Sir, – Your report (‘Public ‘trust chasm’ developed during Covid-19 pandemic, says Dr Mike Ryan – The Irish Times,' Health, March 31st) on the Covid-19 evaluation forum cites Prof Mary Codd as saying “people aged over 70 in residential facilities died at 21 times the rate of their peers who cocooned at home”. This is a sobering statistic behind which, undoubtedly, lies much grief and no little remorse.
The report of the Covid-19 Nursing Homes Expert Panel (Examination of Measures to 2021) stated: “The very infectious nature of Covid-19 makes it difficult to prevent and control in residential care settings”. It also said “the transmission of the virus into and within nursing homes is multifactorial”.
In June 2025, RTÉ broadcast a programme in which two fully-trained healthcare assistants went undercover in homes run by one of Ireland’s leading private nursing home providers, Emeis, formerly known as Orpea. They observed staff shortages, unsafe practices and, in some cases, vulnerable older people left without basic care.
Much discussion ensued about the approach of the regulator and the extent to which nursing home ownership has moved into the ownership of large private investors.
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While the report of the Commission on Care of Older People has yet to be published, we do have an important statement in the Law Reform Commission’s report of April 2024 titled A Regulatory Framework for Adult Safeguarding.
The Commission said “the context of social care in Ireland is highly relevant to adult safeguarding” and drew attention to the fact that provision of social care in Ireland is largely on a policy or administrative basis, in contrast with the statutory social care frameworks in jurisdictions such as England and Wales.
Is it not time to look more carefully at the design of, and culture within, our congregated care settings and for an informed debate that moves us beyond the simplistic argument that economies of scale require larger facilities rather than more small-scale household-type models?
The Law Reform Commission has put the issue of social care legislation on the table. Let us now work to getting it on the agenda and discuss the broad range of issues, including congregated and domestic support and care, that might be addressed in any such legislative framework.
It will probably take a decade but it needs to pick up where Sláintecare left off. – Yours, etc,
Mervyn Taylor,
Stillorgan,
Dublin.
Sir, – Now that the Covid review has begun, I believe its deliberations can be significantly assisted by focusing on two key facts and their consequences.
First, the State transferred or discharged older patients from acute hospitals into nursing homes without Covid testing.
Second, the government actively encouraged and facilitated the recruitment of nurses from private nursing homes into the public acute hospital system, leaving many private nursing homes reliant on agency staff who moved between multiple facilities.
The consequence of these combined decisions was severe. These policy decisions by the State contributed to the level of mortality experienced during the pandemic. – Yours, etc,
Jonathan Roth,
Westport,
Co Mayo.
