HSE ‘bending the rules’ in bid to tackle overcrowding crisis

The head of the HSE has admitted to bending the law in an effort to make a dent in the emergency department overcrowding that resulted in an all-time high of more than 600 patients on trolleys this week.

HSE director general Tony O’Brien told Newstalk they had “torn up the rule book”, even cutting across “certain aspects of minor laws” in an effort to speed up the discharge of patients in need of nursing home care.

The continuing presence in hospitals of more than 700 patients whose acute care is finished but who have not been discharged into more appropriate step-down care settings is being blamed by the HSE as the principal reason behind the emergency department crisis.

The “delayed discharges” are regularly caused by the lengthy application process patients must go through before qualifying for the state’s nursing home support scheme, Fair Deal.

The deal allows the HSE to collect money from the patient’s estate following their demise, taking the pressure off those unable to pay upfront.

The HSE has temporarily dispensed with the ‘red tape’ surrounding the scheme in an effort to free up hospital beds for patients on trolleys.

“We are doing absolutely everything we can, including cutting across various rules, red tape and even certain aspects of minor laws in order to address this precise situation which we have now,” Mr O’Brien said.

The most recently published HSE figures for Fair Deal show 2,135 people on the national placement list awaiting funding, with an average wait time of 15 weeks.

However, €3m in additional funds has been allocated to the scheme since then, to reduce the waiting list and waiting time.

A survey on Tuesday of 277 private and voluntary nursing homes by representative body Nursing Homes Ireland identified more than 1,200 empty beds nationwide.

Its chief executive, Tadhg Daly, said the under-resourcing of Fair Deal in 2014 had led to a crisis in older person care.

“It has led to the distressing situation of an extraordinary number of older persons remaining in hospital beds unnecessarily and inordinate waiting times for older people to access nursing home care,” he said.

Mr Daly said it was incumbent upon the Government to plan appropriately to avert crises such as the current one and to plan for “the significant challenges that will present as our population ages rapidly”.

He said his group was reiterating its call for a forum to plan for our ageing population’s long-term residential care requirements.

“This must address key issues arising such as an appropriate fee structure to support the increasingly complex healthcare requirements of persons requiring such care — as recommended by the Oireachtas Health Committee — and workforce planning to ensure appropriate number of suitably qualified and trained gerontological nurses are available,” Mr Daly said.

Mr O’Brien said they were working with Nursing Homes Ireland to address the crisis.

ALONE, a charity that works to support people in need, has appealed to the Government to provide more housing with supports, nursing home beds, and care in the community while the Alzheimer Society of Ireland said people with dementia are “particularly vulnerable to the negative impact of delayed discharge”.

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