It’s party time in the department as concerns about patients go unheard

ON the face of it, it seemed that the South Western Area Health Board (SWHB) was to be commended when it took action against a Rathgar nursing home on a number of counts following a visit by a team of inspectors twice this month.

Health boards haven’t had a great press of late, so it was reassuring to read that one of them seemed to be acting promptly on discovering a number of breaches of relevant acts and regulations.

That illusion was soon shattered by Mr Justice Vivian Lavin in the High Court.

What those inspectors found this week was that elderly patients were administered discontinued drugs, and that there were faults with fire safety and staffing levels, among other things. It was found that one nurse had been rostered for 72 hours in one week.

What the judge pointed out was that serious concerns had been expressed about the same nursing home by a doctor as far back as January 2001 and again in March of 2002.

The court, he said, had to take cognisance of the serious allegations against the home’s owner. I don’t know if they were the same problems as those uncovered by the health board’s inspectors this month, but it seems extraordinary that vulnerable elderly people should be left in a home with serious problems.

What’s even more extraordinary is that it appears that there is no provision for the immediate closure of such an establishment deemed to be seriously in breach of regulations.

The doctor had expressed his concerns more than three years ago, and yet it was still allowed to operate.

The reason why the case of the Rathgar home ended up in the High Court is indicative that the laws need to be changed. Counsel for the health board, Mary Phelan, said that even though prosecutions had been brought in the district court it did not mean that it would be closed even if that court held in favour of the board. So it was seeking an injunction from the High Court to close it.

The health board wants it closed and removed from the register of nursing homes, because it’s concerned about the health of the patients there. Twice this month it sent a team of inspectors into the place.

What happened three years ago when a doctor expressed serious concerns about the home? Was a team of inspectors dispatched to inspect it - indeed, how often was it inspected? It begs the question of how often private nursing homes are inspected by the country’s health boards.

Most nursing homes adhere to the strictest of standards, but only by having a strict regime of inspection could the health boards ensure that they all do. Nowadays, nursing homes are big business and because the Government can’t, or won’t, provide sufficient State facilities for the elderly - apart from inadequate subventions - families are forced to do so through these homes.

Coming up with the funds to do so is difficult enough, but it can be even more difficult to get somebody into one of them.

Possibly, if the heads in the Department of Health weren’t partying so much they might have the time to ensure that all the nursing homes were being run properly. They might even provide enough inspectors to do the job instead of wasting money on entertainment, catering and hospitality, as we realised this week.

Our healthcare system might not rank too high in the league of patient or hospital facilities, but when it comes to splurging out on entertainment, it is second only to the Department of Foreign Affairs.

Last year the Government spent €2.5m on entertainment, with Foreign Affairs heading the list on €796,000, an increase of €150,000. Runner-up was the Department of Health, managing to get through €427,000, considerably more than the Taoiseach’s department, and an increase of €83,000 on the previous year. Nice to know that the department is able to improve on something.

Comforting, isn’t it, for people on trolleys all over the country, or those waiting for finished but unopened units, that the department can manage to take time - and money - to put the bright side out.

Let’s face it, if they can’t get it right with €10 billion, what’s a mere half a million going to do?

What was intriguing, though, was the €86,000 which the Prison Service spent on entertaining. Was it the small change left from the multi-million overtime budget? And who was being entertained?

And I would have imagined that being entertained by the Prison Service would usually have connotations other than socialising.

IN a similar vein as the Government’s entertainment bill is the “just in case” rent policy of the IDA. This involves the State agency paying out €2.4m a year in rent for 34 empty factories, just in case they might attract a few badly-needed industries sometime in the very long-term future.

It’s a handy little earner for the factory owners and will be for some time, because when the leases run out in about 15 years, the IDA will have cost the taxpayers around €80m.

They’re not all empty, though.

Somewhere in some of those vacant lots are the 7,000 electronic voting machines on which Minister for the Environment Martin Cullen spent €52m.

It gives a totally different complexion to the term “computer virus”.

Whether it’s paying for unused factory space, buying thousands of computers that will be never used or lavishly entertaining, what they all have in common is a cavalier attitude to public money.

The Government, its departments and agencies have no conception of value when it comes to spending taxpayers’ money. They will commit themselves to the more expensive option to cover themselves, with absolutely no thought as to cost. The reason they can and do is that they are not spending their own money. It is endemic in their rationale that it can be spent - or wasted in too many instances - with absolutely no consequences: nobody is held liable - and that’s the beauty of it.

The credo in each department is: “When in doubt, overspend.”

It was graphically illustrated by the ineptitude the Government displayed in the case of Lissadell House in Sligo, the former home of Constance Markiewicz, the Irish freedom fighter.

When it came on the market, there was a huge public campaign for the State to buy it.

The Department of the Environment and Electronic Voting Machines, decided the Government couldn’t afford the €30m it reckoned would be needed to refurbish the house.

It was eventually bought by barristers Edward Walsh and his wife Constance Cassidy for €3.75m. They have since refurbished 70% of it for less than €1m and have estimated that the entire refurbishment will cost somewhere between €3m and €5m - one-sixth of the Government’s estimate.

But then they are spending their own money.

Countess Markiewicz must be turning in her grave at the thought of what’s being done in the name of the Irish freedom for which she had fought.