Northern Ireland

Claire Keatinge criticises lack of consultation over closures

Elderly woman with walking stick
Homes in three of Northern Ireland's health trusts are earmarked for closure

The Commissioner for Older People has criticised the lack of consultation with residents in NHS residential care homes facing closure.

Claire Keatinge described the anguish expressed in the media and to her office by elderly residents and their families as "very serious".

She said it suggested those affected had not been properly consulted.

NHS care homes in the northern, southern and western trust areas have been earmarked for closure.

Ms Keatinge told BBC's The View that the lack of consultation "suggests to me those people have not been engaged with effectively, haven't been consulted properly".

"They don't feel they are being listened to and are afraid. And that is entirely unacceptable. It is not acceptable to frighten older people," she said.

Ms Keatinge said the amount of upset communicated to her office has been significant.

Her comments come on a day the Health Minister Edwin Poots has spent on the airwaves on damage-limitation.

Sue Ramsey, chair of the health committee, said it was time for clarity from the minister amid a public backlash over proposals by most of the health trusts to close their residential care homes.

"Who's in charge here?" she asked on BBC's the View.

Ms Ramsey, MLA for Sinn Fein, pointed out that the minister made a statement in the assembly some weeks ago outlining proposals for consultation that involved half the trusts' residential care homes closing in the next three to five years.

"He needs to challenge the trusts," she said.

"It doesn't seem to me as if the trusts are listening to what the minister says."

There has been speculation in political circles at Stormont that some trusts, frustrated with financial pressures, have sought to embarrass the minister by maximising the closures of residential care homes.

Proposals

Jim Stewart, who was sacked by the minister last year when the Northern Trust he chaired failed to make its health targets, doubted the trusts were seeking to embarrass the minister.

He said he believed the Health and Social Care board (which oversees the trusts) was driving the proposals with the minister's support.

Speaking on the BBC's Talkback on Thursday, DUP minister Edwin Poots insisted he had not been informed by the trusts about the more far-reaching proposals made public in recent days.

Whatever the truth, the minister's previous stance in 2009 has left him vulnerable to cries of hypocrisy.

Back then, he led an assembly debate against the closure of care homes by the then minister Michael McGimpsey.

He also posed with DUP colleagues protesting at the closure of Skeagh House in Dromore - that residential home is now earmarked for closure by the Southern Health and Social Care Trust.

The revelation was characterised as a "politically awkward moment" by Dr Gordon Marnoch from the University of Ulster's Institute for Research in Social Sciences.

Protesters outside Western Health Trust building
Protesters staged a demonstration against the care home closure plans revealed by the western trust

He suggested that in 2009 Mr Poots was motivated by political considerations such as votes - and as a minister he has to consider other factors.

"I'm saying he's probably surrounded by people who emphasise the policy realities to him," said Dr Marnoch.

The new policy is set out in the 'Transforming Your Care' report drawn up by John Compton of the Health and Social Care Board at the minister's request.

The minister has championed this policy, driven by a number of considerations, including cost and the fact that some trust homes are rundown.

Mr Stewart cited the driving forces behind the policy included not just the expense of residential care, but the stated desire of older people to stay in their own homes.

He said that the challenge was to ensure older residents were safe in their own home.

He expressed concern about a lack of funding.

"We have to look at how we provide service - not maybe a third world approach where you get 15 minutes four-times-a-day and you do the minimum for people," he said.

Supported Housing where older people have their own front door, while able to call on 24 hour assistance, is key to the 'Transforming Your Care' policy.

Pressures

Critics complain there is a shortage of this kind of accommodation and the problem will be made worse if trusts rush to close residential homes.

Critics also point out this could increase pressures on the private sector.

This sector is already struggling to break even amid financial pressures, not least the amount of funding per resident the NHS is willing to provide.

Mr Stewart said he did not think the policy was being represented properly.

"I don't believe it meant every residential home to close. We can't put all our eggs into the private sector where there's a risk. We don't know what's going to happen to the private sector in the future," he said.

Dr Marnoch agreed there are risks, and the government must ensure that the required spaces lost as NHS facilities close are actually filled by the private sector.

But in terms of the overall policy, he advised the minister not to retreat.

"Stick with it. I think it's a logical policy. You don't realise ambitions to provide better quality care by maintaining the residential care facilities operated by the NHS," he said.

The minister has insisted the policy is still being consulted upon - but he has blamed the trusts for the disastrous way the proposals have been handled.

Mr Stewart suggested the minister was now under significant pressure and is predicting "another U-turn".

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