Sunday 17 December 2017

Frontline response: 'I am weary of feeling we are the pariahs of healthcare'

(Stock photo)
(Stock photo)

Patricia MacGabhann

'It is not a popular thing to say, but Ireland has a rapidly ageing population and acknowledging good practice and standards in nursing homes would be more productive and reassuring to the public than the constant bombardment of negativity.

The regulator, Hiqa, has acknowledged that private nursing homes have been the most responsive to the need to change and improve.

Our nursing home, Nightingale, was established here in Ballinasloe in 1996. Like other small, rural nursing homes, we are required to provide designer-level services at bargain-basement prices. The National Treatment Purchase Fund (NTPF) negotiates the fees that private nursing homes can charge and outlines explicitly what is covered and not covered by that fee.

So what is not covered? According to the NTPF: "For the avoidance of doubt, newspapers, social programmes, therapies, incontinence wear, chiropody, dry cleaning, ophthalmic and dental services, transport (including care assistant costs), specialised wheelchairs, hairdressing and other similar services." If these services are provided at extra cost to the resident, they must be outlined in the contract of care.

God forbid you make profit because then you are penalised, your fees negotiated down, and at the same time you have to remain financially viable as per the Health Act.

Additionally, nursing homes in rural areas apparently don't warrant the same fees as those in large urban centres and are not on a par with the fees paid to the HSE community nursing units (CNU). In this locality, the CNU fee is €1,300 a week and Nightingale's is €725 a week.

The Nightingale fee is essentially all-inclusive - there are no extra charges levied for therapies, social activities etc. We probably aren't the only ones, but that doesn't make a front-page headline.

Why do we include all of these services in our fee? Nursing homes, particularly those in rural areas, provide care and shelter for a significant number of people who are perhaps single or widowed, who may have no family to advocate on their behalf and perhaps no funds to avail of those services otherwise. Do we deny those services to the most vulnerable because there is no one to speak up on their behalf?

It must also be noted that our costs can be higher in some respects. We don't have a large population source from which to draw staff, particularly nursing staff, which often necessitates the use of recruitment agencies at huge cost. But in a rural area, providing 30 jobs has a significant positive impact on the economy and community.

Nursing Homes Ireland (NHI) is advocating on behalf of its members in an attempt to have some parity in the fees paid to private nursing homes and those to HSE-run units. I hope it is successful.

Nightingale is not a member of NHI. For us, it would cost approximately €1,900 a year. Not a huge sum but to us it's a new hoist, a specialised chair, an additional service. So we made our choice and put the residents ahead of having a voice in political circles.

I am a highly skilled, educated and knowledgeable nurse, committed to ensuring that the care provided in Nightingale is professional, evidence based, informed, respectful and empathetic. I am passionate and committed to my profession and to caring for older people.

But I am tired, weary of feeling we are the pariahs of the healthcare sector.

I will be old one day. You will be old one day. We may need the level of care that nursing homes provide.

Given the choice, most people would perhaps choose not to be in a nursing home, but that doesn't mean they are bad places to be. In fact, on one visit to Nightingale, an inspector simply said: "This is a nice place to live." It's just not front-page news, is it?"

Patricia MacGabhann RGN BNS (Hons) H Dip Gerontology MSc (Science) MHSc (Specialist Nursing).

Sunday Independent

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