Irish Medical Organisation

Ombudsman - Department failed to provide legal entitlement to nursing home care

Press Release: Doolin Lecture 2011


The Ombudsman, Emily O’Reilly, has warned that those sections of our community which are “bearing the brunt of the present [economic] suffering” need to be able to have real hope that, in the future, there will be “a more prosperous and a more equitable society”.  The Ombudsman was giving the annual Doolin Memorial Lecture organised by the Irish Medical Organisation [IMO].  The lecture was given on Saturday, December 3rd in the Royal College of Surgeons in Ireland.

Addressing the issue of Health Care from her perspective as Ombudsman, Mr. O’Reilly warned that the country needs to look carefully at any developments which remove healthcare from the “communal” public arena; “there is a danger in Ireland that with our health services we may head too far down the road of choice, competition, consumerism and commodification.” 

“It seems to me that a state’s public health service should amount to far more than arrangements to ensure services are provided.  Though of course it is essential that services are provided; after the first five hours waiting on a trolley in an Emergency Department one rapidly looses interest in the philosophy underlying the public health service.” 

She said; “Health policy regarding the provision of long-stay care for older people was given legal expression within the Health Act 1970.  The Health Act 1970, as I understand it, created a legal entitlement to be provided with “in-patient services” which, in the case of older people, included nursing home care. 

“My overall conclusion was that the State, through its agencies the health boards (HSE) and the Department, had failed over many years to provide people with their legal entitlement to nursing home care.  This failure, I concluded, had inevitably caused confusion, suffering and hardship.”

Ms. O’Reilly said; “The context in which services are provided, the institutions providing them, the financing of the services, the governance arrangements for those services, the extent to which one is entitled to services – these are all factors which both reflect and support the maintenance of the kind of society we want to be.” 

“Health Services made available on the basis of the exercise of consumer choice within a purely commercial private market do nothing to promote social solidarity or good citizenship. 

“On the other hand, services provided through State agencies which are dysfunctional are not the answer either.” 

Ms. O’Reilly concluded; “We are currently in the midst of an enormous crisis the scale and extent of which is not even yet clear to us.  We have time now to consider what kind of society we want to be once we come through the crisis.  Any collapse in social solidarity, such as it is, would lead to enormous divisiveness within our society. 

“We need to cultivate and promote greater social solidarity.  Those who are bearing the brunt of the present suffering need to be able to have real hope that, in the future, we will have a more prosperous and a more equitable society. 

“The provision of healthcare by the State will be a central element in any new dispensation,” said Ms. O’Reilly. 

Read the Ombudsman’s full address 


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