Sir, – Your Editorial on nursing home care (December 13th) challenges current misconceptions surrounding the cost of State-funded homes and raises important questions for the Minister for Health on the bean-counting approach to planned care for the dependent elderly. His answers to these questions will have important implications for one of the oldest hospitals in the country, Lifford Community hospital, which dates from 1775.
One of the difficulties for those of us who support the continuation of State-organised care for the vulnerable is that we have to overcome the barrier that perceives us as the problem. Reduction in bed numbers to what are seen as “unsustainable levels” raises the unit cost of each bed so that an unfavourable comparison can be made with the profit-driven private sector.
As your Editorial points out, like is not being compared with like when the needs of highly dependent patients are compared with mobile and less dependent citizens.
A compelling reason for maintaining Lifford Hospital is the strong evidence base for the role of community and district hospitals in the provision of health care. International studies have shown that small local hospitals are cost efficient and effective. A decision made now to close the hospital in current (admittedly difficult) circumstances will almost certainly turn out to be a poor decision, made in haste, and adversely affecting the most vulnerable, ill and dependent.
An innovative approach is necessary to instead view small hospitals like Lifford not as the problem but rather as the solution. Critical problems in the health sector such as the lack of step-down beds, inadequate rehab care and scarce palliative care beds are easily and cheaply solvable through the maintenance and development of units like in Lifford.
It will be a major error if a hospital like ours, that over four different centuries has been a key provider of local and regional medical services and has resisted and survived the threat of closure through wars, recessions and famine, will be sacrificed as a result of banking incompetence, financial mismanagement and political cowardice. Hopefully someone, somewhere is listening. – Yours, etc,