asked the Minister for Health if a site for the building of an old folks home in Achill, County Mayo, has been purchased by the Western Health Board; and, if so, when he proposes to make funds available for this building.
5.
Ceisteanna — Questions. Oral Answers. - Old Folks' Homes.
4.
asked the Minister for Health if a site for the building of an old folk's home at Ballinrobe, County Mayo, has been purchased by the Western Health Board; and, if so, when he proposes to make funds available for this building.
I propose to take Questions Nos. 4 and 5 together. The Western Health Board has identified suitable sites for welfare homes for the elderly in Achill and Ballinrobe. The board are about to enter negotiations with a view to purchasing a site in Ballinrobe.
Finance for the building of these welfare homes will have to be considered in the light of the board's overall capital allocation and its priorities for development in the years ahead.
Will the Minister give more detailed information as to when it is likely that the board will purchase the sites mentioned in the two questions?
The board have a major ongoing capital programme. The board are currently developing Castlebar Hospital, Merlin Park Hospital, the Galway Regional Hospital, Portiuncula Hospital, the Psychiatric Day Hospital in Ballina, a major £12 million centre for the mentally handicapped in Swinford, a group home for handicapped adults in Belmullet, a group care headquarters in Shantalla and new health centres in Castlebar and Ballinasloe. These are all the priorities of the health board and the £600,000 which a welfare home would cost is not indicated as a priority by the health board.
I take it that there are no immediate plans to have the homes mentioned provided?
Not from the health board, but they are purchasing the sites.
6.
asked the Minister for Health if he proposes to have various health boards carry out a survey of privately owned old folks' homes so as to ensure that reasonable standards are maintained and that reasonable safety precautions are taken in them.
The responsibility for monitoring standards in private nursing homes rests with the health boards. The Homes for Incapacitated Persons Regulations, 1966, set out the standards required in these homes. I have accepted that the standards provided for in these regulations are inadequate and I will be introducing new regulations shortly which will contain stricter standards including provisions relating to safety precautions.
Does the Minister intend to introduce new legislation or just to amend the regulations?
The legislation will enhance the situation. The registration of such nursing homes would be encompassed in the legislation and then the regulations will be revised and will bring into force a much stricter set of minimum standards, including provisions relating to fire and other safety precautions in private nursing homes. Comprehensive draft regulations are now available and I intend to have these regulations tabled in the very near future.
Will it be necessary for all nursing homes to register with the health boards?
Under the proposed legislation it will be necessary to have registration and part of the registration will be to give permission for the opening of such a home. At the moment anybody can open a nursing home and I am not happy about the rights of people to open hospitals, homes or anything they like in the health area.
When will we have the legislation?
The legislation is currently with the Government.
7.
asked the Minister for Health if he is satisfied that the limitations imposed on staff recruitment and on funding of the health boards are not liable to expose the patients of many geriatric homes and hospitals to grave risk should an outbreak of fire occur at night when the staff cover is now minimal in many cases.
Arrangements for staff cover in geriatric homes and hospitals are a matter for local management in each health board. There is no evidence in my Department to suggest that limitations on staff recruitment and on funding of the health boards have resulted in any reduction in night time cover in these institutions. Health boards are, of course, responsible for ensuring that fire precaution arrangements in hospitals and other health institutions are reviewed periodically and that all staff are aware of fire prevention measures and are familiar with proper fire drill and procedures, should it become necessary at any stage to evacuate patients.
Will the Minister accept that in view of the reduction in the allocations to health boards and the fact that he recommended to them that there should be a reduction in staff numbers similar to that taking place elsewhere in the public service — where only two out of every three vacancies may be filled — inevitably this will lead to a reduction in the number of staff on duty at night? Is there any set ratio of the number of staff to patients in geriatric hospitals? Is the ratio adhered to in all hospitals?
We are dealing with the question of fire risk. I do not have any reports to the effect that staffing ratios impinge in any way on the fire regulations. If I had I would take immediate action. I have invested some money in improving the position in regard to fire precautions. More than £600,000 was spent on fire precaution works in 1984 in all institutions. Undoubtedly, there is room for further improvement but I have not received any specific complaints. If Deputy Leonard, who tabled the question, or any Deputy, has any complaints about specific geriatric institutions he should bring them to my notice and I will have them examined and considered by the health boards concerned.
Surely it is relevant to the question to ask the staff-patient ratio because in the event of a fire the risk is related to the ratio of staff to patients.
As the Deputy is aware that ratio varies from institution to institution. It depends on the age of the institution, the structures and ward sizes and they vary considerably from area to area. I do not have a specific ratio but where health boards feel that the ratio is not adequate they are not slow in coming forward and making that point to the Department. The Department are not slow in responding and discussing such matters with the health boards.