Covid having ‘lasting impact’ as Ireland’s hospital bed numbers lower than statistics suggest

Hospital bed numbers in Ireland are even lower in reality than statistics suggest as rising Covid-19 cases further reduce the numbers available, a senior ESRI officer said.

He recommended swifter action on building or expanding hospitals to address this crisis which, despite workforce increases of 20% in some areas, is continuing to worsen.

Senior research officer Brendan Walsh warned: “Absolute (bed) numbers can also hide true shortages. I think there is also good evidence that Covid-19 is having a lasting impact.”

“In Ireland in 2021, we treated 8% fewer in-patients than pre-Covid-19. As we have to continue treating individuals with Covid-19, it does mean the total number of beds available for non-Covid activity is likely to be lower than some of the figures which are out there.”

Patients with this virus need to be isolated, and doctors find they tend to stay in hospital longer than average.

“There are fewer beds to be provided for people waiting in the emergency department or on trolleys, and also there are fewer beds being provided for people who require elective care,” he said.

When you look at in-patient beds in Ireland, only about 15% at any one time are being used by elective patients, and 85% are being used by emergency presentations.

He added: “In the NHS in England, the ratio is actually closer to 50:50.”

This week many hospitals are again canceling elective operations to make way for emergency patients, and he highlighted this as a serious concern.

Based on ESRI analysis of beds needed to 2030, he said: “It seems we currently have a shortfall of between 500 and potentially over 1,500 in-patient beds in the system.” This comes against a backdrop of a growing population in Ireland, and a growing number of older people.

“For two decades now, we’ve had potentially below the number of hospital beds we’d need, which means we have high bed occupancy at any given point of view,” the analyst said.

“Then, when it comes to the winter months, we have very high demand and we just don’t have enough beds to meet demand.”

Staff increases have been called for by unions and commentators this week.

“Since Covid-19 we’ve actually increased the staffing levels in hospitals by quite a lot,” Mr Walsh said.

“Looking at the HSE workforce figures, we have 19% more consultants than we had at the end of 2019, we’ve 18% more registrars, 11% more staff-nurses, but again our bed numbers haven’t necessarily increased at all .”

Increasing bed numbers requires capital investment in buildings, he recommended.

“The decision to develop new beds won’t be put on stream potentially until the actual physical infrastructure has been built,” he said. “It can often take years for the decision to be made to invest in hospital beds, and actually for those hospital beds to be delivered.”

He shared a graph from the Health in Ireland 2022 trends review showing the number of hospital beds per 1,000 people is lower than it was in 2009, having dropped from 2.55 beds per thousand to 2.26 now. It found that there are currently 11,337 beds.

“(This is) higher than 2015, similar to 2009. But on a per capita basis, inpatient bed supply has been stagnant since 2015,” he said.


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