The Health Service Executive has had to issue bills of more than €1,600 a week to well patients occupying hospital beds in an effort to get them to move to step-down care.
Officials said a “small proportion” of well patients in hospitals had been levied with €1,650 a week charges because they are “not co-operating” with attempts to move them out of hospital. The number of patients involved is “in single figures”, they added.
The High Court earlier this week ordered the transfer of a woman patient to a nursing home after hearing she has been medically fit for discharge from a busy hospital since April. The woman, who has dementia and will be made a ward of court, remains in hospital because her family failed to pursue nursing home care under the Fair Deal scheme, the court heard.
HSE unscheduled care lead Robert Morton on Thursday said litigation against a patient who refused to move was “the last port of call” while engagement with families was “the first”.
Significant factor
There were 705 delayed transfer of care cases in hospitals last week, up almost 50 on the previous week. The high number of well patients continuing to occupy beds has been cited as a significant factor in hospital overcrowding.
Of this figure, 33 patients are wards of court, said Mr Morton, which can lead to delays in arranging step-down care.
The HSE has legal powers to impose hospital charges on patients who refuse to move after 29 days, but this is a seldom resorted to measure.
Mr Morton was speaking at a briefing at which officials predicted a difficult winter ahead for the health service as it announced the flu season has begun officially. Three people have died so far this winter from the flu virus and 12 have been admitted to intensive care, according to the HSE. Most cases are among those aged 65 and up.
Last week, there were 143 cases of the virus, bringing the total this winter to 324, said HSE officials.
Flu has come earlier and stronger than usual this season and, combined with respiratory virus outbreaks, norovirus (vomiting bug) cases and the worst mumps outbreak in a decade, it has served to put the health service under even more pressure than is expected during the winter period.
The number of patients on trolleys last week was up one-third on the same week last year, while attendances at hospital emergency departments were up more than 5 per cent. Admissions are down slightly, however, indicating more patients are being treated in the emergency department (ED) or leaving early.
The trend is driven by increased demand from over 65s, who are disproportionately hit by the flu and are more likely to attend the ED.
Vaccine
This year’s flu vaccine is a good match for the predominant strain circulating, influenza A, and it is not too late to get it, HSE officials have said.
Some 107 new beds promised by Minister for Health Simon Harris earlier this week will not become available until mid-January, health officials said. But other measures being taken to help the system cope include scheduling of additional MRI sessions in Galway and longer opening hours for some local injury units.
Doctors urged anyone who falls ill with flu to stay at home, rest, drink plenty of fluids and use over-the-counter remedies to ease symptoms. At-risk groups should contact their GP.
HSE officials also emphasised that older people should make themselves “winter ready” and use shoes that fit properly to prevent falls, considera personal alarm and goto the doctor for a check-up.
"We're heading into a difficult winter, when the system is already challenged. But people can help us in the health service by taking preventative strategies to stay well," said HSE national clinical adviser Dr Vida Hamilton.
