Sir, – Ian Simington (January 10th) suggests that increasing bed capacity will not help the patients that I and my colleagues regularly meet and care for while they suffer the brute necessity of languishing on trolleys, or worse, semi-recumbent in chairs all day and all night in some of our emergency departments.
Mr Simington makes a good point, in that for those lucky patients upstairs in beds, their journey through the system will be held up at various stages along the way as they wait for access to investigations and treatments that are themselves very constrained in terms of resources, and this leads to inevitable bottlenecks which delay their care and ultimately their discharge from the hospital, freeing up their beds for other patients who need them.
However, let us not lose sight of some important figures. In 1980, Ireland had 17,665 hospital beds; by 1986, it had 16,878; by 1990, 13,753; by the year 2000, 11,832 beds; and by 2012 10,492 beds.
Our bed supply is estimated to be 30 per cent below the OECD average, and even if we generously include all private hospital bed stocks in the calculations, that deficit still only drops to approximately 20 per cent.
Despite the ever-increasing number, age and complexity of patients, the average length of stay for a patient between 1980 and 2012 decreased from 9.7 to 5.6 days. Day-case work also exploded during this time, and tens of thousands of patients are cared for by that route each year.
There are limits beyond which efficiency cannot compensate, so we are surely not expected to believe that with our ever older, larger and ever- more medically complex patient population, that this trend in bed supply has not played some role in the genesis of the horrendous conditions into which a patient must face, should they find themselves in the unfortunate position of requiring acute hospital care. – Yours, etc,
Dr DERMOT BOWDEN,
Glasnevin, Dublin 11.