Poots’ residential care home fiasco shows risk aversion brings its own troubles

So last week it was the Health Minister’s turn to get burned. Yet at the end of the week, it is not at all clear as to how the Health Trusts came to interpret ‘at least 50%’ of all Trust residential care homes as 100%, in the case of the Northern Trust, over the longer term.

On one level the Minister is getting it in the neck because of his own aggressive and highly populist positioning when Michael McGimpsey was Health Minister. BUt, as Jude Collins rightly notes, the one thing that did not feature in last week’s reporting to any great extent was the quality of care available there.

Jude’s own experience very much accords with my own. I had one elderly relative who only went in for two week’s care after a knee injury, and ended up taking to her own room since the level of social interaction in such a large institution was almost zero.

Having been wheelchair bound for a week and a half, she leap out of the wheel chair and almost ran into her own house on the day I brought her back home. In Jude’s case, it was…

…[an] old man who lived into his early 90s and whom I visited from time to time in his care home… he read, he watched TV and he was a vigorous conversationalist. He never left his room, and when I asked him if he didn’t want to mix with the other people in the home, he was very definite the answer was No. He didn’t say “I’d be fearful I’d catch their mood of hopelessness’ but it was clear that was what he felt.

Now it is not hard to see how a trust would want to get rid of the burden and the risk of some of these places. And in the case of the Northern Trust, there has been some pretty vexed relationships between to the Trust’s management structure and the Minister…

Two things strike me.

One, this jointed management style, with Trusts making recommendations which are at significant odds with the Minister’s intentions if not express instructions is a recipe for disaster. It’s not the only department playing this game. The focus on area plans in Education has the same potential for unravelling.

Two, parties in a mandatory coalition have no time out from management of the coalition (never mind managing their own departments) to give knotty problems like this sufficient investment in time and/or ideas to make such reforms work. Avoiding risk by pressing responsibility further down food the chain is no guarantee you won’t get caught short.