The exchequer is facing a €4 billion bill to provide thousands of additional acute hospital beds for public patients over the next decade or so if the health service continues to operate its existing model of care, a major new report given yesterday by the Health Service Executive to trade union leaders has found.
The report by external consultants PA concluded that under the current model of care, the number of acute hospital beds would have to increase to 20,000 by 2020.
The report maintained that given the demographic trends, the demand by public patients for acute hospital facilities would rise by 60 per cent over the next 12 years.
It said that under the current model of care, acute hospital bed numbers would have to be increased by about 40 per cent to meet this level of demand.
In a presentation to health service trade unions at Farmleigh House in Dublin yesterday, the HSE said that the capital cost of providing such increases in the acute bed stock would be about €4 billion.
The revenue costs for providing staff for these new facilities would be extra.
The HSE said this would involve the equivalent of opening new hospitals of the scale of Tallaght or the Mater every year for the next 12 years and that even then there would be no guarantee that better outcomes for patients would be achieved.
The HSE argued that there was currently an over-reliance in Ireland on acute hospital care.
The report, which will be published by HSE chief executive Prof Brendan Drumm today, proposes a new integrated healthcare system, which would involve more emphasis being placed on community and non-acute service, as a preferred model of care into the future.
This system would involve greater development of GP and community facilities as well as medical assessment units in hospitals, improvements in discharge planning and increased numbers of non-acute, therapy and long-stay beds.
The report estimated that under this integrated healthcare model, the number of acute hospital beds could be reduced to 9,000.
However, sources said that about 10,000 more long-term places would be required.
It is understood that the HSE indicated to union leaders yesterday that there may not be any major financial savings generated by a changeover to the proposed integrated healthcare model, given the need to develop community facilities.
Separately, the consultants' report concluded that there was currently a shortfall of 1,118 acute hospital beds in the country.
However, the HSE has argued that this figure will be offset by the number of new public beds currently being planned, as well as by the development of the co-located private hospitals which will free up existing beds in public hospitals currently reserved for fee-paying patients.
It is understood that the report maintains that about 450 new acute beds are currently being planned and that 660 beds will become available when the co-located hospitals come on stream.
The bed capacity report was set out yesterday by HSE management as a discussion document at a meeting of the steering committee of the new health forum.
The forum, which will look at non-pay issues in the health sector, will meet again in early February.