Dáil Éireann Debate, Tuesday - 27 April 2004
479 Mr. Gormley asked the Minister for Health and Children the steps he intends to take to ensure that proper quality care is provided to the older person; the system that is in place to measure staffing levels in centres for older persons; and the further steps he intends to take to ensure that nappies are distributed to older persons. [11152/04]
View answerThe policy of my Department on the care of older people is to maintain them in dignity and independence in their own home for as long as possible in accordance with their wishes. This policy was first enunciated in the "Care of the Aged Report" which was published in 1968 and confirmed in the report, "The Years Ahead: A Policy for the Elderly", published in 1988. Numerous research studies have shown that the vast majority of older people have a preference to remain living in their own home for as long as possible rather than moving into long stay residential care.
Since my appointment as Minister of State I have encouraged the Eastern Regional Health Authority and the health boards to introduce personal care packages for older people as an alternative to long stay residential care. Personal care packages are specifically designed for the individual concerned and could possibly include the provision of a home help service, home subvention payments, arrangement for attendance at a day centre or day hospital and other services such as twilight nursing. Personal care packages allow older persons the option of remaining living in their own home rather than going into long stay residential care.
Standards of care in private nursing homes are governed by the Nursing Homes (Care and Welfare) Regulations 1993. My Department is currently reviewing the Health (Nursing Homes) Act 1990 and the nursing home subvention regulations to determine their relevancy and efficacy in providing long-term care to the elderly. The objective of the review is to develop a scheme which will be transparent, offer a high standard of care for clients, provide equity within the system to include standardised dependency and means testing, be less discretionary, be consistent in implementation throughout the country and be financially sustainable.
The position regarding measuring nurse staffing levels is that, on foot of recommendations made by the Commission on Nursing, a working group was recently established with the following terms of reference: to agree a common understanding of the term "skill-mix" in the health care environment and its application in determining nurse staffing levels; to identify and evaluate the current systems being utilised in the Irish health care setting and to identify areas of best practice; to review literature on current systems of determining nurse staffing levels in a national and international context and to determine whether these systems have the potential to be adopted or modified to suit the Irish health care system; to recommend principles underpinning systems of determining nurse staffing levels within the Irish health care system. The working group is chaired by the chief nursing officer of my Department and includes representatives of the Health Service Employers Agency, the Psychiatric Nurses' Association of Ireland, the Irish Nurses Organisation, SIPTU nursing, IMPACT, employing agencies and the Department of Health and Children.
Standards for the management of nursing homes in the private sector are provided for under the various legislative instruments mentioned above. Furthermore, the implementation of the provision whereby incontinence wear is supplied to older people in private nursing homes is a matter for each health board in the context of it's overall revenue allocation as notified annually in the letters of determination. The request to health boards to implement a provision whereby incontinence wear is supplied to medical card holders in private nursing homes issued from my Department in February 2001.
