It has been known for some time that significant State investment would be required if the country’s 119 public residential care facilities were to achieve compliance with standards laid down by the health watchdog Hiqa.
Last September in a confidential assessment of needs for this year given by the HSE to the Department of Health, its director general Tony O'Brien described this issue as "critical".
He forecast that of the 119 publicly-run nursing homes, only 37 would meet the Hiqa standards by the end of 2015 based on the level of capital funding available.
“The risk is that the remaining 82 facilities will be deregistered or registered with significant conditions, resulting in considerable loss of public bed capacity at a time when any loss of community beds will significantly negatively impact on the whole hospital and community system.”
‘Urgent’
Mr O’Brien in his letter to the department said it was “urgent that the capital requirement is addressed”.
He also said it was vital that a “settlement is agreed between the Department of Health, Hiqa and the HSE which extends the time frame for compliance, in line with the availability of the capital investment required to meet the infrastructural deficits”.
The HSE was given seven years after the introduction of Hiqa regulations to bring units up to compliance. That deadline expires this year.
In July 2013 The Irish Times revealed details of a confidential internal HSE assessment which maintained that 84 existing units – providing 3,555 long-stay and 1,228 short-stay beds – could be made Hiqa compliant with capital investment ranging from €240,000 to €9 million.
However it said in the case of 25 units – providing more than 1,220 long-stay and 380 short-stay beds – it would be cheaper to develop new buildings than refurbish.
“Refurbishment costs to bring potentially compliant units up to Hiqa standards is approximately €210 million. Replacement costs to rebuild units where it is cheaper to rebuild is approximately €525 million.”
Risk of closure
In January the
Sunday Business Post
stated that 21 public residential care facilities were at risk of closure due to lack of investment enabling them to reach required standards.
Fianna Fáil leader Micheál Martin told the Dáil the nursing homes in question spanned 14 counties.
“We are talking about institutions such as Peamount, Leopardstown Park, Gorey district hospital, Tralee, Monaghan, Nenagh and many others, and of course St Finbarr’s in Cork city, Castletownbere, Bandon, St Joseph’s in Bantry and St Joseph’s in Millstreet.
“The bottom line is that unless the standards are met by July, or unless there is some indication of a real commitment to meet those standards, the options are closure of the institutions, a significant reduction in beds, or closure of high-acute or high-dependency units.”
Taoiseach Enda Kenny said some of the homes were 100 years old. "Efforts have been made over the last years to bring some of them up to the standards Hiqa requires. It is true to say they are not all up to standard now.
“They have been identified by Hiqa, discussions are going on between Hiqa, the HSE and the Minister of State, and €122 million has been allocated from this year to bring them up to full infrastructural standards.”
