The Cabinet will be asked to fund nearly 4,000 hospital beds over the next six years to cope with growing demand, a late draft of the Department of Health's seven-year strategy document argues strongly.
The long-awaited report from the Minister of Health, Mr Martin, will go before Ministers shortly and be published before the end of the month, a Department of Health spokesman said yesterday.
Urging the supply of 1,500 public beds over the next two years, the strategy document also warns that 500 more will be needed every year after that to cope with demand.
A late draft, seen by The Irish Times, proposes that 6,000 further beds will be needed before 2006 to care for the elderly, while old people's homes should finally be regulated. Extra assessment and rehabilitation beds will be provided in acute hospital services, geriatric services will be expanded, and more geriatricians should be hired.
All major accident and emergency units should have observation wards alongside to ease pressure, though these should not be used as a backdoor to general hospital treatment.
A new National Quality Authority will lay down rules to govern the operation of waiting lists "to ensure that patients with the greatest need are offered treatment first".
The opening hours of operating theatres, X-ray departments and laboratories should be extended significantly. The public should be treated as day patients wherever possible. Nurses should be give more powers in A&E units.
Better day care will be offered in hospitals to treat elderly patients for osteoporosis and fractures, Parkinson's disease, heart failure and continence.
Stroke units will be provided on general hospital sites.
GPs should be free to use diagnostic equipment available in local hospitals, while equipment in privately run hospitals should also be made available to public patients.
Special teams, comprised of GPs, nurses, and other health workers, should be created in large towns to improve primary care and keep people out of hospitals where possible The future of the health boards and all other health agencies is be reviewed urgently. A similar investigation into the Department of Health should also begin shortly.
Medical-card rules should be eased to extend coverage to over 30,000 intellectually and physically disabled.
Decisions about medical-card eligibility must be more transparent. In particular, the powers of the country's health-board chief executives are questioned.
All remaining patients held in psychiatric institutions will be transferred to "appropriate accommodation" by 2004.
The medical card should be given to all of the 27,149 people recorded on the intellectual disability database, while the physically disabled will hold onto their card even after three years work.
