Belfast Telegraph

Thursday 2 October 2014

DebateNI home of Northern Ireland politics

Edwin Poots U-turn on care homes both brave and risky

Health Minister Edwin Poots
Health Minister Edwin Poots

Congratulations to Stormont Health Minister Edwin Poots who has finally extricated himself from the long-running row over the closure of elderly care homes.

This time last year the minister was on the ropes, seemingly on the brink of losing his job after health trusts revealed that care homes were earmarked for closure.

However, Mr Poots has proved himself a doughty fighter. Pummelled by the media, he resurrected himself before Easter with a tour of reassurance of the very care homes that were under threat.

In so doing he won the plaudits of residents, relatives, the staff of the homes who faced redundancy and, crucially, with council elections next month, the approval of the voting public.

The reprieve for 18 care homes seems the end of an embarrassing episode for the minister. Mr Poots is now painted as a white knight, slaying the health service bean-counters.

The future of the 300 residents of these homes is paramount. However, there is still a need to cut through all the emotions; to reflect on how the issue arose in the first place and what the future holds.

There are also questions which need to be asked of the minister and the health authorities as to the continued viability of these homes as numbers fall and no new residents are admitted.

It is easily forgotten that Mr Poots (below) gave his blessing to the blueprint strategy for the future of health in Northern Ireland – the document known as Transforming Your Care.

The redirection of nursing care lies at the heart of this strategy – away from the care homes which Mr Poots announced would remain open.

Many have closed already without much fuss and the strategy which Mr Poots accepted originally envisaged the closure of 50% of existing homes.

Now, he says, they must all remain open – a U-turn brought about by the media and public pressure, but possibly not in the best interests of the future funding of health and social services here.

The balloon went up for the Health Minister a couple of months after his announcement, when it was revealed that some health trusts were planning to close not 50%, but up to 100% of homes in their areas.

The Transforming Your Care strategy on home closures to which had subscribed was thrown into turmoil.

It appeared to be lost in translation by the health trusts, but also by the minister himself, swiftly back-tracking on his support for the strategy.

According to then chief executive of the Health and Social Care Board, John Compton, the 50% figure related to 58 facilities, including the 18 care homes still functioning across Northern Ireland.

The health trusts charged with making savings, which they dare not shirk, focused on the homes because many of them were costing so much and had diminishing numbers of occupants. Only 300 elderly residents are now cared for in this way.

When Mr Poots made his reassuring tour, one of the homes was half-empty. While he affirmed it would remain open, he did not reverse the policy of no future admissions. Instead, he says he has asked health officials to come up with some as-yet-undefined plan to use the vacant space in these homes for other forms of healthcare support, such as releasing space from nearby hospitals. It remains to be seen whether this alternative is practical or cost-efficient.

The whole issue illustrates the pros and cons of devolution. On the one hand, local accountability is seen to be working.

The policy of care home closure is reversed unilaterally by order of a Stormont minister, who found himself in a very uncomfortable, career-threatening position a year ago.

On the other hand, some might argue that his U-turn betrays the weakness of devolution, insofar as Stormont ministers and MLAs are constantly looking over their shoulders, acting more like local councillors.

By calling into question the very policy to which he gave his support in the first place, he has hung out to dry the credibility of senior health officials in Northern Ireland.

Where that leaves trust and confidence between the minister and those charged with managing the health and social care services is open to question.

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