in 2010.

The Minister told the Joint Oireachtas Committee on Health and Children yesterday that the HSE's allocation was €1 billion down on last year. However, €630 million of this reduction was accounted for by cuts in pay costs and there were €250 million in drug savings.

Referring to the HSE's plan to cut hospital admissions through emergency departments by 33,000 this year, Prof Drumm said currently 17% of admitted patients come in for 24 hours or less and 30% were there for less than 48 hours.

"The vast majority of these patients should not be in hospital."

Prof Drumm said more senior decision-making in hospitals on whether to admit a patient and the greater use of medical assessment units would be critical in achieving the 33,000 figure.

He said 1,100 beds would close this year and this figure would be in line with the reduced admissions target.

Current figures show that around 1,700 beds are unavailable in the system due to closures and delayed discharges. However, the HSE expects the delayed discharge numbers to fall when the Fair Deal scheme for nursing home care kicks in.

Labour health spokeswoman Jan O'Sullivan queried how the planned 33,000 reduction in inpatient admissions through A&Es would be achieved.

Prof Drumm told the Committee the HSE planned to continue to reduce the numbers admitted to hospital beds through A&Es just to get a consultant opinion or access to a diagnostic test.

He said the HSE planned to make it easier for these patients to see senior clinical decision makers in medical assessment units and improving access to diagnostic testing and other ambulatory care services.

Prof Drumm said while there were several successful medical assessment units already in place, more medical assessment units needed to be provided in the Dublin area.

He said with more active chronic illness management in primary care, supported by direct access to a consultant opinion when needed, ED visits which often lead to admission can be avoided.

Prof Drumm said with this in mind, a number of projects would be launched in disease areas such as diabetes and asthma this year in order to develop alternatives to hospital admission.

Fine Gael health spokesman Dr James Reilly queried how the HSE was going to maintain the same level of services in 2010 with fewer resources.

He said while 30% of A&E admissions might be in hospital for less than 48 hours, this did not mean that all 30% did not need to be admitted.

He said the continuing increase increase in ED trolley numbers was a matter of serious concern.

Whether the trolleys were in the A&E or on hospital wards, it was still not a safe situation, Dr Reilly said.

He said ambulances were queueing up at some EDs in Dublin for up to seven hours.

Prof Drumm said the A&E issue was now focused on a small number of hospitals and there was a situation where  A&E processes in hospitals were not standardised - these included provision of medical assessment units, and the use of nurse practitioners.

He told the Committee that the NTPF could be utilised more to help reduce outpatient waiting lists.

He said it was a source of of frustration for the HSE when the NTPF was not being used sufficiently by some hospitals to reduce inpatient lists.

Minister Harney, at the Committee meeting, said that following the recent 40% price reduction in off-patent branded drugs, some generic drugs were now more expensive than branded products.

She called on generic manufacturers in Ireland, who were not part of the recent price agreement, to reduce their prices.

She revealed that the drug firm Sanofi had successfully tendered for the provision of the cervical cancer vaccine in the scheme for 12-year old girls to be launched shortly.

Its vaccine, Gardasil, will be used in the campaign due to begin before the summer.

[Posted: Wed 10/02/2010]