No national clinical oversight of care being delivered to those in nursing homes, watchdog to tell TDs

Hiqa to raise concerns about care oversight shortcomings for some of State’s most vulnerable citizens

The State’s health watchdog will today raise major shortcomings in the oversight of care for the most vulnerable citizens in nursing homes, the people most affected by the Covid-19 pandemic.

Health Information and Quality Authority chief executive Phelim Quinn is expected to tell the Dáil's committee on Covid-19 that the current model of private residential care for older persons has no formal clinical governance links with the Health Service Executive. "Importantly, this means there is no national clinical oversight of the care being delivered to some of our most vulnerable citizens," he is expected to say.

He will also say 80 per cent of nursing homes are operated by private providers and although funded by the HSE through the Fair Deal scheme the health authority did not know the sector.

Nursing homes have borne the brunt of the coronavirus pandemic in this country, accounting for 878 or 54 per cent of the 1,606 deaths from the virus in the State.


No further deaths from Covid 19 in the State were reported on Monday for the first time since March 21st.Taoiseach Leo Varadkar said it was a "significant milestone.

The National Public Health Emergency Team (NPHET), which made the announcement, said 59 new cases of coronavirus had been reported, however.


The Dáil’s Covid-19 committee, which is examining the State’s response to the Covid-19 pandemic, will also be told today that key State organisations left the nursing home sector and its residents “isolated” in the early days of the coronavirus pandemic.

The chief executive of Nursing Homes Ireland, Tadhg Daly, is expected to tell TDs that "the dismay will live forever with us".

“We were exasperated. The sector required a specific plan. We knew that Covid-19 disproportionately impacts on older people. The planning and focus was almost exclusively on our acute hospitals. Multiple clusters initially emerged in our hospitals. But the numbers in nursing homes started to increase.”

Mr Daly is expected to tell the committee that in the absence of a national strategy and response for the nursing home sector, a number of challenges emerged. These included insufficient testing and personal protective equipment and the release of patients from acute hospitals to nursing homes without testing.

The committee will also hear from representatives of Sage, an advocacy group for vulnerable adults and older people.

According to the group’s opening statement which was sent to TDs in advance of the hearing, the initial warning signs regarding a Covid-19 pandemic were generally recognised by private nursing homes.

“However, because of the lack of effective working relationships with the HSE, and the focus at State level on an expected surge and resultant threat to the acute system, the dangers to the most vulnerable who were in nursing homes did not become centre stage until the systemic weaknesses of the outsourced system became clear.”

The group says that “the development of such a significant ‘blind spot’ at statutory level is something that requires considerable reflection.”

Furthermore, staff shortages in some cases led to “risk-taking with staff in some facilities having to continue to work while ill and in other cases encouraging people back from isolation”.

“Other staff, frightened for their own health and aware of the Covid-19 payments, chose to stay away, with the result that some nursing homes were so short-staffed that phone calls from extremely concerned and distressed relatives went unanswered, in some cases for days.”

Speaking in advance of the hearing, Sinn Féin TD Louise O’Reilly said the statement from Nursing Homes Ireland “points to a complete failure of the State to enact a structural plan for the nursing home sector, with the necessary financial and staffing resources, until late in the day”.

Martin Wall

Martin Wall

Martin Wall is Washington Correspondent of The Irish Times. He was previously industry correspondent

Jennifer Bray

Jennifer Bray

Jennifer Bray is a Political Correspondent with The Irish Times

Simon Carswell

Simon Carswell

Simon Carswell is The Irish Times’s Public Affairs Editor and former Washington correspondent