The shocking scandal of official indifference and negligence on the care of the elderly

The report we publish in this issue of Village (in edited form) is a truly shocking indictment, not just of the Leas Cross nursing home itself, but, far more significantly, the public health system – the health boards, the HSE and the Department of Health and Children. The scale of negligence and indifference of the Department, the Health Boards (as they were) and the HSE are bordering on the criminal.

Take just a few aspects of the report written by Professor Des O'Neill:

• Although the heath authorities had every reason to believe that Leas Cross was not submitting up-to-date declarations of deaths in the nursing home, nothing was done, no follow-up queries, no inquiries, no expression of concern.

• There is almost a complete absence of systematic monitoring of deaths in Irish nursing homes (how, conceivably, could the health authorities have discharged their duty to care for the welfare of people in nursing homes without such information and what scale of indifference does this convey?).

• A coroners investigation into one death at Leas Cross revealed appalling standards of care but, yet again, nothing was done by the health authorities.

• Elementary data on the welfare of patients at Leas Cross was not maintained, including data on patients' weight and skin sores.

• An alarming number of patients were forcibly restrained on a regular basis at the nursing home.

• Medical cover for the patients in the home was woefully inadequate. The health authorities had a means of knowing about this but, again, nothing was done.

• The staffing at Leas Cross was clearly deficient in terms of expertise, nursing numbers and nursing infrastructures. This must have pertained for years but again went ignored.

• The provision of services by old age psychiatrists and geriatricians generally have been stretched to the limit and have clearly been inadequate. Nothing done.

• There was no designated inspection team for the Northern Area Health Board before October 2004.

• After October 2004 repeated reports, including the report on the death of Dorothy Black, revealed the appalling standards of care at Leas Cross but the health authorities failed to respond.

• Repeated representations about the standards of nursing care at Leas Cross were made by relatives of patients and by psychiatrists at St Ita's hospital. These "did not trigger the appropriate response".

One can only guess at the scale of negligence that exists in nursing homes around the country right now and the scale of the misery, pain and indignity suffered by thousands of old people. Our health bureaucracy could hardly be bothered.

What has been revealed by Des O'Neill's report is such as to demand a wider and public inquiry. This is abuse on the scale of the abuse suffered by children in residential institutions over decades. It is right that those responsible for the infliction of injury, misery and indignity onto old people be identified, that the policy-makers and administrators responsible be exposed, that the practices be revealed so that it never happens again – or is that expectation too optimistic?

The wider significance of this abuse of old people will be deliberated upon – the indifference of our modern society generally to the needs of old people. The growth of the nursing home industry is testimony to a general indifference. No longer are there family supports such as to ensure that people in their old age are looked after by their sons and daughters, who they looked after in their young age. That is a serious issue but, in the context of this Leas Cross report, a side issue.

Here the issue is the shocking scale of official indifference and negligence over the treatment of vulnerable people and it is that public issue that now should be confronted, through a full public inquiry. Not just into Leas Cross but into the institutional care of old people generally.

Vincent Browne