Liam Twomey (Wexford, Fine Gael)

This is a very important debate which does not arise solely from the "Prime Time Investigates" programme last night. This is an ongoing issue that has created considerable concern for a number of people for the last number of years. Much of what has occurred in this area and much of the lack of concern about what is happening here has occurred in the life span of this Government. This is why we expect the Government to give clear answers about why it has failed so badly to look after older people.

Only 5% of the elderly population will end up living in nursing homes so it is vital there are regulations and legislation in place to protect this very vulnerable group from abuse of the kind reported on "Prime Time Investigates".

The Government has done very little to combat elder abuse in nursing homes. The National Council on Ageing and Older People submitted a report on elder abuse to the Government in 1998. A working group was set up which did not report back to the Government until November 2002. The former Minister of State at the Department of Health and Children, Deputy Callely, this self-styled champion of the elderly, said on publication of the report that:

up to recent times, there was a feeling that elderly abuse didn't exist in this country but I can assure you that, as a politician who keeps in very close contact with his constituents, I was aware that there was a problem out there, the extent and nature of which needed to be identified. I will be immediately seeking to have this report formally accepted by Government and I am determined to press ahead with its implementation, starting the year 2003.

Nothing has been done in that length of time. The former Minister of State was merely following in the footsteps of his colleagues in Government because it is not just since 1998 that this Government has chosen to ignore this issue.

One very important aspect of this issue is the Government's commitment to the social services inspectorate, an independent group that can inspect nursing homes. This differs from the current arrangement whereby owners of nursing homes are given prior notice of inspections with very little follow up. What we are discussing has arisen from this regime. The Government gave a commitment to establish the social services inspectorate in the national health strategy, in An Agreed Programme for Government in June 2002 and Sustaining Progress between 2003 and 2005. Yet nothing has been done to protect extremely vulnerable patients in nursing homes. That is the basis of this debate.

What happens when a nursing home is inspected? It is quite clear that there are limited guidelines about what a nursing home inspector can do and a lack of uniformity around the country in the reinforcements of these same standards of care. Tonight's debate revolves around private nursing homes. I will let other speakers focus more on private nursing homes. Only a small percentage of private nursing homes provide poor standards of care for their residents. The vast majority of nursing homes, both private and public, show great respect in their care of the elderly. However, we have let down a small minority of patients, who in some respects are being tortured in nursing homes, by having very unclear regulations.

Does the Minister of State know how many public institutions across the country house their residents on the third, fourth and top floors of buildings? Many of these patients are bedridden or immobile and would not be able to escape if a fire broke out. We have witnessed such tragedies in other countries. Patients are still being tied to chairs. I am sure the Minister of State is aware of Buxton chairs. Patients are put into these chairs, are tilted backwards and are left in them all day so they cannot be a nuisance to staff. There are many other issues about which the Minister of State has done nothing. It is a disgrace and I hope the other speakers will highlight these issues.

During the deliberations on the Travers report, civil servants were brought in to explain what went wrong with the illegal nursing home charges. An issue that was raised at that time was that despite an amendment made to the Health (Nursing Homes) Act 1990 in 2001 which gave the Minister power to make regulations governing standards requiring convalescent homes to have adequate medical, nursing and paramedical staff and facilities consistent with their patient profiles, no new regulations governing standards of care in nursing homes have been introduced since 1993. We have had reports, commitments, promises about legislation and the introduction of amendments, but nothing has been done.

I am sure members of the Government would like to see if there is anything positive they can talk about with regards to this issue. The only positive thing they can focus on is that the Government has committed approximately €2.5 million to fighting elder abuse in the last three years. However, this figure has been committed right across the community services and hospital services sectors. On the basis of these recommendations, the Government promised to spend €13.5 million but spent only €2.5 million on elder abuse. There has been total and utter neglect in the care of the elderly and this, especially the abuse of elderly patients, is a disgrace on the Government. We are discussing a small minority of private nursing homes that have been allowed to get away with this. In some respects, they have been allowed to get away with murder.

Earlier today on Leaders' Questions we discussed the case of a very elderly lady who was admitted to hospital. The medical registrar at the hospital said the lady had massive necrotic ulcers in her buttocks, was dehydrated and had sepsis, in other words blood poisoning from infected wounds as a result of being totally neglected in a nursing home. It was the same former Minister of State at the Department of Health and Children, Deputy Callely, who sought to make representation on behalf of this patient. Luckily, this woman wound up in an acute hospital and survived the massive necrotic ulcers in her heels and buttocks. When the Minister of State, Deputy Callely, received the report did he say this must never again happen under his watch? He did exactly what he apparently did with illegal nursing home charges. He probably whispered it in somebody's ear and left it at that. This issue was far too serious.

We have neglected the care of the elderly, particularly elder abuse in many of our institutions. I am very interested in hearing what the Minister of State has to say about this issue. I do not think people could believe this type of abuse was occurring until they saw it on "Prime Time Investigates" last night. Those of us who have been involved in medical services know that all is not well.

I hope the Minister gives a clear commitment and not the type of commitment we have seen since 1998, with promises of reports, working groups and legislation that is basically useless. If we cannot close down these places, the least we can do is regulate them properly. Many of them were built on the basis of tax concessions for people who needed some place to put their money. They are not motivated to look after elderly patients but to cut their tax bill. Throughout the country we see what is going wrong. People who are not really interested are being put into this sector and this is the result.

Serious and enforceable regulations are the responsibility of the Government, and it cannot wriggle its way out of this issue. It tried to wriggle out of the illegal nursing home charges and is trying to wriggle out of this problem. It must introduce regulations and a care of the elderly policy for the future. It must stop stalling, as it is doing.

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