The findings of the investigation into the treatment of patients at Killarney Community Hospital since the 1980s are disturbing, as is the decision by the Southern Health Board not to publish the full report of the independent investigator, Ms Noreen Spillane, a director of nursing with the Mid-Western Health Board.
The affair also highlights a serious deficiency in health and social services, namely the fact that health board homes and hospitals for older people, and longstay geriatric wards in general hospitals, are not subject to the inspection regime which applies to private nursing homes.
The lapses in standards at Killarney Community Hospital have come to light due to the work of an independent member of Kerry County Council, Mr Brendan Cronin, who brought complaints from a number of local families to the Southern Health Board in March. That the board's chief executive officer, Mr Sean Hurley, immediately launched an inquiry is to his credit.
What we know of the outcome of that inquiry - from the 19 lines of the findings which the health board deigned to publish - is disturbing. First, an absence of records of all kinds stopped Ms Spillane from investigating all the allegations received. Second, she found that the hospital's practices regarding the administration of drugs breached the guidelines set down by An Bord Altranais, the body which regulates the nursing profession. Third, she discovered defects in hospital procedures and practices which were, it is clear, a source of distress to patients.
Patients had to go to the toilet in the hospital dayroom, for instance. There was inadequate nursing to cover a 24-hour period. It was unclear who was responsible for aspects of patient care such as shaving. One man complained he had to be washed and shaved by his wife. Perhaps the most poignant case was that of a woman refused permission to stay overnight with her husband who subsequently died.
But these are only glimpses of the situation. The Southern Health Board has chosen to summarise the complaints made to an extent which, in one case, removes all details and in others, removes most of them. And it has provided only the skimpiest summary of Ms Spillane's findings.
Confidentiality has been cited as the reason for the board's approach. This is simply not credible. This newspaper has obtained and published inspection reports from this board in the recent past. All this was done without infringing confidentiality, simply by blanking out names.
From this affair, two lessons are clear. One is that the publishing of reports of this kind must not be left in the hands of the body which is the subject of the report. The second lesson is that publicly owned and run facilities for older patients, and long-stay geriatric wards in general hospitals, must be subject to the same inspection regime as private nursing homes and that the reports of these inspections must be available under the Freedom of Information Act.