Yesterday.

The Dáil sitting at the Convention centre, Dublin

Aontú leader Peadar Toibín revealed new information about how as many as 10,000 older people were moved from hospitals into nursing homes at the start of Covid. Over 2,000 people died reportedly with Covid in nursing homes.

Peadar Toibīn: “Yesterday, under freedom of information, a document was released to me from the National Treatment Purchase Fund, (NTPF). The document was an email (above), which was issued to nursing homes by the contract manager of the NTPF shortly before 10am on 12 March 2020.

I have already furnished the Minister of State at the Department of Health, Deputy Mary Butler, with a copy of this email, which states that the NTPF had been asked to establish capacity within the nursing home sector. It goes on to state that nursing homes will need:

“…to have the ability to care for patients coming from [the] acute hospital setting…”

and further states:

“Facilities must be able to facilitate short term residents being discharged from [an] acute hospital. …residents…may be nominated by the HSE [and] the Department of Health as applicable for receipt of appropriate funding.”

Describing what will happen, the letter states that the individual facility would co-ordinate directly with the discharge unit within the hospital.

This is a damning document. In many ways, it is a smoking gun. We know that the Covid-19 nursing home expert panel found that 10,000 patients were discharged from hospitals into nursing homes in the first six months of 2020.

Was it a Government decision to move elderly patients, wholesale, out of hospital beds and cram them into nursing homes?

The major question is who instructed the NTPF to issue this email? The email states that nursing homes were asked to establish capacity. Who asked them? That is the first question.

We have also learned a pot of money was offered to nursing homes at this time. How much was offered to get older people out of hospitals? The context of this discussion is pivotal. In early March, nursing homes voluntarily closed their doors to visitors in an attempt to protect vulnerable residents.

On 10 March, Dr. Holohan, the Chief Medical Officer, issued a statement stating that these restrictions were not necessary. This document shows that two days after telling nursing homes to reopen their doors, an email was issued to nursing homes instructing them to make way for a large influx of patients from hospitals.

Further FOI documents released reveal that, throughout all of this, the Minister for Health at the time, Deputy Simon Harris, repeatedly ignored requests for meetings from the CEO, of Nursing Homes Ireland, Tadhg Daly.

The Fianna Fáil Opposition spokesperson at the time was the Minister, Deputy Stephen Donnelly, and he revealed that the HSE “intercepted” supplies of oxygen, personal protective equipment, PPE, and staff that were meant for nursing homes.

Was there a concerted effort by the Government or the HSE to take older people out of the safety of hospitals and cram them into nursing homes during the pandemic?

How could this decision be made when the Minister in charge was ignoring appeals from the sector to meet with him, when nursing homes were having their PPE, oxygen and staff taken from them by the HSE and when the CMO was telling nursing homes to keep their doors wide open to the public?

These were an incredible set of events at a period when there was an influx of Covid-19 in this country. It should be remembered, in all the conversations we have had about Covid, the majority of people who died with Covid were in a nursing home or hospital, two locations owned, or under the regulation of, this Government. Can the Minister answer these questions?”

In her reply, Hildegarde Naughton,  Minister of State at the Department of Transport, declined to address these issues, but stated:

“The decision to discharge patients from hospitals to nursing home settings is always subject to clinical assessment. Discharges to nursing homes and other settings are a regular, daily feature of a functioning health system. The period from early March 2020 to mid-April 2020 saw an increase in the number of such discharged patients as the health system prepared itself for an expected surge in Covid-19 cases. From an older person’s perspective, being admitted for longer than necessary increases the risk of a patient contracting a healthcare associated infection or deconditioning. The vast majority of these discharges took place from 10 March 2020 onwards, when clear public health guidance was in place across all acute hospitals.”

Paedar Toibín: “In fairness, none of the questions I asked about accountability have been addressed by the Minister of State whatsoever. This is a serious problem. We need clarification with regard to who is behind these decisions.

She [Deputy Naughton] mentioned that HSE support was provided to the nursing homes. That is not exactly true. Further freedom of information documents I have received show that on 19 October 2020, the Minister of State with responsibility for older persons and mental health, Deputy Mary Butler, wrote to the chief executive of the HSE, Mr. Paul Reid, seeking assurances that the HSE would continue to provide staffing support to homes.

Paul Reid did not respond to the Minister of State for a month. When he did, he said that all was well and that the HSE would continue to provide funding for nursing home staffing and support for nursing homes. On 16 October 2020, a similar letter was sent to Mr. Phelim Quinn, the chief executive of HIQA. Paul Reid said he was disappointed that Mr. Quinn stated certain private nursing homes had not reported that they have received support from the HSE.

When Mr. Reid was telling HIQA and the Minister of State that all was well, I had people from nursing homes on the telephone to me crying for staff. I have in mind specifically a case in the Minister of State, Deputy [Martin] Naughton’s, county, Galway. It occurred almost at the same time that these letters were issued. All staff in a nursing home, bar two, tested positive and it was left without any support. This resulted in the two staff who had tested negative being unable to leave the nursing home because there were no replacement staff.

That is an incredible situation. In case the Minister of State did not notice, the headlines in the newspapers at the time were screaming about staff shortages in nursing homes. All the while there were 75,000 people who had applied to Be On Call for Ireland but they were pretty much left untouched.

The Minister of State mentioned people being discharged under normal regulations. People were being discharged from these hospitals into nursing homes without being tested. It was an incredible situation. When will there be a full investigation? When will there be accountability? When can we be sure this will not happen again?”

Yesterday: Damned

Previously: Left To Die: Nursing Home Timeline

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