Patients not being discharged from hospital due to cutbacks

Elderly patients in the greater Dublin area are being forced to remain in hospital even though they are well because of cutbacks to care supports to allow them return home.

Internal correspondence seen by The Irish Times shows Dublin South City and Dublin West have no funding at all for homecare packages. Dublin South-West and Kildare West Wicklow are providing funding only where an existing holder of a homecare package dies or goes into a nursing home.

A separate memo stated all funding for homecare packages had ceased in the three Dublin areas and all applications received thereafter were to go on a waiting list.

Homecare packages are designed to allow people with medium-to-high care needs to live independently. The level of care varies, but typically involves input by home helps, nurses and professionals such as physiotherapists.

A manager in one hospital outside Dublin said staff had received no replies to repeated emails to HSE officials seeking homecare packages for a number of patients. The local hospital group and the Department of Health’s special delivery unit made representations, but to no avail.

Waiting list

He claimed his staff were eventually told the HSE officials were instructed to “drag their feet” to save money on the budget.

All new applications are being placed on a waiting list, but the HSE was unable to say in which areas waiting lists exist and how long they are.

A spokesman denied funding had been frozen. He said a “managed budgetary situation” was in place and “localised limits” on spending had been applied.

Leading geriatrician Prof Des O’Neill of Tallaght hospital described the cuts as “totally bonkers and self-defeating”.

“This is deeply troubling so early in the year. It will cause significant personal distress for frail older people who are prevented from being able to go home in a timely and supported manner, and will also have significant consequences for an already over-loaded hospital system.”

Beds occupied

One hospital said six of its beds were occupied by patients who were well but could not be released because no home care package was available. Another said four beds were similarly taken up; three of the patients have dementia.

The HSE said its 2016 service plan provides for 15,450 people to be provided with a homecare package at any one time. The actual number benefiting will be about 21,000 because some packages will not run for the entire year.

Although the number of packages required last year turned out to be 1,500 more than anticipated, the increase provided for this year is less than 200.

The HSE said demand for home help hours and homecare packages was growing as the number of over-65s continued to increase. Resources were finite and the costs must be managed in a way that ensured those with the greatest needs are supported and the budget is not exceeded.

“Homecare packages and home-help services continue to be allocated to new clients having regard to the resources. . . available through existing clients no longer requiring their homecare service, and importantly, taking account of the overall resources available for the home care service.”