Criticism at lack of urgency on reforming Hiqa powers, despite nursing home deaths
Oaklands Nursing Home in Listowel, Co Kerry, where eight patients died from Covid-19 last November, had repeatedly failed to pass Hiqa’s checks and inspections on some of the most basic standards. Picture: Dan Linehan
Hiqa needs to be given more powers over nursing homes “immediately”, the Social Democrats have said.
And they have also condemned as "shocking" the fact proposed legislative reform that would give the health watchdog more “teeth” is so far down the Government's legislative priorities for this year.
A ban on fur farming is higher up the latest legislation list than plans to give Hiqa more clout – a move that could save lives.
The 31-page list also puts legislative measures related to ticket touts, e-cigarettes, and e-scooters ahead of Hiqa-related reforms.
It contains a list of 32 items of priority legislation.
But despite repeated calls for years for tighter regulation of the public and private nursing home sector, Hiqa regulatory reform is not on that list.
Instead, it appears on the “other legislation” part of the official list.
Earlier this month, the Oireachtas heard 1,543 residents and staff have so far died due to Covid-19 in public and private nursing homes.
This is just under half the total death toll in Ireland of about 3,590 deaths to date.
The last time there was an outcry over Hiqa’s lack of enforcement powers was last November.
This was after eight residents of Oaklands Nursing Home in Derry, just outside Listowel, Co Kerry died after contracting Covid-19.
It emerged the home had repeatedly failed to pass Hiqa’s checks and inspections on some of the most basic standards.
The watchdog insisted at the time it was powerless to shut the home down because the current enforcement process takes so long.
Relatives simply could not understand how the home was allowed to operate.
Many still believe action to shut the home down should have been taken as far back as 2018.
This was when it was discovered the home was in breach of every single regulation for which it was inspected.
Writing in the last November, Hiqa chief inspector Mary Dunnion appealed yet again for her organisation to be given powers to act faster.
The regulator had first flagged Oaklands Nursing Home to the Department of Health as far back as March 2020.
It had warned there were 212 residential care facilities for the elderly “deemed to be at risk” in the pandemic.
Social Democrats health spokesperson Róisín Shortall believes legislative reform for Hiqa “needs to be brought up the priority list”.
She told the : “It is shocking that it seems no lessons have been learned from the tragic first wave of Covid in nursing homes.
“We need this legislation to ensure private nursing homes have clinical oversight, safe ratios of nurses to residents, and proper regulation.
“Instead the Government is continuing to keep elder care at arm's length and view it as a business activity rather than part of our social care service.
“Also, there’s a statutory right to nursing home care but not to homecare.” Holly Cairns, in whose constituency there were 10 Covid-19 deaths at Clonakilty Community Hospital last April, backed her party colleague’s call for action.
The Social Democrats Cork South West TD added: “There is an immediate need for greater regulation of the sector.
“It is unbelievable that the Government is not prioritising this, given all we have seen in the past year.”
A Department of Health spokesperson said the chief inspector of social services in Hiqa has “significant and wide-ranging powers” to “ensure residents are safe”.
They pointed out that last year’s Covid-19 Nursing Home Expert Panel Report included 86 recommendations, over 15 thematic areas.
One of the “thematic areas” was regulatory enhancement and review.
The spokesperson added: “Work is under way to scope out the nature of the recommendations and the associated policy and legislative requirements.
“Given the nature of the recommendations, it is envisaged work will be progressed on a phased basis, with some enhancements to primary and secondary legislation developed this year.
“Others will form part of a longer-term programme of reform as wider nursing home reform further develops.”
The department was unavailable to explain exactly what “enhancements” to what primary and what secondary legislation are to be “developed” this year, and when this might happen.
It was also unable to say when Hiqa will realistically be given more powers of oversight and regulation in nursing homes.
On p20, under the heading of all "other legislation" report of the 31-page Legislation Programme Spring Session 2021, there is mention of the "Health (Amendment) Bill".
This is to "enhance the oversight and regulation of nursing homes".
And as far as progress on this is concerned, the report notes that: "Preparatory work is underway."
However, "preparatory work is underway" is a progress status that appears on a wide variety of matters for years.
It is usually – as well as the place in any legislation session list – an indication that a Bill or amendment is years away from getting anywhere.
The Health (Adult Safeguarding) Bill is a case in point.
Since at least 2018, the status of the Bill – "to underpin a new national health sector policy on safeguarding vulnerable or at-risk adults in the context of their interactions with the health sector" (and something that would help underpin Hiqa's work) – has been "preparatory work is underway".
A special cross-party Oireachtas committee examining the State’s response to the pandemic has already concluded the overall model of care for older people in this country is “deeply flawed”.
And they have recommended an urgent review by the Department of Health of clinical oversight and governance arrangements in public and private nursing homes, as well as strengthening Hiqa's powers.
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