There could be more cases of institutional abuse in nursing homes like that which occurred in Leas Cross unless there was a meaningful change in care for the elderly, the author of the Leas Cross report, Prof Des O'Neill, said yesterday.
He called on the Department of Health and the Health Service Executive to undertake their own analysis of what happened at Leas Cross to ensure that the gaps that caused this major systems failure were identified and that the problems there could not recur elsewhere.
Prof O'Neill said this analysis was important to reassure the public. "If an aeroplane crashed due to a system failure, I think we would expect that the aircraft maintenance people and the airline would wish to examine the process of that system failure.
"So I think it is important for the general public's reassurance that both the Department of Health and the HSE undertake that type of analysis and reassure people that they have seen where the gaps may be in this system failure," he said.
Prof O'Neill, whose review of 105 deaths at Leas Cross between 2002 and 2005 was published recently, was speaking after addressing a conference on best practice in the management of older persons in residential care, at Clontarf Castle in Dublin.
He said the Government needed to consider putting in place either an Older Irish People's Act or a constitutional amendment to ensure elderly people got the services they require.
There was "neglect" in many aspects of services for the elderly, not just in nursing homes. It was disturbing, for example, he said, that a new Mater hospital was planned with no provision for specialist medicine for older people. A new St Vincent's Hospital had also been built without such a unit, while provision of services for the elderly had been left until last in refurbishments at St James's.
"Can you imagine the uproar if they decided not to put the paediatric unit in into a new-built general hospital. There would be absolute uproar," he said.
He said the Kennedy report in the 1980s said older people should be central to the function of the general hospital, but sadly they were often put on the back burner. This was discrimination.
Prof O'Neill, who is due before the Oireachtas health committee this morning to discuss his Leas Cross report, also said it was not clear to him that the HSE had now a robust nursing home inspection regime in place.
"It is not clear to me that that is the case. It may be, it may not be, but certainly as a senior professional in the area, it is not clear to me that this necessarily reflects what's going on on the ground."
He stressed that significant investment was required in services for the elderly and while both the Department of Health and the HSE had accepted virtually all of his report's recommendations, he was waiting for Budget day to see if funding was provided to implement them.
This would show the "seriousness of intent".
He praised a number of actions taken to assist older people, including the extension of medical cards to all over-70s.
Meanwhile, Bob Carroll, director of the National Council on Ageing and Older People, told delegates that appropriate staffing levels and skill-mix in long-stay care facilities were critical to residents' quality of life. He called for guidelines that would ensure adequate and appropriate staffing was provided in all facilities.