MINISTER FOR HEALTH Stephen Donnelly has said there are issues around decision-making and patient flow at some of the country’s largest hospitals.

Donnelly said there was a need for reforms such as increased weekend discharges to tackle capacity constraints.

Speaking to reporters today, the minister said there was a need to move to a seven-day-a-week service.

He said: “The answer to this is two things: capacity and reform.

“The clinicians have said to me many times, ‘we need more beds, we need more healthcare professionals’.

“We’ve added a lot of beds, we’ve added over 1,000 beds, more beds are going to come online this year.

“I am looking for an additional 1,500 beds through a rapid-build programme but that’s not enough. There must be reform.

“So, we can only be adding capacity and more beds if we’re also seeing a move to seven-days-a-week weekend discharge and very effective patient flow.”

He said the Health Information and Quality Authority (HIQA) has noted improvements in patient flow and senior decision-making in emergency departments, but best practice is not being seen consistently across the country.

“We’re aware of some of the bigger hospitals that are consistently under pressure, and I am not yet satisfied that everything that needs to be done is being done in some of those hospitals in terms of patient flow and senior management.”

Donnelly was speaking after visiting the site of the South Dublin surgical hub at Mount Carmel to view progress on the development.

Six of the hubs are being developed nationally to impact day-case waiting lists in advance of the delivery of regional elective hospitals.

“We are not resting on our laurels, we’re going to keep the momentum going, we’re going to keep adding capacity, and we’re going to reform as well.

“One of the really important reforms is the surgical hubs. I’ve sanctioned six surgical hubs around the country.

“These will do day-case procedure minor operation, some major operations as long as they don’t require inpatient care.”

The other surgical hubs will be located in North Dublin, Cork, Waterford, Limerick and Galway.

Donnelly said there is an ongoing conversation with the HSE about “keeping options open” for an additional hub in the northwest.

“We have a big focus on outpatients because so many more patients are now being seen by consultants, obviously there is a there is an impact on inpatient care because the number of people that are needing inpatient care or day care goes up – that’s really where these centres come in.”

The Department of Health is launching a waiting-list action plan this year including additional beds in hospitals and the community, and rolling out new healthcare facilities.

Donnelly said the average amount of time people waited for an appointment last year fell from nearly 10 months to seven-and-a-half months.

He acknowledged there was “a ways to go” to reach the 10-12 week target.