Post code lottery leaves vulnerable patients being treated ‘unequally’

The unequal treatment of patients needing specialised seating is costing some people thousands of euro, a meeting of the HSE West Regional Health Forum was told. Specialist seating can be required for patients who have disabilities and to prevent pressure sores.

Cllr Emer Kelly asked the HSE what plans are in place to fund and provide specialised seating to patients going to private nursing homes.

“At the moment, I understand there is a process in place at Galway hospital that if patients require private seating, there is an occupational therapy service that will cover that and follow up.” However, if the patients attended Portiuncula or Roscommon hospitals, this is not available, the independent councillor continued.

“It falls back on the family or patient to fund the seating, which can cost €4,000 to €6,000 depending on their needs.” She said she was concerned about the inequity of this. “It is luck of the draw whether your Eircode falls in Galway or Roscommon, or where the ambulance brings you, as to what your care might be.” In response, the HSE said that currently there is funding provision for clients discharged from Galway University Hospitals (GUHs) for long term care (LTC).

This service provided a full-time occupational therapist for the Long Term Seating Pathway, with a budget for seating equipment to facilitate clients to be discharged home.

“This Long Term Care Pathway is for clients discharged from GUHs to nursing homes, including private nursing homes,” the HSE said. “Once seating is provided through the Long Term Seating Pathway, follow-up is provided through the OT from GUH, assigned to the LTC Pathway. This process is currently available for clients discharged through GUH.” However, it is not available in Primary Care Galway, and there are currently no OT services provided to private nursing homes in Roscommon.

“There have been no formal discussions around the provision of such a service,” the HSE said. The HSE accepted that there is a need for a standard operating procedure to be developed regarding the provisions of specialist equipment within private nursing homes.

Speaking at the forum, integrated health area manager for Galway Roscommon, Ann Cosgrove said the service in Galway, an occupational therapist who could provide outreach, is funded through the HSE Winter Initiative.

“We don’t have the same funding for Portiuncula or Roscommon,” she said. “If there are exceptional cases, we do try to deal with them.” She said that the local HSE would strive to improve the situation, but there is no funding for additional posts for such a service this year.

“But we will look at how we can deal with it and have a standardised process in the two areas. It is something we will work towards.” Cllr Kelly said it was something that needed to be prioritised “because it is an unequal service”.