Sunday 18 August 2019

'We'll improve the business for the next generation' - Meet the family looking after Irish people since 1825


Stephen Eustace says staff accommodation is a big challenge.
Stephen Eustace says staff accommodation is a big challenge.
Ellie Donnelly

Ellie Donnelly

'The centre was open three months before the first patient came in the doors in 1825. In the medical notes, the patient was in for three months and went home well. But in a business context can you imagine you were waiting three months for your first customer?" Highfield Healthcare CEO Stephen Eustace asks.

Maybe not, but 185 years later in 2010 - with the economy on its knees - Highfield had what Eustace thinks was the only crane on the Dublin skyline, driving ahead with a major development at a time when most of the public and private sector had ground to a halt.

Long-term thinking appears to be an enduring trait in the family business.

Today, Highfield Healthcare is a modern, private care facility for elderly patients and those with mental health issues in Dublin's Whitehall.

Stephen and his cousin, Dr Andrew Eustace, are the sixth generation of the family to operate the business. Patient records go right back the earliest days.

"Back then it was a thing called moral treatment, so there would not have been as much medication used. Patients would come in and be treated in little houses with nurse care and attendees," he says.

Long-established healthcare facilities tend to be run by religious orders or the State, but Highfield has always been a family business.

Every generation since 1825 has grown the business, Eustace says. Its not a bad record for a firm that's traded through famine, revolutions, war and two great crashes.

Today the healthcare provider employs over 400 staff, and has just over 300 beds, split into two divisions - nursing home care and mental health care.

Under the nursing home division, the centre has 204 beds, while its mental healthcare division has 111 in-patient beds. In addition, a day hospital for mental health patients was established in 2016, where patients use the service on a Monday-Friday, 9-to-5 basis.

"Using this day service you are going home in the evening, you can look after the kids in the evening and so on. We are finding the service very popular. We have 15 places today with a large waiting list."

With such a long history, the family business has traded through plenty of change in the healthcare industry in Ireland, and some tough times.

"In my father's day they saw a gap in the dementia market.

"When they looked at the population in the mental health service, they noticed that over 50pc of those patients were suffering from dementia. Research would say that they should be looked after in a dementia-specific service, and so they set up Ireland's first purpose-built Alzheimer's care centre in 1991."

Back then funding was an issue. "My father tells me that a year after the nursing home being open, interest rates were at 17pc. I always look back on that and what that time must have been like, the pressures back then, but again they drove on and did another dementia facility. They also went into convalescent care."

On taking over as CEO in 2005, one of the first things that Eustace did with Andrew, the clinical director at Highfield, was to develop a strategic plan.

"At the time we wanted to go back to the roots of where Highfield started from, which was in acute care. We had a development plan, which was ultimately the €33m development in 2012."

The funding was raised by the family, with help from Ulster Bank.

"We went to the banks to get the funding, this was in, and I'll never forget it, October 2008, and I was with my father and I said: 'Here, things aren't looking great in the economy at the moment, we will ring our bank'.

"Our incumbent bank said that the money was ring-fenced 'no problem there', so we said we would drive on.

However, a phone call to the same bank in January 2009 revealed a different story. The loan was no longer available, and the bank could not help fund the development.

"So we started a nine months due diligence process with a new bank - Ulster Bank - to get over the line. We eventually got there."

They then had to cope with fears that the development would damage the Port Tunnel, which it was being built over. The project was delayed by three months while tunnelling experts were consulted to check their calculations.

And by the time building work eventually started in October 2009, the economy was on its knees in Ireland.

"I look back on that and we were the only crane in Dublin city at that time in 2010. Everything had stopped, and we were the foolish ones ploughing on."

However, the decision paid off for the group.

"We needed to do it and the timing was right for us to make that quantum leap to improve the environment for all the service-users," Eustace says.

"From it, there has been a big lift in our turnover figures. Back in 2012 we would have had turnover of about €12m, today we are looking at €25m."

Today economic conditions in Ireland are considerably healthier than in 2009. The recovery brings its own challenges for Highfield as an employer.

One of biggest problems is the cost of accommodation. Most staff are Irish, but there are 40 nationalities on the payroll, many of whom come to Dublin to take up posts.

"We have staff accommodation here for about 50 people, but ultimately you are looking for these people to come in, stay for three, six, eight months, and gain friends and then move into a shared house in Beaumont.

"But that room up in Beaumont isn't there and even if it is, it's crazy money."

"It then drives our costs up. For every euro that comes in here 70c goes out on staffing, in hospitals the figure is probably more. That's the difficultly - that's the challenge, for all industries really."

In terms of the wider health sector in Ireland, Eustace cites two big challenges: changing demographics, with people living longer, and staffing.

"The cost of business today is also a challenge, whether it's rates or insurance."

Looking to the future and Eustace says that the company will focus on primarily on the provision of mental health care.

"The stats say one in four people today will suffer with a mental health problem. Depression is number five on the scale of illnesses, and they say by 2030 it is going to be number one.

"We have seen a demand in that area, and we are seeing it in our current waiting lists into that service at the moment. We are not adding any beds, we are reconfiguring our service."

As part of this he says that the business would love to roll out the day hospitals around the country.

"That would be our vision of where we want to go there. The State are doing that. Mental health needs to happen a lot more in local communities, rather than in the old days."

What appears to be certain is that the business will remain in the care of the Eustace family.

"We are not going to sell up. I have been passed the baton with Andrew, and we will make it a better place and hand it over to the next generation.

"Looking at the seventh generation, they are only knee-high but you do look them and think 'who is going to be the next consultant'? But what I will say to the seventh is it is a difficult industry because of the demographics, the funding, insurance costs, but it is also very rewarding."

Indo Business

Also in Business