Sir, – We welcome your Editorial (December 12th) and wish to convey our deep concern and disquiet at the precipitous closure of public nursing homes for older people around the country.
We are aware of at least four units that are due to close now with further announcements predicted in the New Year. What is deeply troubling is the absence of open and informed debate on a major shift in the ratio of public to private beds in the system, barely five years after the publication of the Leas Cross report which showed a lack of strategic and policy focus in the Irish health services on the sophisticated nature of provision of high quality long-term care for our older people.
Some private nursing homes are refusing to accept substantial numbers of older people with significant physical and mental disability (due to resource issues which mean they cannot safely cater for the needs of applicants). The HSE's own guidelines reserve admission to public nursing homes to this group with higher care needs. Whois to look after them if the public units are closed?
We are also deeply concerned about current superficial discussion on the levels of funding of public and private units. Not only is the current NTPF (National Treatment Purchase Fund) funding of private nursing homes likely to be inadequate by yardsticks, such as indicated in the reports of the Joseph Rowntree Foundation; but clearly catering for the more disabled is likely to be more expensive.
Currently both private and public/voluntary beds are unevenly distributed around the country. A core of public nursing home beds is required in each local health area. (Ref. unpublished Prospectus Report).
From a civil liberties aspect and rights of residence, these facilities are truly home for hundreds of frail and disabled older people around the country where they are cared for by dedicated staff. The premature closure of such units in the absence of their replacement by newer domestic-style dwellings represents an abdication by the HSE in its responsibilities towards this most vulnerable group.
The closure of these units will cause great hardship and suffering for residents (and their families) and contravene their human rights to dignity, health care and a home.
We call on the HSE to reverse these ill-considered decisions and to open a wider and informed debate on the appropriate levels of public/voluntary and private nursing home beds in each area. Discussion, with all involved, on the best model to provide both a domestic environment as well as optimal care, with a view to a phased development and reallocation of resources is urgently needed. In the interim it should hold off further closures of public units. – Yours, etc,