The Eastern Regional Health Authority (ERHA) has proposed to a number of Dublin hospitals that they "cohort" so-called bed-blocking patients into defined areas to save on staff costs.
It has suggested that if all bed-blockers - mainly elderly patients awaiting long-term care facilities - were accommodated in one area of a hospital, the hospital could replace some registered nurses with cheaper healthcare assistants.
The plan, however, is meeting with resistance. The Mater Hospital, which has over 90 patients fit for discharge who have nowhere to be discharged to, believes the plan is non-viable. A document prepared by its director of nursing, Ms Anne Carrigy, states that it would effectively mean the establishment of a long-stay geriatric service within the hospital.
"The current set-up at the hospital is not equipped nor has the facilities to establish such a unit," she wrote in the document, which was released to The Irish Times under the Freedom of Information Act.
It added: "Long-stay geriatric services require a very different service to that of an acute hospital such as daycare facilities, enhanced physiotherapy and occupational therapy services. It must be pointed out that, although such patients may be medically discharged, many need appropriate levels of nursing care.
"Overall, while the concept may be a valued one, it is not appropriate or equitable to cohort patients whose discharge is delayed for whatever reason to one area without providing the highest level of service to them in line with the mission and ethos of the Mater Misericordiae University Hospital."
The Mater lost 30,000 bed days last year due to the delayed discharge of patients. The bed days lost were the equivalent of having 82 beds closed for the full year.
Meanwhile, the plan to cohort bed-blockers was also discussed at a meeting of the medical board of Tallaght Hospital in April. It concluded that such a move would be inappropriate and vowed to oppose the plan.
A spokeswoman for the ERHA said yesterday that the plan was just one of a range of options being looked at to address the problem of patients fit for discharge occupying acute beds.