There are some things need to be in the public realm. Health is one of them. We can only ensure best quality of care for every citizen if public health care is owned, delivered and employed by the state. No attempt at private health care, whose bottom line is profit, can ensure that everyone who needs care, attention and professional intervention will get it.
The NHS is far from perfect. But I can tell you as a person who grew up in Dublin and who had to pay for every piece of medical attention from contraception, to a trip to accident and emergency, this model is far better than the dysfunctional, hybrid disaster across the border.
Profit has no role to play in looking after those with dementia. As we have seen in two horrendous episodes in our own community, our elderly and those with dementia have been let down. Last week alone former Kilwee Nursing Home careworker Lisa Cullen was sentenced for the systematic abuse of five patients with advanced dementia, and the assault of a whistleblower, and separately the Ombudsman for the Elderly initiated an unprecedented investigation into Dunmurry Care Home. Surely this must bring all of these issues into sharp relief.
How can any family sitting with a loved one with onset of dementia have confidence that they can rely on residential care when they need it? Right now, they probably cannot.
Is every home going to have staff that scream obscenities at their residents, lock them in cupboards, put hoods over their heads, denigrate them and scare them? No, not all of them. Will every home try to cover up when whistle blowers see this type of behaviour, rather than address it transparently and robustly? No. Will every home elevate a person employed to clean the floors one week to the position of full time dementia carer the next, without due diligence and appropriate training? No.
But how can we know the bad from the good? There is absolutely nothing to reassure families. For relatives in the horrific position of coming to the point of needing the support of residential care, that is unacceptable. For them this is the most scary, guilt ridden, horrendous position to be in. A family will be repeatedly told “they will get the care they need”, “they will be safer in there”, as they battle with conflicting feelings of not doing enough for the person they love most and not being able to cope with the ravages of dementia in a home setting. But when putting that person into a home left their loved one vulnerable to abuse it is almost unbearably difficult.
The RQIA has failed families. The privatisation of this form of care has failed families. Thatcher’s policy has failed families. As rates of dementia continue to rise and more instances of early on-set dementia become more prevalent a radical re-think is required at the highest levels of the health service.
Fully qualified, professional and dedicated staff are needed. Only the health service can ensure this. Families need to know that those they trust with their spouses and parents have a vocation and will care for their family members professionally and with the highest levels of respect that they deserve. This is a crisis that will not go away.