Health firm must explain discrepancies in €27,000-a-month care plans

A private healthcare company seeking €27,000 a month from the HSE to care for a vulnerable man has been asked to explain apparent discrepancies in its proposed care plans for him after an intervention by the President of the High Court.

Mr Justice Peter Kelly queried whether two plans advanced by Nua Healthcare for the man, a ward of court, may relate to another person as they referred to release and review dates going back to 2014 when the man was not in a Nua facility.

While the matter is urgent because the man remains inappropriately placed in an acute hospital where he has been for over a year, the court would not commit him to a Nua facility until it knew exactly what was being offered to him, the judge said.

Someone else

One of Nua’s plans for the man referred to matters that have nothing to do with his particular situation and appear to relate to someone else, he said. He wanted “an explanation about what is going on” and not “a box-filling exercise”.

The General Solicitor for Minors and Wards of Court said she shared the judge’s concerns about the “bare” plans.

The judge adjourned the matter to Tuesday to allow Sarah McKechnie NL, for the HSE, to get an explanation from Nua about the reports.

Counsel said the HSE had just received the plans that morning and she could not explain the incorrect dates. When she said perhaps the urgency of the matter led to errors, the judge asked: “Could it be that this is someone else’s transition plan and they have just lifted it and filled in the boxes?”

Raised issues

Ms McKechnie said she was aware the judge had earlier raised issues concerning Nua’s programme for another man, a resident in another of its facilities, and she was optimistic documents provided by the HSE/Tusla and Nua in that case would go some way towards addressing the issues in this second case.

The case relates to a young man from a non-EU country, who appears to have no family here. He is believed to have an acquired brain injury and has been assessed as of unsound mind and incapable of managing his own affairs.

The earlier case on Monday arose from an emergency late-evening application last week by the HSE and Tusla to address Nua’s concerns – which Shane Murphy SC, for Nua, said were communicated to them by Nua since last October – a physically and intellectually disabled young man placed with Nua had booked an unaccompanied transatlantic flight after getting some €6,000 in social welfare payments. The flight was due to depart last week and the HSE got orders the previous evening to stop the man travelling.

Late response

Counsel for the HSE/Tusla accepted their late response to Nua’s concerns was “unsatisfactory” but said the situation has now been addressed by measures including the man’s willingness to remain voluntarily in the Nua facility and his passport being secured. The judge said the agencies’ response was “more than unsatisfactory”.

Millions are being spent by this country now as a result of how vulnerable people were treated 30-40 years ago but here was a vulnerable person about to travel alone with nothing done by the statutory agencies until a “last-minute” application to court, he said.

He was also concerned the man has been in the Nua facility for over a year without any application by the State agencies for an inquiry as to whether he should be made a ward of court.

Adequate therapy

Arising from the judge’s concerns whether the man is getting adequate therapies in the Nua facility, counsel said the HSE was satisfied the man is appropriately placed there. The facility has a large level of staffing and a range of materials concerning the regime was being handed in to court, counsel said.

The judge said he wanted a “full explanation” from the HSE and Tusla how the flight situation arose and concerning the man’s care in the Nua facility. He adjourned the matter to consider the documents provided and for other reports to be prepared. An inquiry will be held later as to whether the man should be made a ward of court.