A spotlight upon St. John’s Hospital Sligo reveals the shocking human cost of Irelands continued programme of economic austerity.

St. John’s Community Hospital provides a number of vital services for Sligo’s elderly, including; a Rehabilitation Unit, four Extended Care Units, a Day Hospital, Physiotherapy and Occupational Therapy Departments.

Negative Impact of Cutbacks:

In recent years government cutbacks have had a devastating impact upon the provision of services within St. John’s.  Large staffing decreases, bed closures, overcrowding, restrictions on therapeutic services and a general lack of necessary refurbishments have all combined to make the situation within St. John’s intolerable for both patients and staff alike.  

Government Reports:

The impact of cutbacks upon St John’s elderly service users has been well documented in a series of very damming reports by the Irish State’s Health Information and Quality Authority (HIQUA).  Identified concerns include:

(1) Low staffing levels resulting in the diminished ability of St. John’s to meet the dependency needs of its residents.

(2) Staff workloads described as being unreasonable and unsafe.

(3) Residents insufficient access to GP and Health Care.

(4) Insufficient toilet and bathing facilities for residents.

(5) A lack of constructive meaningful activities resulting in a lack of stimulation for residents.

(6) Inadequate levels of staff management.   

The most recent HIQUA report, October 2013, states that as a result of cumulative findings in relation to risk management, medication management and staffing, “inspectors were not assured that all reasonable measures were in place to safeguard resident’s welfare and wellbeing”. 

HIQUA assessed the level of a number of identified risks within the hospital as being “extreme or catastrophic”.  

Concerns Raised by St. John’s Nursing Staff:

Staffing issues within St. John’s have been highlighted by nurses working at the hospital.  Breedge Scanlon, a senior nurse at St. John’s described to the Irish Nurses and Midwifes Organisation Annual Conference in 2011, how in her opinion there were not enough nurses on some hospital wards to “wash, feed and keep patients alive”.  Nurse Scanlon described staff stress levels as being at “breaking-point”.  She reported how nursing staff had made their management aware of the situation but nothing had been done.    

Local People’s Experience of St. John’s: 

Reports from local people who have had elderly relations resident in St. John’s have confirmed Nurse Scanlon’s concerns, describing how they have been necessitated to supplement the short fall in professional care within the hospital by providing their own voluntary efforts to ensure their loved ones needs were met.  One woman described how a group of relatives even organised a timetable amongst themselves to ensure that an elderly resident without any local family was not left out.

The Failure of Government Policy:

Clearly, State funded residential elderly care within Sligo has been severely impacted by underfunding and cutbacks.  Worryingly, a recent BDO report titled “Health’s Aging Crisis: Time for Action, A Future Strategy for Irelands Long-term Residential Care Sector” indicates that the situation is only likely to get worse under current government policy.  

Tadhg Daly, Nursing Homes Ireland (NHI) CEO argues that financial cutbacks in the elderly residential care sector run the risk of “real long-term damage to Ireland’s capacity to care for our growing ageing population”.  Mr Daly calls for urgent significant capital investment by the government to avert a looming crisis, as current sector capacity is not keeping pace with rapid increasing demand.

However, under current government policy this urgent necessary funding is unlikely to be forthcoming. Current government policy states that no extra funding will be provided for health services under the Government’s plans for universal health insurance cover, over and above that already being spent on public and private healthcare. 

In addition, current plans under the universal health insurance scheme provide a package of healthcare services including hospital and primary care services - but does not include cover for long-term nursing home care.  Nursing home care would entail an additional insurance payment to the projected annual 1672 Euros standard fee. 

The BDO Health’s Aging Crisis report is also critical of current government policy that seeks to divert funding away from elderly residential care settings into ‘other’ unregulated, underfunded, community based care settings such as the family home.

A significant inconsistency in present government policy that seeks to divert elderly care provision from central state funded care into community settings is the recent series of cutbacks in services and grants that make home care for the elderly possible i.e. home help services and local authority administered grants schemes such as Housing Aid for Older People and Mobility Grants. 

Labour Party Minister for Housing, Ms Jan O’Sulivan, recently imposed funding cuts of 80% for Housing Adaptation & Mobility Grants in Sligo, from €1,192,707 in 2011 to €221,587 in 2013.

The combined sum of Sligo’s grant funding to aid the elderly in 2014 remains diminished at €375,371, the second lowest grant allocation of any county in Ireland. 

Evidently, Sligo’s elderly persons and their families are between a rock and a hard place should long-term State funded residential care become necessary.  The present governments underfunding of State run elderly residential care services in Sligo - makes this an option of last resort, leaving home care as the poorly supported, unsatisfactory second worst option.

Commenting upon the ongoing concerns at St. John’s Hospital – Sligo’s People Before Profit, local election candidate, Seamus O’Boyle, stated:

“It’s simply not good enough that after their many years of contribution, Sligo’s elderly should be treated this way... In my opinion this is the unacceptable human cost of diverting Billions of State funds into bailing out banks and bondholders...We urgently need a more humane form of government, one that is prepared to put people before profit”.