A patient in a Dublin hospital who has been fit for discharge for more than a year is still in an acute bed, the Minister for Health Mary Harney has told the Dáil.
The Minister said that the patient in question was unwilling to go to a nursing home or a long-term care facility, and was also not prepared to go home on a home-care package.
Ms Harney, who did not identify the hospital concerned, said that it was "not appropriate for somebody to choose to stay in an acute hospital when alternatives have been put in place".
She said that some existing issues in this regard would be addressed as part of the new "fair deal" scheme for funding long-term care, which is expected to be introduced by the Government later this year.
Ms Harney said that it was "dangerous" for a patient to remain in such a hospital if he or she does not need to be there.
"People should be in such hospitals only if they have to be," she said.
Ms Harney made her comments in a debate in the Dáil on accident and emergency services. In her contribution, the Minister also said that she knew of one hospital in Dublin that could free up to 64 beds - and tackle overcrowding in the emergency department - if it were to organise its acute-beds system differently.
"Consultants went in there. Experts who have brought about change in other countries made recommendations about the hospital in September. I have seen a letter sent to the hospital by the HSE asking why certain recommendations have not been followed, given that there are people on trolleys," she said.
Ms Harney did not identify the hospital concerned but The Irish Times has learned that the HSE letter was sent last month to the Adelaide and Meath Hospital in Tallaght.
In the strongly worded letter, the HSE warned Tallaght hospital that unless it moved quickly to implement measures to eliminate lengthy waiting times for patients on trolleys in its A&E department, it would have to pay the private sector to provide the treatment required.
The HSE said that the targets for waiting times in emergency departments, which were set by the recent A&E taskforce, were being breached "almost on a daily basis at Tallaght".
It said that it now required Tallaght hospital management to implement the consultants' findings by the deadline of the end of March.
"Failing this, the HSE will be left with no option other than to put alternative arrangements in place, most likely with the private sector, to treat patients who are waiting over the 12-hour deadline.
"These alternative arrangements can only be funded from the existing resource and this will therefore have the effect of reducing the funding available to Tallaght hospital," the letter stated.
The Fine Gael spokesman on health Dr James Reilly said that problems with management in any area should not be allowed to result in services for patients being reduced or to undermine the public system in general.
