Washington - The city of New Orleans has only 456 staffed hospital beds, compared with 2,269 before the city was struck by Hurricane Katrina, according to government auditors who say rebuilding the health care system will be vital for bringing people back.

While emergency care is available, auditors noted that patients at two hospitals waited up to two hours to be unloaded from ambulances. They also found patients being kept and treated in the emergency room because beds weren't available elsewhere.

The Government Accountability Office said several planning efforts are under way about how to rebuild that system, but no clear consensus has emerged.

The lack of clarity stems in part from the uncertain estimates of how many people plan to return. The latest estimates put the city's population at about one-third of the 485,000 people who lived there before Katrina hit.

Democrats who requested the study said the findings show the Bush administration must be more aggressive in leading the rebuilding efforts.

"It is unacceptable that six months after Hurricane Katrina, people are still receiving health care services in mobile tents and old department stores," said Rep. John Dingell, D-Mich., taking aim at Health and Human Services Secretary Mike Leavitt. "Exactly how does the secretary expect the Gulf Coast region to prepare for a potential flu pandemic or the next hurricane season given the current state of their health care system?"

Leavitt spokeswoman Christina Pearson said the secretary has met regularly with state officials to hear how they would like to see the health care system improved, and he sees opportunities to make the system better than it was before the hurricane struck, particularly through the use of health information technology. She did not have a timetable for when those improvements would be proposed.

The GAO report said that when auditors visited New Orleans, they found primary and emergency health care was available, but access to specialty care was quite limited.

The report also noted that the federal government's estimate of repair costs for two major hospitals run by Louisiana State University - Charity Hospital and University Hospital - amounts to about $36 million. But a private consultant estimated it would cost more than $360 million to repair both hospitals - aging facilities LSU had wanted to replace before the storm.

The city also relied on a network of clinics to treat poor patients before the hurricane, but more than three quarters of those clinics are closed. About 19 clinics are open now, but they generally operate at less than half of capacity.