Extra 2,500 hospital beds could cost €1m each, HSE warns

Body says new building would be needed to absorb the necessary additional capacity

HSE chief executive Tony O’Brien said they could not simply go to Bargaintown and buy additional beds. Photograph: Emma Jervis/Press 22
HSE chief executive Tony O’Brien said they could not simply go to Bargaintown and buy additional beds. Photograph: Emma Jervis/Press 22

The 2,500 extra hospital beds envisaged under the Government's new plan for tackling overcrowding could cost €1 million per bed to provide, the HSE has estimated.

This excludes an expected €306,000 in annual running costs for each bed.

The HSE figures are significantly higher than those provided by the Department of Health to the Oireachtas committee that produced the Sláintecare reform plan last year.

The department suggested at the time that the construction and capital cost of each new bed would be about €325,000, although some sources suggested this could have been based on providing additional beds in existing facilities.

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The HSE has signalled, however, that existing hospital infrastructure could not absorb the provision of hundreds or thousands of additional beds, highlighting the need for new building work.

Taoiseach Leo Varadkar said on Wednesday the bed capacity review would be brought to Cabinet in the next fortnight.

The Irish Times reported on Saturday that the review would recommend the provision of an additional 2,000- 2,500 hospital beds if the Sláintecare reforms were implemented and up to 9,000 additional beds if the health system remained unchanged.

The department said last night the bed capacity review did not set out the cost of its proposals as this was not required under its terms of reference.

"The department is consulting with the Department of Public Expenditure and Reform in relation to the bed capacity review and the implications it will have for the National Development Plan, due to be finalised shortly.

“It is important to state that there is no one cost for a hospital bed. The cost is dependent on the nature of the bed (day, critical care etc), the specialty and where the bed will be delivered (existing hospital, extension, new development).”

No to Bargaintown

HSE chief executive Tony O’Brien said on Wednesday that the development of hospital infrastructure was a complex, long and expensive process. He said the HSE could not simply go to Bargaintown and buy additional beds.

He added the current level of hospital overcrowding would “look like a picnic” compared to what would happen in the future unless capacity was increased.

Mr O’Brien made his comments to RTÉ radio after new figures compiled by nurses revealed there were 551 patients on trolleys in emergency departments or on wards awaiting admission to a hospital bed.

Some months ago the HSE told Fianna Fáil health spokesman Billy Kelleher that the existing hospital infrastructure could not accommodate the provision of up to 2,000 additional acute beds.

“Therefore to introduce this number of beds, a new build would be required. The capital cost of new hospital build is estimated at €1 million per bed,” the HSE said in answer to a parliamentary question.

Capital costs

The HSE also estimated that the average cost of running an in-patient bed was €839 per day to take account of issues such as clinical and nonclinical staffing, theatres, laboratories and cleaning and maintenance.

The HSE said the daily cost was an average that amalgamated all different types of procedures carried out in the hospital, from the most simple and inexpensive to the most complex and expensive.

“If a new hospital was to be built with the average case mix of work and cost of the existing system, the annual daily running cost would be €839 per bed.”

The HSE forecast that providing an additional 500 beds would cost €500 million in capital costs with an additional bill of €153million each year to operate them.

The additional running costs for 2,000 extra hospital beds would be €613 million each year as well as €2 billion in capital costs.

Martin Wall

Martin Wall

Martin Wall is the Public Policy Correspondent of The Irish Times.