Action by the Health Service Executive (HSE) in seeking to transfer public patients from Leas Cross nursing home and to close down the facility is a welcome, if belated, development. The quality of nursing home care in this State has been neglected for far too long.
The flurry of activity at Leas Cross resulted from last month's exposure of unacceptable nursing practices by RTÉ's Prime Time programme. But reports by health board inspectors, going back to 1999, had raised serious questions about hygiene and medical standards at the home.
The limited powers of the HSE became apparent last year when a health board failed to close down the Rostrevor nursing home in Dublin. And the owner of Leas Cross, John Aherne, has indicated he will resist closure in the courts. It is clear that legislation is urgently required to regulate nursing homes and to enforce standards. And, because of a potential conflict of interest involving the HSE - it procures beds for public patients in the private sector - the establishment of an independent regulator and inspectorate, with formal training for care workers, would be the best approach.
Criticisms of Leas Cross by health inspectors tended to focus on kitchen hygiene and on an inadequate drug recording system. Last year, however, a special report into the death of a patient questioned whether the home had the nursing expertise to deal with him. The RTÉ programme showed worrying footage of patients being treated for bed sores. In spite of that, the families of some patients are happy with the care they receive and do not want them moved.
Poor standards of hygiene are not confined to nursing homes, although elderly patients may be at greater risk. A lack of formal hygiene training for care staff is a common failing in both hospitals and nursing homes. Even where training has been given, consultants, doctors and nurses frequently fail to engage in regular hand-washing as an anti-disease measure. In such circumstances, the hospital superbug, MRSA, becomes a real threat. Even when it does not prove fatal to patients, it can seriously damage the quality of their lives. Last year, about 500 cases of MRSA were detected in Irish hospitals.
In an attempt to focus the attention of staff on the necessity for better hygiene practices, the Tánaiste and Minister for Health, Ms Harney, has commissioned an audit of all hospitals and will publish the results.
Naming and shaming hospitals with poor records may be the only way to eliminate sloppy, dangerous and unhygienic practices. Nursing homes should be treated similarly.