Management at Leopardstown Park Hospital are meeting the HSE today in a bid to secure funding to redevelop four overcrowded and outdated wards. Hélène Hofmanreports
About 80 elderly patients at Leopardstown Park Hospital in Dublin are staying in overcrowded and outdated wards, which offer little or no privacy and make it difficult to prevent the spread of hospital-transmitted infections, according to staff working at the facility.
Staff at the hospital, which is dedicated to the care of elderly, long-stay patients, have raised concerns about four so-called "Nightingale Wards", each of which has 20 beds.
Management at Leopardstown Park Hospital is meeting the Health Service Executive (HSE) today in a bid to secure funding to modernise and redevelop the wards.
"Those wards are almost 100 years old. I'm afraid that people will see those wards and not want to have their loved ones here," says Dr Joseph Yazbeck, medical officer at the 200-bed hospital. "The HSE has been telling us they'll do something about it but unfortunately there has been no commitment yet."
The four wards, three of which are reserved for female patients and one for male patients, are full. The 20 patients on each ward share two toilets and one shower, both of which are in need of renovation. Staff have reported long queues to use the facilities at certain times of the day, particularly in the morning. An additional hand basin, funded by the HSE, has only recently been added to the ward.
There is also concern about the cramped conditions on the wards. Beds are about a metre apart, with just a small bedside locker per patient and a curtain between them. The beds are so close together there is no room for chairs for visitors. According to staff, the wards are difficult to heat in winter.
"At the time when care of the elderly is becoming a priority and everyone is talking about it we can't understand the difficulty [with securing funding]. This is a prime location - 25 acres of land in south Dublin with the Luas line nearby. The land is here, the demand is here and it's just crying out for this development," says Yazbeck.
Leopardstown Park Hospital first opened in 1917 to care for soldiers who had been disabled or injured while serving in the British armed forces. In 1979 the Leopardstown Park Hospital Board took over the running of the hospital and extended its role to include the treatment of other elderly patients in southeast Dublin. Although the land is owned by the board, as a voluntary hospital it relies on funding from the HSE and donations.
The hospital now has 180 long-stay beds, 20 respite beds and a separate 50-bed day unit dedicated to care of the elderly. Facilities include physiotherapy and occupational therapy units and patients have access to a social worker and a pharmacist. X-rays and laboratory testing are carried out externally.
About 20-25 of the patients are ex-service people, while the rest come from the hospital's catchment area which includes Ringsend, Tallaght and Bray, Co Wicklow. A certain number of beds at the hospital are allotted to patients coming from acute beds in St James's, St Vincent's, St Michael's in Dún Laoghaire and Loughlinstown Hospital.
Five years ago extensive work funded by the HSE was carried out at the hospital to create 50 more beds and a new physiotherapy unit. As part of this development a number of four-bed wards with a separate toilet and shower were built, while the remaining beds are in single occupancy rooms.
However, the main concern for staff at Leopardstown Park remains the four wards. Last summer management of the hospital submitted a proposal to the HSE for their redevelopment and modernisation. Although they have met the HSE on several occasions to discuss the development, no agreement has been made. Yazbeck says they need the wards to be replaced by a new unit with at least 50 beds. According to financial sources at the hospital, that would cost about €12 million, while a further 50 beds would cost another €6 million.
Pat Smith, chief executive of Leopardstown Park Hospital, says he is hopeful they will make progress at today's meeting. "Nothing has been agreed yet but I have received letters of support from the HSE and we are looking for a positive commitment from the meeting. Our buildings are old and we've been looking for them to be redeveloped but we know that can't happen overnight," he says. "There is a long list of similar proposals from other hospitals, this is not just an issue for Leopardstown, it's a societal issue."
In a statement to The Irish Times the HSE said it was engaged with the management of Leopardstown Park Hospital regarding the physical infrastructure of the hospital and has been on a continuous basis. It added: "Potential developments at the hospital have been flagged for inclusion in the HSE's capital development plans. These developments included both the replacement of existing beds and the provision of additional beds which allow the hospital to meet the relevant standards for residential care into the future."
Meanwhile, speaking about conditions for elderly hospital patients in general, chairman for the Irish Society of Physicians in Geriatric Medicine (ISPCM) Dr Shaun O'Keeffe says many public hospitals are facing similar difficulties with space to Leopardstown Park Hospital.
"This is more a problem that affects the public sector where there is a shortage of beds. This has often led to patients finding themselves in constrained conditions and can impact on the quality of care being delivered. Dependent patients may also require hoists and frames around their beds which leads to further clogging on wards and reduces the space available again," he says.
However, according to O'Keeffe, the Government's Health Information and Quality Authority (HIQA) published a draft proposal on standards for nursing homes earlier this month. The guidelines have been drawn up in response to concerns over the care of elderly patients which have arisen in recent years. The proposals cover staffing and management issues and include recommendations on physical space per patient. The final version will apply to all public, private and voluntary homes.
"If these standards come in it will be the first time that the public sector will have its standards exposed, which is no bad thing. Now is the moment for any concerned staff to look at the proposals and ensure quality of care in future," says O'Keeffe.