Hospitals should look at the possibility of charging families the full cost of caring for their elderly relatives in acute hospital beds where these families have "blocked" the discharge of their relatives from hospital, according to an unpublished report commissioned by the Health Service Executive, writes Eithne Donnellan, Health Correspondent.
The recommendation is made by a UK healthcare consultancy following its inspection of 10 hospitals to assess the factors which lead to A&E overcrowding.
The consultants, Tribal Secta, found huge numbers of patients whose discharges had been delayed, particularly at Dublin's main hospitals, because of a lack of alternative facilities in the community. They also found there were cases where families of elderly patients were refusing to apply for nursing home subventions. These are grants paid by the State to assist with the cost of care in private nursing homes.
At Tallaght hospital, Dublin, they found that 27 per cent of cases of delayed discharges on one date last July were associated with the patient's family refusing to apply for nursing home subvention.
This report on the 10 hospitals visited by Tribal Secta was released to The Irish Times under the Freedom of Information Act.
The report on St Vincent's hospital, Dublin, noted that families refusing to apply for subvention payments were also a factor in delayed discharges there.
It also said this hospital, along with St James's Hospital, Dublin, reported a significant amount of bureaucracy associated with subvention applications.
"There are also challenges that families and carers might not accept first places available and refuse to condone a move from hospital," the report on St Vincent's said. The hospital, it said, could "look at the possibility of charging, where discharge is blocked because of preferences".
This suggestion, however, has been condemned by Age Action Ireland spokesman Gerry Scully. He said people have to be able to decide where their older relatives go.
Families were refusing to apply for nursing home subventions because they knew the maximum amount available was €460 a week, when private nursing home beds cost on average €800 a week in Dublin, he added.
In response to the RTÉ programme Primetime Investigates, which last night highlighted problems in A&E departments, the HSE said: "We deeply regret the discomfort and indignity that is sometimes suffered by patients in our hospitals' A&E departments. Addressing these difficulties is our top priority.
"We believe that no patient should have to wait unduly in A&E departments for hospital admission and that it is unacceptable for anybody to be waiting more than 24 hours. Our target is for no patient to be waiting longer than six hours and for all patients to be afforded privacy and dignity."