Professor Des O’Neill, who is chair of the Irish Society of Physicians in Geriatric Medicine (ISPGM), said responsibility for the shortage of nursing home beds outside urban areas rests at the door of the Department of Health.
Speaking on Newstalk Breakfast and RTÉ radio’s Today with Claire Byrne show, Prof. O’Neill said the Department of Health ignored the issue “for a long time” and he was concerned that there was “a massive vacuum of policies in the Department of Health.”
“Instead of creating a framework of what we should have in nursing homes, into this vacuum has come in large, private operators making huge barrack-like institutions of hundreds of beds.”
Prof. O’Neill called for “an absolute reboot” of how optimal nursing home care was viewed. He said he really hoped that the Department of Health had finally “come out with a document on what the design of nursing homes should be.
“They've stipulated a maximum size of 72 beds of six domestically scaled units. This is really a small spark of hope in really what is a most worrying report, and suggests that drastic action is needed.”
The issue was much more complex for rural nursing homes, he warned. “There was indeed an element of over-supply in the rural areas when consultants looked at this a number of years back. It was about nine percent of the older population, whereas it should be around four percent.
“The most worrying part of the report is the loss of the public beds. In fact, one of the Sláintecare recommendations was belatedly to recognise that we've left the field far too much to the profit and private sector and that we needed to restore the balance towards public beds. So, what has happened has been a direct contravention of Sláintecare policy.
Prof. O’Neill said the ideal scenario would be a largely public and not-for-profit sector with a maximum of 72 units which resembled a house environment.
“Obviously there are examples of very good practice within the private sector. But the problem is that consistency is not clearly there. And we have left ourselves hostage in many ways.
"And what we see was what these large players can see is a fairly steady flow of cash from the government and a relatively light regulatory system from the point of view of division of the clinical governance.”
There had been too much focus on funding on not enough attention paid to terms and conditions for staff across the sector, both public and private, he said. What should be the vision for the appropriate level of care, for the appropriate level of access and independence?
On Newstalk Breakfast, Nursing Homes Ireland CEO Tadhg Daly said he welcomed the issue being addressed.
The ESRI report highlighted that the Government needed to put in place policies that “harmonise financial incentives for nursing home providers with the primary objective of fulfilling residents’ health and social care demands within a more integrated care environment.”
