Covid-19: Further powers to investigate complaints over deaths in care sought

The ombudsman plans to write to the Government seeking to fast-track an extension of his powers to investigate clinical decisions in nursing homes and other healthcare settings.

Peter Tyndall has said he wants new regulations, promised in the programme for government, introduced to extend the remit of the Office of the Ombudsman that would allow it to investigate complaints about the care and deaths of residents in nursing homes and hospitals.

Mr Tyndall said the “whole health complaints systems” had to be revamped as a matter of urgency because of the coronavirus pandemic.

“We have got a big gap in the complaints landscape and it needs to be filled,” he said.

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Mr Tyndall said at present he could investigate administrative issues arising in nursing homes, such as complaints about fees, but he “quite often” had to turn away complaints relating to a decision to admit an individual to hospital or for treatment based on the judgment of a clinician. He acknowledged this was “very frustrating” for complainants.

His remarks follow criticism by the widow of a Co Meath nursing home resident who died in June, two weeks after being admitted to hospital with infected wounds infested with maggots.

Mary Bartley-Meehan has said that she has felt like “a parcel being passed” around by various State bodies in response to her call for an inquiry into the death of her husband, Ultan Meehan. He died in June, two weeks after being admitted to Connolly Hospital in Blanchardstown, west Dublin from Kilbrew Nursing Home in Ashbourne, Co Meath.

Medical records note that the nursing home had been “unable to manage” the wound.

Kilbrew has said that the nursing home worked to provide “the best of care” and that, like other homes, it had been “under acute pressure in the midst of the pandemic”.

Legislation

Sage Advocacy, a support group for the elderly, has criticised the absence of a statutory mechanism to investigate individual complaints against private nursing homes.

The health service watchdog, the Health and Information Quality Authority, can carry out inspections of nursing homes but cannot investigate individual complaints against homes.

Mr Tyndall said it was up to the Department of Health, liaising with the Department of Public Expenditure and Reform, to propose legislation to extend his investigative powers.

“We can deal with individual complaints about private nursing homes but there is a restriction on our jurisdiction, so people can complain as long as clinical judgment is not involved,” he said.

“People can complain but we are a little frustrated by not being able to deal with the clinical judgment aspect of complaints that also affects complaints about hospital care.”

Mervyn Taylor, executive director of Sage Advocacy, said the core issues in Mr Meehan’s case relate primarily to clinical care and governance, falling outside the ombudsman’s remit.

“An investigation into administrative aspects of care in this particular case would be inappropriate and would cause disappointment and upset for Mary Bartley-Meehan,” he said.

Mr Taylor welcomed the reminder from the ombudsman that there was a commitment in the programme for government to extend its remit to “clinical judgment actions”.

The programme, which was agreed in June, promises to “expand the remit of the Office of the Ombudsman to consider decisions in health and social care complaints”.

Mr Tyndall noted that his counterparts in the UK can investigate clinical judgments. The Office of the Ombudsman has received a small number of complaints, about 40, during the pandemic about nursing homes, the vast majority relate to care and treatment, he said.