Dáil Éireann Debate, Tuesday - 11 May 2021
831. Deputy Holly Cairns asked the Minister for Health his views on the recommendation in the Ombudsman report Wasted Lives: Time for a Better Future for Younger People in Nursing Homes (details supplied). [24310/21]
View answer832. Deputy Holly Cairns asked the Minister for Health his views on a recommendation in the Ombudsman report Wasted Lives: Time for a Better Future for Younger People in Nursing Homes (details supplied). [24311/21]
View answer833. Deputy Holly Cairns asked the Minister for Health his views on a recommendation in the Ombudsman report Wasted Lives: Time for a Better Future for Younger People in Nursing Homes (details supplied). [24312/21]
View answer834. Deputy Holly Cairns asked the Minister for Health his views on a recommendation in the Ombudsman report Wasted Lives: Time for a Better Future for Younger People in Nursing Homes (details supplied). [24313/21]
View answer835. Deputy Holly Cairns asked the Minister for Health his views on a recommendation in the Ombudsman report Wasted Lives: Time for a Better Future for Younger People in Nursing Homes (details supplied). [24314/21]
View answer836. Deputy Holly Cairns asked the Minister for Health his views on a recommendation in the Ombudsman report Wasted Lives: Time for a Better Future for Younger People in Nursing Homes (details supplied). [24315/21]
View answer837. Deputy Holly Cairns asked the Minister for Health his views on a recommendation in the Ombudsman report Wasted Lives: Time for a Better Future for Younger People in Nursing Homes (details supplied). [24316/21]
View answerI propose to take Questions Nos. 831 to 837, inclusive, together.
As Minister for Health, I welcome the publication of the recent report by the Ombudsman on the circumstances of younger people living in nursing homes. While nursing homes can be an appropriate care option for younger people with a clinically assessed complex medical and social care requirement which cannot be supported in their own home, alternative solutions are needed for others to give them more independence and choice in their daily lives.
The Programme for Government is committed to providing a pathway to eliminate the practice of accommodating young people with serious disabilities in nursing homes. As a first step, €3m has been allocated for a HSE led pilot project this year to assist 18 people inappropriately placed in nursing homes to move to more appropriate housing options in the community. The HSE intends to undertake a mapping exercise to identify the number of people with disabilities living in nursing homes who wish to access an alternative support service in the community. Each Community Healthcare Organisation (CHO) will be allocated a budget for proposals to facilitate the transition of two people within their catchment area, with the first such moves expected in the second half of this year.
My Department is working to introduce a statutory scheme to support people to live in their own homes, which will provide equitable access to high-quality regulated homecare. The provision of home support on a statutory basis is key to giving younger people with complex disabilities more alternatives to nursing home care and wider opportunities to live fuller, more independent lives.
In relation to nursing home placements, it is my view that informed consent in line with national policy should be followed at all times. I understand that consent matters will be further addressed by the HSE though integration within the plan to move from Local Placement Forums (LPFs) to Integrated Decision Making Forums. Integrated Decision Making Forums are to be stood up in each CHO area for the purpose of identifying a range of pathways of care across the different care groups including Mental Health and Disability Services. These forums will support the principle of a ‘Home First’ approach recognising the fact that service users want to be cared for within their own homes and communities. The project team for the Assisted Decision Making Act, in the absence of the full enactment of the 2015 Act, have been asked to develop an operational guidance document based on the National Consent Policy to be used as a reference guide for forum members. Valid consent will be embedded in every decision making process of these forums.
In addition, my Department is reviewing the regulatory framework with the aim of enhancing the oversight and regulation of nursing homes at both primary and secondary legislation level. This work will support the implementation of the learning and recommendations from the COVID-19 Nursing Homes Expert Panel. This year I intend to bring forward interim enhancements to the primary legislative framework to, amongst other things, enhance the governance and oversight of nursing homes and improve the reporting of key operational data. The secondary legislation will also be enhanced further. In January 2021, the Government approved the inclusion of a Health (Amendment) Bill 2021 on its spring legislative agenda. Developmental work is ongoing in my Department in collaboration with HIQA. It is anticipated that a stakeholder consultation process, through the Expert Panel implementation structures, in the first instance, will be undertaken in the coming months on proposals. It is then intended to seek Government approval to draft a General Scheme of a Bill, and progress these interim enhancements. A scoping exercise for a wider, comprehensive root and branch review of the legislation will be undertaken later this year with a view to commencing that review in 2022. Finally, the recommendation for CHOs to ensure full access to primary care services is most properly an operational matter for the HSE. However, it is important to note that individuals living in nursing homes (irrespective of age) have the same level of access to primary care services as individuals living in the wider community. At the same time, it is accepted that capacity deficits, especially in relation to staffing, can mean delays in accessing primary care services or, in some localities, can even mean that a particular service may not be available. The increased investment announced in Budget 2021, combined with the development of reformed delivery models, is intended to ameliorate the challenges that may be faced by individuals in accessing primary care services in line with the overall intention of the recommendation.
