Mr. Peter Tyndall:

The committee has seen my submitted opening remarks and I do not intend to read them out. If I may, with your permission, Chairman, I will make some remarks in summary. As Ombudsman, much of the work of my office has involved dealing with matters of institutionalisation and congregation, whether they were the consequences of the Magdalen laundries and the redress scheme, direct provision or, as in this case, the situation of younger people in nursing homes. Institutionalisation and congregation have been a theme throughout and it seems to me that they are ones on which we are seeing welcome progress but not necessarily haste. That is my first observation.

The second thing I wish to make very clear is that this report was not a criticism of nursing homes per se. What the report is about is people in nursing homes who do not want to be there and people under 65 in services that are quite clearly not designed for them. I pay tribute to the individuals who contributed to the report, the people living in the nursing homes. Sadly, as the Chairman noted, four of those people have died since the report was drafted, and there are others whom my office cannot contact. If anything, that again emphasises the need for urgency in addressing the issues that have been raised.

I welcome the commitment in the programme for Government, the commitment from the HSE and the commitment from the Department of Health to implement the recommendations of the report. We need first to act to stop further people being admitted against their will. While people are in nursing homes we need to make sure not only that they have access, as we have heard, to primary care but also that steps are taken to improve their quality of life while they await an opportunity to move to the community.

We need active measures to support people to move to the community. I welcome the initiative in the programme for Government but emphasise the importance of urgency.

We do not know the will and preference of these people because, sadly, the only record that we have been able to get is the number of people who receive the fair deal funding. We cannot be sure if the figure of 1,300 plus is an accurate number because we know that other people are in nursing homes funded by different means or may be funding their own time in nursing homes. There is a need to move forward with a database, as the Department has indicated, on a consistent basis to assess not just what people's requirements are but also what their will and preference is. We need to do that as a matter of urgency. That will then provide the basis for the action plan, which is to be set up by the HSE. We welcome its establishment. I have made clear that staff from my office will want to continue to be engaged with that action plan, as we have been in the implementation of other reports. For instance, we were successfully engaged on end of life care.

I am pleased that we have been able to highlight this issue. I am pleased with the positive response and the commitment to get things done. I will want to see that being done with urgency. There are people whose lives continue to not be the lives that you or I would want for ourselves and certainly not the lives that they envisaged for themselves. We have a duty and responsibility to address their needs.

The final thing I want to say relates to the work of an ombudsman. We have sought to give a voice to people who might otherwise be voiceless. We are not a voice for voiceless people. We are trying to let them be heard. That is important. Those who have had an opportunity might have seen the video on my website which accompanies the report, in which the voices of some of those who participated can be heard. There is nothing more powerful than listening to people describing their situations and the despair that they feel, as well as their legitimate aspirations for living a decent, proper, engaged life in their communities and how they do not have the opportunity to do so. I commend that video to members. Listening to people is what we do. The committee might want to reflect on whether the investigative approach taken by an ombudsman and staff to address complex issues of this kind, which involves sitting down and sharing a cup of tea with people, talking with them, listening to them and valuing what they have to say, might be an approach which is more widely used for the difficult issues that we face currently and with historical issues. I ask the committee to think on whether the way that we have been doing things, contrasted with how this report has been compiled, contains lessons for future examinations of complex current and historical issues.