Bed closures are saving the HSE €0.65m per day

Current bed closures throughout the country are saving the HSE an estimated €645,414 a day, new figures have suggested.
A total of 726 beds were closed in the acute hospital system in the latter half of January, the Minister for Health has revealed.

Some 689 inpatient beds and 37 day beds were closed for reasons of either cost containment, infection control, refurbishment or the seasonal closure of facilities in the week ending 17 January 2010, the period for which the most recent information is available.
According to Brian Donovan of the HSE’s National Casemix Programme, the national average cost per bed day in a public hospital is €889. This is calculated from the 39 hospitals who submit costings to the Casemix/HIPE Unit and, as it is based on 2008 activity levels, would be a slight underestimate of today’s true cost.
Assuming a 100 per cent occupancy rate, the average annual cost for a bed in a public hospital for a year is €324,485. Thus the annual saving to be made from the closure of 726 beds is €235.6 million.
Responding to criticism from Fine Gael health spokesperson Dr James Reilly that a further 1,100 beds closures were likely this year, Minister Harney was adamant that the HSE could deliver the volumes by focusing on length of stay: “For example, 37 per cent of hernia repairs happen on a day-case basis. It varies from Tallaght where 84 per cent happen on a day-case basis to Mayo, where only 16 per cent happen on a day-case basis. The length of stay in Mayo is on average three days.”
“In the case of varicose vein procedures, 56 per cent are done on a day-case basis, varying from 99 per cent at St Columcille’s Hospital, Loughlinstown, to 57 per cent at Mercy Hospital, Cork,” Harney said. “For cataracts, day-case rates vary from 90 per cent in the Mater, Waterford, Sligo and Letterkenny hospitals to 42 per cent in St Vincent’s Hospital. In the case of hip replacements, it goes from seven days in Croom to 18 days in Waterford.
“If all facilities could operate to the level of best practice within the country, that in itself would have enormous potential to decrease dependence on inpatient activity,” she added.
Ireland has significantly fewer acute hospital beds than most other developed countries. According to the OECD’s Health at a Glance 2009 report, Ireland has 2.7 acute beds per 1,000 of the population, compared to the OECD average of 3.8 per 1,000 of the population. Japan, with 8.2 beds per 1,000 of the population, has the highest.