Bríd Smith (Dublin South Central, People Before Profit Alliance) | Oireachtas source

I thank all the witnesses for attending. I firmly believe the key issue, if not the cause, of the policy that worsened the impact of Covid-19 in nursing homes was the decision taken in the 1990s to contract out the care of elderly people to private, for-profit nursing homes. Some of the points made by the expert panel and in other reports support that view. The fact is that we have 80% of all beds in the private sector where there are long hours of work, precarious employment and low pay, as well as a skills shortage and a push to cut costs. That is the reason we saw the restrictions and lack of early use of PPE among other issues. That, combined with a failure of medical care and clinical governance, worsened the impact of Covid on the nursing home sector. I believe that this, as well as other issues that arose during the crisis, such as the lack of testing and other factors, laid the basis for the disaster.

I have a few questions which I want to ask together. Perhaps the witnesses will take note of the following four questions. Could they comment on the call by relatives and loved ones of those who lost their lives in the nursing home sector, as well as advocacy groups, for a full public inquiry into the deaths in nursing homes? Many of us feel that while the report from the expert panel is welcome it is not what is needed.

I seek assurances that all staff in nursing homes have access to a functioning sick pay scheme so that we do not have concerns that employees who are sick may feel compelled to continue to work if they are unwell. Could the witnesses also indicate, if they know, whether the use of agency staff is still as widespread as it was and whether agencies in general are being used widely in the nursing home sector?

My third question is an important one and is probably for Mr. Walsh. Who was it that changed the regulation referred to on page 96, in chapter 7, of the expert panel's report, which specifically meant that it was no longer a requirement for the person in charge on site in a nursing home to be a qualified registered nurse or gerontologist? What was the purpose of that change and what were the consequences when it came to the pandemic and elderly care?

Will the witnesses comment on the view expressed recently by Ms Phil Ní Sheaghdha of the INMO that we do not need an audit of the staffing ratios in the sector? We already know that the staffing problems are bad and we know how to address them. Specifically, how would it help to have a regulated and mandatory staffing ratio and skill set, as well as sector-wide pay and conditions applicable across all nursing homes and elderly care centres? There are four questions there and I am spouting them out together because otherwise I might run out of time.