Sir, – As the Covid-19 public health emergency enters what may well be its most critical phase so far, it is nearing time to consider how the learning emerging from it can best be gathered, assessed and acted on.
For sure there will be a role for internal reviews and Oireachtas committees. Most likely there will be a need for some form of gathering of experts and sage citizens who can distil the wisdom. There is certainly a need for a civic awards system to honour those who are contributing so much and, in many cases, putting their lives at risk. Hopefully, we will look with fresh eyes at old issues: healthcare, homecare, childcare, and accommodation. We will certainly need to urgently focus on rebuilding our economy so that we can pay for what we have been so cruelly reminded matters most.
From the experience of Sage Advocacy as a support and advocacy service for vulnerable adults, older people and healthcare patients some key points are starting to emerge.
The need for a single integrated statutory system of long-term care covering domestic homes and nursing homes, and a wider variety of options in between. The system should be deliberately biased towards home, which is where the vast majority of people want to live, and to die.
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Plans by the outgoing government for a standalone statutory system for homecare should be dropped; we need no more schemes with siloed funding.
In planning the six new health regions arising from Sláintecare, the need for community hospitals, nursing homes, high-support housing, respite and hospice services must be given as much consideration as the needs of acute hospitals. With proper design, integration into local authority development plans and appropriate incentives we might well be able to meet many of these needs on the one campus.
Private nursing homes must be more closely integrated into the wider framework of health and social care and there must be guidelines on the level of nursing staff and medical care required related to the needs of residents. A wider range of ownership models, including social enterprise, should be encouraged.
Legislation for adult safeguarding is urgently required and safeguarding services need to be organised on a multidisciplinary basis, blending social work, policing, public health nursing, financial and legal skills. The service should be free to operate across all care settings, regardless of whether they are in the public or private sector.
The role of An Garda Síochána and An Post in supporting vulnerable citizens, and the engagement of local authorities and the voluntary sector through Community Call, suggests that public services have the potential to be as flexible and responsive as any other sector if they continue to be supported in adopting innovative approaches.
Finally, the development of independent advocacy to promote, protect and defend the rights and dignity of people who may be vulnerable requires the development of national quality standards, recognised training courses, equitable funding and an effective system of oversight and coordination. – Yours, etc,
MERVYN TAYLOR,
Executive Director,
Sage Advocacy,
Ormond Quay Upper,
Dublin 7.