Consultants in the Irish Medical Organisation yesterday renewed their attack on plans to move some patients from acute hospitals to nursing homes.
But the use of so-called "stepdown facilities" was defended by the Eastern Regional Health Authority which has taken up 280 nursing-home beds for hospital patients who, it says, are ready for convalescent care.
The Labour Party spokeswoman on health, Ms Liz McManus TD, condemned the use of nursing-home beds for hospital patients as "little more than a panic measure by Minister Martin to avert public anger over the appalling condition of our health services".
As part of his "winter initiative" the Minister has provided funding for health boards to pay for 500 nursing-home beds for patients who would otherwise remain in acute hospitals.
So far, 280 beds have been taken up by the health boards serving Dublin, Kildare and Wicklow in the ERHA area.
Dr J. Bernard Walsh, chairman of the Irish Society of Physicians in Geriatric Medicine and a member of the IMO consultants' committee, said elderly people recovering from acute illness needed more intensive "step-up" care.
This included active rehabilitation in the acute hospital environment, he said. Older patients need a longer stay in an acute hospital than younger people because recovery takes longer. Step-down facilities should not be used as an alternative to proper rehabilitation, he said.
"You have to step up to rehabilitate." The period of cutbacks in health services had seen a loss of acute hospital beds, he said.
The plan to use step-down facilities is a national one but hospitals in the Eastern Regional Health Authority area experience particularly heavy demands for beds.
An ERHA spokeswoman said the patients being moved to nursing homes had finished the consultant phase of their treatment. She said they had been discharged by their consultants as no longer requiring acute care and that convalescent care could be provided more appropriately in nursing homes.
In previous times the patients would have been discharged to their homes, but with more couples working fewer families are in a position to care for a person coming out of hospital.
The ERHA is working on initiatives to enable people to live in their homes rather than in institutions, the spokeswoman said, adding that what people really want is to be able to return home.
The Minister of State for Older People, Dr Tom Moffatt, said the treatment of patients would be decided by consultants. Older people would not be discharged prematurely, he said. Further rehabilitation and assessment services would be provided under the National Development Plan.
Ms McManus said "the facilities available in nursing homes are not comparable with the level of care provided by hospitals, particularly in terms of rehabilitation, which requires comprehensive services like physiotherapy. In many cases nursing homes are not able to provide these services for sick, elderly people".
The Minister, she said, was planning to "decamp elderly patients to nursing homes". This "is an inappropriate response which does not put patient care at the centre of health policy".
"Instead of playing musical chairs with sick patients the Minister should be investing in rehabilitation facilities that are properly staffed and resourced within the hospital sector," Ms McManus said.
pomorain@irish-times.ie