Private ICU beds seen as a temporary solution
Every day the ambulance service receives at least 20 calls for cases that will require a bed in an intensive-care unit (ICU), yet only two to three a day are available for new cases. At present, hospitals linked to the National Health System (ESY) have a total of 480 ICU beds. However, there are another 120 fully equipped beds but these are unavailable due to staff shortages. The Health and Social Solidarity Ministry has promised to provide these units with new personnel, but in the meantime is resorting to using ICU beds in private hospitals as a temporary measure. According to Professor Haralambos Roussos of the Athens University Medical School’s Department of Pulmonary Medicine and Intensive Care, hospital care is undergoing a sea change. «Patients who used to be admitted are now treated as outpatients, while what were once considered difficult cases have become much simpler to treat,» said Roussos, who is also the director of Athens University’s ICU at Evangelismos Hospital. «The problem is that people’s expectations have been raised and the ESY is unable to satisfy them. And that has caused major problems,» he said. Roussos says that in the last 50 years there have been three «explosive» developments in medicine – pharmacology, advanced technology and intensive care. «Nowadays in countries with developed medical care, ICU beds comprise 20-50 percent of the total. In Greece, the percentage is barely 8-10 percent at best, such as at Evangelismos. So clearly we are way behind,» he added, before going on to suggest both short- and long-term solutions. «The health minister has understood both approaches. Renting ICU beds in private clinics helps, but is not a solution, particularly for the big hospitals where someone who is seriously ill needs to be near his doctors. If Evangelismos did not have operating theaters and ICU beds, it would simply be a collection of very wasteful outpatients departments,» said Roussos. «We need general hospitals that cover all specializations and offer every kind of medical treatment and where patients who are seriously ill can be placed in ICUs. No doubt additional ICU beds are a welcome gift. But I can’t understand why ministry heads, both past and present, tolerate the situation and are not able to provide nursing staff for the ICUs that remain closed, even though they have the means to do so. I am afraid there is no explanation that will be acceptable to those who are in need of these beds.» «What we need are available ICU beds,» said Deputy Health Minister Thanassis Yiannopoulos. There are 120 ICU beds in the ESY that are not being used. For example, only six of the 24 ICU beds at Attiko Hospital are being used, six of 17 at the Laiko, 10 out of 24 at Larissa Hospital, but none at hospitals such as those in Livadia, Xanthi or Kalamata. «Our first concern,» added Yiannopoulos, «will be to give priority to staffing ICUs. Until then, however, we have to do something else.» One of the stopgap measures is the use of 30 ICU beds at the Errikos Dunant Hospital, with the possibility of another 14 being used. Patients will be assigned to them solely though the ambulance service, and they will be supervised by the Health Sector Coordinating Body. However, this will only take place after the Health Ministry bill is passed by Parliament – it has already been tabled. The ministry has also called for tenders from private hospitals for the use of ICU beds by social security funds based on Ministerial Decree 1320/1998. «Many private clinics, such as the Iaso and Mitera maternity hospitals, the Central Athens Clinic and Metropolitan, have responded to the call and will be making 35 beds available to the funds,» said Yiannopoulos, who added that the necessary contracts would be signed within the next week. The cost will be covered by the social security funds. Yiannopoulos says these moves should cover requirements at least until new staff is hired for the ICUs. «Every year, the ambulance service brings in 1,100 calls that are intensive-care cases. Given the average duration of stay in ICUs of about 10 days, we are essentially asking for 11,000 additional days in the year. An extra 30 beds in the Errikos Dunant and another 35 in private clinics makes 23,000 days, so we will be able to cover the increase due to the aging population and developments in medical science.»
