Private nursing homes welcome new regulations, but say issues of resources must be confronted, writes PAUL CULLEN, Consumer Affairs Correspondent
PRIVATE NURSING homes are to seek an independent review of additional costs they say will arise when new regulations are imposed on their sector.
Nursing Homes Ireland (NHI), the new umbrella body representing most of the country's private-sector operators, says the regulations will have a significant impact on running costs, with major new investment required by homes in staffing and facilities.
These extra costs are likely to be passed to the residents of nursing homes unless the level of State subvention is increased, according to Tadhg Daly, chief executive of NHI. "We'll be looking for a review of what it will cost an operator to provide a new package of care to ensure best standards are met," he says.
NHI, which is being launched today by Minister for Health Mary Harney, is an amalgamation of the Irish Nursing Homes Organisation and three regional groups, and claims to represent almost 70 per cent of all long-term care beds in the country.
Daly, in his first interview on behalf of the organisation, told The Irish Timesthat NHI will provide a "strong unified voice" for a sector that has been through a lot of changes in recent years and faces considerable challenges in the future.
"Our members are small businesses and, ultimately, part of the health service. Without us, it would struggle."
Daly is not inclined to see the formation of the new group as a reaction to the problems that have arisen with Leas Cross as well as controversial incidents in a number of other homes; instead, he points to the need to respond with a strong focus to developments such as the appointment last year of a Minister of State for older people, the creation of the Health Information and Quality Authority (HIQA) and its independent inspectorate, as well as Ms Harney's proposals for a "fair deal" to fund nursing home care - at least in part - from people's estates after they die.
It is unjustified and unfair that all homes have been "tarred with the one brush" as a result of Leas Cross and other controversies, he says. "There is an issue in relation to perception versus reality. Issues have arisen, and we have an obligation to deal with them. However, the vast majority of homes are run by people who are working hard to provide a good service and are deeply committed to older people and their needs."
So could another Leas Cross happen in the future? His response gives no hostages to fortune: "I'd like to think that with the support of organisations like us, we'll move away from what has been a critical and difficult phase in long-stay care."
Where residents or their families have issues with standards of care, complaints procedures are in operation in all homes, he notes. However, where problems cannot be resolved with staff, the HSE (and soon, HIQA), and not NHI, is charged with investigating.
Daly says NHI will not condone any malpractice by members and promises that any home that loses its State registration will cease to be a member of the organisation. Apart from this rather superfluous power, he admits it has no powers of sanction against members and, indeed, doesn't wish to.
"We're committed to enhancing the lives of residents, providing a safe environment and respecting the dignity and privacy of people in our homes. It's not our role to deal with people who don't fulfil these commitments. We're not self-regulators, we're not in that space."
He says the private sector has already invested heavily in improving facilities and the quality of homes, and hopes to continue that investment by building new homes in the locations where they are most needed.
As always with the health service, however, the issue of resources rears its head. The majority of residents in private nursing homes get some State support, but Daly says this goes nowhere near meeting the true cost of care.
He also believes there is huge unfairness in the current system because of the differing levels and forms of support doled out in different parts of the State.
NHI is a keen supporter of the "fair deal" proposal as a way of ensuring the sector is adequately funded in the future, bearing in mind that the number of over-65s in the population is expected to treble by 2050. "The current system is unfair. There are some who could contribute to the cost of their own care," says Daly.
However, NHI says issues relating to the selection criteria for nursing homes to be included in the scheme, as well as the implementation of the scheme, require further examination.
Daly also welcomes the advent of HIQA and the move away from inspections by the HSE which, he believes, is a potential conflict of interest, as the HSE both operates and inspects homes.
NHI is "absolutely satisfied" with the independence of the new inspectorate, Daly says, but is determined to be part of discussions about the regulations which will have the backing of legislation.
A fast-talking Corkman, Daly comes to the job from the Irish Nursing Homes Organisation, so he has plenty of experience in the sector. Previously, he worked for the ISPCC.
With a staff of five, he sees his job as providing leadership for the sector in a new era of funding and regulation, with care issues high on the public agenda as the greying of the population continues apace: "We've a lot done, and more to do."