Newton's Optic: Newton Emerson finds an increasing debate over "league tables" for nursing homes in Ireland.
Releasing nursing home inspection reports could lead to "crude league tables", experts have warned.
"League tables tell us little about the wide range of work that nursing homes undertake," said the minister, Mary Hanafin, yesterday.
"Inspection reports, by contrast, provide a sophisticated evaluation which is why they cannot be given to anyone who might be tempted to summarise them for public consumption in hierarchical tabular form."
Publishing concise comparisons of social institutions is a serious crime under Irish law. Offenders can expect to serve up to five years in prison, plus an additional 12 months if they briefly compare the prison to other prisons. On Tuesday, the Supreme Court threw out a challenge to this law under the Freedom of Information Act by a majority of two to one, although The Irish Times in no way wishes to suggest that this means one of the judges has any more or any less sense than the other two.
In response to the ruling, the Government has promised to examine ways to make the inspection reports themselves more widely available.
"Obviously children want to know as much information as possible about where they are sending their parents," said Ms Hanafin yesterday. "However, if they obtain that information from a series of condensed abstracts arranged on a page so as to imply a ranking order then they are clearly evil." League tables have long been a fact of life in Britain, but the prospect of a similar move in Ireland has always proved highly contentious.
"As the Minister has acknowledged, this debate boils down to the difference between crude league tables and sophisticated evaluation," explained Prof Pat Answer, Dean of Applied Socialism at Dublin Sunday Business College. "The difference is that everyone wants league tables, but only crude people actually say so. Sophisticated people know how to evaluate things for themselves."
Evaluation techniques used by sophisticated people include eavesdropping on conversations in the golf club, hoping that the rest of the building is as clean as the lobby, assuming that higher fees aren't wired straight to Bermuda and quietly obsessing over where other sophisticated people send their parents.
Unions representing nursing home staff also have strong objections to the concept of non-sophisticated evaluation. "Nursing homes are complex organisations," explained a spokesman for the Irish Geriatric Laundry Operatives' Organisation (IGLOO). "In fact, they are so complex that it is impossible to describe them fairly using anything less than unabridged 60,000-word official reports which must not, repeat must not, be arranged on a shelf in anything other than strict alphabetical order. This is not an attempt by our members to run away from accountability. However, any further questions about tables must be addressed to the chair."
Nursing home operators believe that their performance should be seen in the context of wider social problems.
"All old people may be equal, but not all old people are the same," said one owner, who asked to remain anonymous due to the controversial and possibly illegal nature of that statement.
"For example, many of our residents come from families where the children are divorced. Most have difficulty concentrating and all of them take drugs. None even want to think about their Leaving Cert.
"Deprivation is also a major issue, especially after we've sold their houses."
In response, the Government has set up an inclusion strategy to ensure that any attempt to compare nursing homes in print includes these excuses. "This is a comprehensive, integrated policy approach," explained a spokesman for the Minister. "Any statistical synopsis of two or more nursing homes appearing consecutively in a sequence which insinuates a judgmental classification must be fully cross-referenced for all discounting indicators, while omitting crude averages unless they are identical, in which case the exercise may be considered a sophisticated evaluation. Let's see them fit all that into a double-page spread in the weekend section."
The Government has also responded quickly to Monday's Prime Time investigation into neglect at a Dublin nursing home. "It must have been terrible for families to discover this information through the media," said Tánaiste Mary Harney yesterday. "However, the main thing is that the information was presented as an hour-long television documentary rather than as a printed table or even worse, God forbid, a list."
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