They are known as bed blockers, an unflattering label attached to people accused of outstaying their welcome in acute hospitals where only the sickest of patients should be.

In the public mind they are occupying beds, weeks or maybe months after they were ready for discharge. Meanwhile, at the other end of the hospital, patients needing a bed are on trolleys in emergency departments. Those without health insurance on waiting lists for treatment sit by their phone in the hope of being told they can be admitted.

In December there were 783 of these so-called bed blockers in hospitals across Ireland. But why would anyone spend a minute longer in hospital than they had to?

The Health Service Executive (HSE) has provided an insightful breakdown of why these people, many of them elderly, simply cannot leave.

The reasons are varied. A small but significant number cannot go back to their own home without the support of home help or home care.

So they are waiting for the paperwork to be completed to allow them to live independently under their own roof.

Another group needs a place in a rehabilitation centre -- it could be a young person who had a terrible traffic accident or someone who suffered a stroke, leaving them facing the hurdle of learning how to live with their disabilities.

The biggest group appears to be those who need to go to a nursing home but are waiting on the HSE to assess them for financial aid. One of the most striking figures provided by the HSE was the number of patients' families who don't want them discharged. There are 13 of these patients in hospital, double the number last year.

Is it that the family doesn't want to have to care for somebody who is highly dependent and again -- another horrible term -- a 'burden'?

The reality is that while hospitals are there to look after the sickest at varying stages of illness, they also have to pick up the pieces for a lot of social problems. They are a safe harbour for so many of our citizens.

Another startling figure is the number who are holding out for a bed in a public nursing home -- 306 compared to 198 this time last year.

Bear in mind the Government introduced the Fair Deal scheme in October, which now assesses people's means to make nursing homes more affordable in their lifetime. But the downside is that the State will ensure it is recompensed, either now or after their death.

Age Action Ireland fields a lot of calls from people in this predicament. Eamon Timmins, its spokesman, explained that elderly people need to be financially assessed for this scheme. If they move in before it is finalised they pay upfront nursing home fees of around €1,000 a week until they are accepted. So they are staying in hospital instead.

"Delays in processing applications for the Fair Deal have no doubt contributed to the increased numbers of patients who would previously have got a public nursing-home bed.

"They may be medically assessed as being in need of a nursing home bed but must have their financial assessment processed.

"No older person wants to remain in an acute hospital bed beyond the time when they are well enough to go home or to a nursing home. They are victims of the system. There is a desperate need to accurately assess the demand for services such as home-care packages and home helps. This issue will continue to grow as our population ages."