Chapter 12 - Conclusion

The HSE has accepted all of the findings in this case and has agreed that Mrs. Byrne will be repaid the In-Patient Charges which were incorrectly levied on her mother from March 2003 to December 2004. It has also undertaken to review the position of other residents of the Roscommon nursing home who were placed there by the NAHB in similar circumstances to those of Mrs. Coffey.

The HSE has accepted that this report has brought clarity to the key question of whether Mrs. Coffey was effectively a public patient or whether she was in receipt of subvention. It has accepted also that its administrative processes were not consistent with good practice and do pose very serious questions for the area of the HSE which includes the former Northern Area Health Board.

The introduction of the Nursing Home Support Scheme in 2009 means that the provision of long term residential care is radically different to the situation which pertained in 2003 when Mrs. Coffey first entered nursing home care. As such, the issues in this case are historic or legacy issues related to contract and subvented beds.

In response to the view of this Office that the NAHB took on the role of promoting the services of one private company by introducing its own patients to the company and encouraging them to avail of its services, in circumstances where that company’s business was being managed by a senior member of NAHB staff on leave of absence, the HSE has stated “We note that the Ombudsman accepts that personnel involved in this case were motivated by a desire to make suitable arrangements for people in Mrs. Coffey’s position, at a time of significant resource constraints. However, we also accept that the arrangements made could not be considered consistent with good practice and do pose very serious questions for HSE DNE, which includes the former NAHB."

In light of the HSE’s response to the draft report, it is not necessary to make recommendations in this case.

Emily O’Reilly
Ombudsman

December 2011