HSE confirms loss of 20 per cent of acute

The HSE has confirmed this week that it has closed 20 per cent of the inpatient beds at Mullingar Hospital - as was revealed in last week's Westmeath Examiner.A statement issued by the HSE on Monday revealed that while the number of day beds has increased by 13, and there are an additional five Observation Unit beds at the hospital, the number of emergency beds has dropped from 197 to 158 - a reduction of 39 - or 20 per cent.Counting inpatient, day, Medical Assessment Unit and Observation Unit beds, there are now 199 beds in the hospital in total - down from the 220 the hospital had up to this Summer.However, within the hospital, staff are arguing that what matters is the loss of inpatient, or "emergency" beds."There were already 6 Observation beds, now there are 11. We do not regard these as in-patient beds because they are not available 24/7; are not SARI [Strategy for the Control of Antimicrobial Resistance in Ireland] compliant and are supposed to close each day by 2pm" a senior medic at the hospital told the Examiner on Monday.He added that on Monday, the beds remained open until 6 p.m., as they aren't allowed "close" until the patients leave.The HSE argument is, however, that the reduction in in-patient beds is balanced by the increase in the number of day beds, and was in line with the policy of encouraging a greater emphasis on Day Care medicine.This will, the HSE says, reduce the cancellation of elective surgical work at the hospital through the ringfencing of day beds in the surgical ward for surgical procedures; facilitate the treatment of Gynaecology patients at the Hospital on a day basis; increase the availability of medical Day Ward procedures in the area of Cardiac interventions Bronchoscopy, OGDs, Colonoscopies, thus reducing the need for inpatient admissions to the Hospital.The statement adds that the existing Medical Assessment Unit, which has received much favourable comment, will also increase its throughput.The statement adds: "It is important to note that the revised bed compliment in place as a result of the move to the new Hospital has been fully endorsed by the Consultant Surgeons and Consultant Obstetricians at the Hospital.In addition many discussions led by the Clinical Director have taken place with all relevant Consultant staff at the Hospital to increase the throughput of surgical and Gynaecology work at the Hospital. The provision of additional Day Ward beds as detailed will facilitate this increase in workload."BudgetThe budget for Mullingar Hospital has increased by €10m over the course of the last four years. For 2009, it is €63.669. Ten years ago, it was €54.8m, and the approved number of whole-time equivalent staff for the hospital is just under 778, and a staff to bed ratio of 3.72, compared to the national average of 4.26.Praising the hospital, the HSE says that in the last four years, Mullingar has been in the top four in the country in the annual casemix adjustment; it has one of the lowest lengths of stay in the country at 3.3 days in 2008; it provides outpatient sessions not just at base, but also in Longford and Athlone; and in 2008, it treated 6,874 day cases and had 18,956 inpatient discharges. The hospital's A&E department handled 34,474 attendances in 2008, and its maternity section had a total of 2m890 births, an increase of almost 15 per cent on the 2007 figure.The Hospital treated 6, 874 Day Cases last year and 18,956 inpatient discharges last year; its Early Pregnancy Unit had 2,338 attendances, and inpatient admissions to the 5-cot Special Care Baby Unit amounted to 225.Specialist servicesThe HSE lists the full extent of services provided at the hospital, and points out that the hospital has the only Level 2 Intensive Care Unit department in the midlands, and that last year, it catered for 469 patients.Denying that Mullingar has never received the funding adjustments due to it on foot of its performance in the casemix surveys, the HSE listed a number of services which could only have been made possible "through casemix-type funding".These include the bone densitometry service; the early pregnancy unit, which cares for women with threatened complications in early pregnancy; and the respiratory service, which provides full bronchoscopy service, non invasive ventilation, full PFT Laboratory services and Lung cancer services. In addition the Respiratory Specialist Nurse provides COPD, Asthma, Home invasive ventilation and long term oxygen therapy.Also under this heading, the hospital has engaged a new consultant endocrinologist, and with that, the new services provided as part of the diabetic service, including multidisciplinary management clinics, structgured education programmes for diabetic patients, a weekly multidisciplinary foot clinic, and outreach monthly clinics to the Longford area.The HSE concluded by stating that it has "no plans" to close the maternity units in Portlaoise and Mullingar.