Public beds in a dedicated unit in the Mater hospital, Dublin, which have been closed only three months after the unit became fully operational in February, may be used to treat patients under the private National Treatment Purchase Fund, The Irish Times has learned.
The heart of the Medical Emergency Division (MED) - 62 beds specifically set aside to relieve pressure on the hospital Accident and Emergency Unit by quickly investigating and treating patients with acute illnesses - has been affected by the hospital recently closing 104 beds.
According to a consultant at the hospital, the unit, for which two additional consultants, additional nurses and extra paramedical staff had been recruited, cannot function with such a reduction in capacity.
"The closure of the most effective clinical areas of the hospital for the care of acutely-ill patients in the present circumstances is similar to decommissioning the lifeboats on a sinking ship," he said.
However, a spokesman for the Mater said bed closures had been spread evenly across the system. "The MED has suffered, but not out of proportion to the rest of the hospital," he said, adding that 51 out of the 62 beds remained open.
The spokesman acknowledged that the bed closures were adding to delays in the A&E department.
On Monday night, the hospital had 34 patients in the A&E unit waiting for admission.
By last night there were still 20 acutely-ill patients waiting for a hospital bed.
The consultant said this reflected the hospital's reduction in bed capacity.
He said the A&E department was "becoming medically unsafe because of overcrowding".
Recent statistics have shown a 9 per cent increase in A&E admissions at the Mater hospital.
Asked about the reopening of closed beds for use by the treatment purchase fund, the hospital spokesman said this was "a possibility".
However, he emphasised that such a development should be seen in the context of bringing in much needed funds to help address the Mater's €18 million funding short fall.
"The National Treatment Purchase Fund [NTPF] money - in the region of €4 million - is part of the hospital's financial survival" he said, "and must be seen in the context of keeping wards open." The Mater hospital ran €5.4 million over budget in 2001, €1 million over in 2002, and so far this year is facing a €12 million deficit.
The hospital is negotiating with the NTPF to see if it can treat the more acute patients on the funds list of "long-waiters".
Surgical sources have confirmed that the fees they earn from treating such patients will be diverted to help alleviate the Mater's financial crisis.
Meanwhile, another teaching hospital in Dublin is to formally open a 60 bed medical assessment unit similar to the Mater's today.
Dr Bernard Silke, the joint director of the Acute Medical Assessment Unit at St James's Hospital, said the facility had already contributed to a significant reduction in the time that patients had to wait on trolleys in the A&E department.
"With two centrally-located wards, and a dedicated team of nurses, doctors and other staff, the new unit is ideally placed to shorten the investigation and treatment time for patients," he said.
Open for six weeks, Dr Silke said that so far the unit has discharged 55 per cent of patients directly home.
The remaining 45 per cent of patients have required admission to the main wards in St James's Hospital for further treatment.