The announcement by the Minister for Health of an additional 709 acute hospital beds is a welcome one. That they are the first additional beds to be added to the public health system in over 20 years, is a sad reflection on the priority accorded our national health service by successive governments.
The system has lost 6,000 beds since 1980. We are promised 3,000 additional beds for public patients in the next ten years. When the system had 6,000 additional beds, only 8 percent of medical procedures were carried out as day cases. The level of day hospital activity is now at 35 per cent and is projected to grow to 50 per cent. Therefore a rough calculation would suggest that 3,000 new beds should be sufficient to make up the shortfall.
However, this simple calculation ignores two important factors: our population has increased significantly since 1980, and crucially, the percentage of the population who are aged over sixty-five - and in greater need of hospital care - is set to increase by 40 per cent by 2020.
In addition, the Minister has given a commitment that by the end of 2002 no adult will wait longer than 12 months, and no child longer than 6 months, for hospital treatment. Whether this is achievable by treating an additional 30,000 patients in 2002, as the Minister promised yesterday, remains to be seen. The authors of the Acute Hospital Bed Review Report suggest that the system requires in excess of 4,000 beds over the next ten years. However, they argue that 3,000 will be sufficient if certain efficiencies are met.
A more rapid throughput of patients, better use of daycare and outpatient procedures and a reduction in the number of referrals from primary care must all sucessfully coalesce if the projected bed numbers are to suffice.
That so few efficiencies were recommended in the Health Strategy document, published by the Minister last November, does not augur well for meaningful reform. Why are pre-operative clinics, in which patients are fully prepared prior to surgery, not part of our system? As the accepted way of ensuring an efficient throughput of patients in many other national health services, they allow patients to be admitted for major surgical procedures on the day of operation, thereby saving the system at least one bed day per procedure. Implemented nationally, this single change would yield thousands of extra beds.
For each new bed announced yesterday, there is a need for additional nursing, medical, laboratory and operating-theatre resources to ensure that it contributes to more treatments for a greater number of patients. How quickly can the system deliver on the additional resources? Mr Martin is clearly in pre-election mode, as evidenced by the careful national spread of extra beds he has put into the system. Whether they provide a tangible "feel-good" factor for individual voters in time for the forthcoming election is open to question.