The lack of clear government policies on the care of the elderly is leading to an increase in demand for hospital beds and institutional care, according to the Ombudsman.
A set of transparent guidelines would help hospital authorities move towards an improved administration of “hospital space, resources and improved public health service provision”, Ombudsman Joseph Said Pullicino said in his report.
Although a number of elderly patients could, and wanted, to return home after completing rehabilitation, they had to be backed up by an “assurance that community primary care services” were up to expectations and responsive to their needs.
Instead, among other things, there was a substantial investment promoting “standards of institutional care” which was a “constant source of encouragement” to family members to place their elderly relatives there –but this was creating “unacceptably” long waiting lists.
Dr Said Pullicino pointed out that it created a situation where Karin Grech Hospital was used as a “half-way” house for the elderly who did not need acute hospital treatment while waiting to be admitted to a home. Although there was “awareness” on the importance of community care for the elderly and people suffering from chronic illnesses, “these services do not seem to be provided in a holistic and personalised manner according to patients’ particular needs”.
Dr Said Pullicino also highlighted that primary healthcare services were not provided in a “holistic and personalised” way because of the lack of professional and specialised resources and recommended authorities give it “urgent attention”.
He made these observations after an elderly woman asked him to intervene with health authorities to compensate her for the expenses of physiotherapy and occupational therapy sessions for her infirm and bedridden husband.
The woman argued she deserved compensation because she chose to keep her husband at home under her care instead of using institutional care, such as St Vincent de Paul.
Saying her claim for financial compensation opened a “much wider panorama”, Dr Said Pullicino said that an elderly person entitled to institutional care but who did not do take up this option was not eligible for compensation. “Although the situation is legally in order, it could in effect amount to injustice,” Dr Said Pullicino said.
He questioned whether laws should be amended to grant compensation to those who opted out of care services they were entitled to.
While pointing out that it was not his role to determine the quality and type of services, he had a duty to establish the extent to which government policy contributed towards a “heavy build-up” in the demand for beds at homes for the elderly.
“As a result, patients who ought to be cared for elsewhere, occupy beds in state hospitals at the expense of, possibly, other more deserving cases… this situation could be considered as tantamount to maladministration,” Dr Said Pullicino said.
The government’s agreement with private hospitals where patients were referred for certain operations, such as cataract removal, helped cut down on the waiting lists.
He also highlighted a positive proposal to organise teams of doctors on call on a 24/7 basis to respond to the needs of elderly patients under their care with direct access to their medical history.
“These arrangements, if implemented wisely, would mean savings to the national coffers and at the same time reduce the need of institutional care to these patients,” he said.