asked the Minister for Health if he is aware of a report recently prepared on behalf of the National Council for the Aged which found that many homes for the aged were in breach of regulations laid down by his Department; if he has any plans to increase supervision of the operation of these homes and ensure proper compliance with the regulations; and if he will make a statement on the matter.
Ceisteanna — Questions. Oral Answers. - National Council for the Aged.
12.
The research programme used in the preparation of this report included a fieldwork study of 24 homes which commenced in March 1985 and was completed by May 1985. The new regulations "The Homes For Incapacitated Persons Regulations, 1985" did not come into force until the first day of October 1985. These regulations provide for stricter standards of care, supervision and operation together with frequent monitoring of these homes by the health boards.
Has the Minister any indication of how effective these new regulations are in upgrading standards in these homes? Is there any obligation on homes to register with his Department or with the health boards on a continuing basis? Have his Department a complete register of homes operating in this area?
I would agree that a formal, statutory registration system in relation to these homes is needed, but the immediate issue that arose was the general level of standards of care, such as having a qualified nurse in the home, supervision and operation. I am in favour of registration of those homes but that can only be done if there is a statutory registration system for all such institutions, including private hospitals, public voluntary hospitals and health board hospitals. At the moment anybody can open any kind of a home or hospital provided they meet planning regulations. The only hospitals that cannot be opened are those dealing with maternity and psychiatric cases but there is open season for anything else. I agree we should have registration and in the proposals I have made to the Government for the reorganisation of the health services I have included the registration of hospitals and nursing homes for the Government's consideration.
Has the Minister any indication of how the new regulations are being implemented? A number of these home owners and organisations representing them have claimed that the regulations are unrealistic, presumably on the basis that they consider them not capable of being implemented. Can the Minister comment?
It was the best part of 20 years or more since previous regulations had been brought in. We had to bring in regulations which would not result in a general closure of nursing homes and provide a reasonable opportunity to those homes covered by the 1964 regulations to upgrade their facilities. In fairness, the general standards of a large number of nursing homes have improved considerably in the past two or three years with the impact of those regulations. They have been in operation since September 1985 and I would hope they would be reviewed again in mid-1987, tightened further and made stronger, without having to force the closure of a number of homes who are on the margin.
Are the health boards, particularly in the Dublin area, aware of all the homes for the elderly so that they can check to see if the regulations are being enforced? Is it possible there are a number of homes for the elderly of which the health boards are not aware because they do not have to register?
By and large the health boards have a full register of persons who keep such homes. The regulations about the supervision of those homes are quite specific. One must have a qualified medical practitioner attached to a particular home and a general nurse supervising the home. The fire regulations are certainly being enforced with very considerable rigour and the health inspectors keep in close contact with regard to the consumption of food on those premises. The Eastern Health Board have a much greater awareness of the role of such homes. At the same time, I am very anxious to expand the general geriatric public bed numbers because many such nursing homes are beyond the means of many people, even with a limited health board subvention.