A review of the country's hospital bed requirements, which Minister for Health Simon Harris will bring to Government in the next few weeks, is the third such national analysis carried out over the past 15 years or so.
A review was carried out by the Department of Health in 2002 when current Fianna Fáil leader Micheál Martin was minister for health. And a further one was conducted by the HSE in 2007.
However, the main recommendations in these reports were never implemented in full.
In 2002 the report launched by Mr Martin proposed providing almost 3,000 additional public beds by 2011.
At that point there were about 11,800 acute hospital beds in the public system – not too far off the 12,000 or so available at the moment.
The Martin report pointed out that in 1980 there had been more than 17,600 acute hospital beds. It argued that in gross terms – when future demographic changes, waiting list numbers and occupancy levels were taken into account – more than 4,300 additional beds were required. However, when proposed measures and investment strategies aimed at reducing hospitalisation were factored in, a net 2,840 additional beds would be needed by 2011.
Reduction in beds
In 2007 the HSE report, commissioned from PA Consulting, said at that stage there were 11,660 acute hospital beds in the public system.
It forecast that if the existing type of health system remained in place, the number of hospital beds needed to grow to 12,778 – an increase of 1,118.
However, it argued that if what it described as a preferred model of care – which involved patients receiving greater care in the community or at home – was implemented the number of acute beds could actually be reduced by over 5,000.
But it forecast that if the model of care continued to focus on delivery of health services via acute hospitals, where patients were in attendance for many services better suited to being delivered in the community, the requirement for additional beds would soar by 2020.
“Based on current practice, the number of public patient hospital beds Ireland is going to require in 2020 will be 19,822. This is 8,162 more public patient hospital beds than are currently in place and so requires an annual increase of 4 per cent per year until 2020. This will be during a period where most other countries are reducing their acute hospital bed numbers.
“The cost of provision based on current practice will be immense. It will require extensive investment across the hospital network to deliver the additional beds as well as the associated staff and technology. Delivering this additional number of beds would require a total capital investment of over €4 billion and additional revenue costs of almost €26 billion over 14 years.”
However, shortly after the HSE report was published came the collapse in the public finances, which saw health budgets shrink.
The new report for Mr Harris recommends that without the implementation of healthcare reforms such as moving services to the community, an additional 7,000-9,000 additional beds will be needed.
It says even if these changes are put in place an increase in bed capacity of the order of 2,000-2,500 beds will be required.
Whether this report goes the same way as previous ones remains to be seen.
