Seán Ryan (Dublin North, Labour)

The information was there long before that and has been well documented in the Department of Health and Children. In a letter dated 1 December 2004, the Tánaiste and Minister for Health and Children, Deputy Harney, in response to questions I submitted, acknowledged that a range of problems had been identified throughout the country by the existing, and totally inadequate, inspection system.

The Tánaiste said these problems included staffing levels and nursing policy issues, maintenance of accommodation standards, hygiene problems and a lack of activity for residents. Elderly people, who would prefer to be in their own homes but who were in nursing homes were taken out of bed at 8 a.m. and put sitting in chairs for the day. They had no activity during the day and were put back into bed at night.

Other problems included poor record keeping and insufficient or no active involvement by local authorities in fire safety matters. One can imagine that a nursing home could go up in flames leaving 100 people dead. Thankfully, it did not happen but it could have because there were major problems in that area.

In the same reply, the Tánaiste told me about a lack of equipment appropriate to clinical practice — for example, pressure mattresses. Pressure mattresses are the main requirement for dealing with bed-ridden patients suffering from bedsores. Anyone conversant with the needs of the elderly would be aware of that, but it seems that while everyone in the Department knew about it, they did sweet damn all about it.

According to the Tánaiste's reply, the problems included discrepancies in the contracts of care. I do not know what that means but, by God, it is another element of which the Department was well aware. Notwithstanding the information available about all the problems identified, nothing was done. Ministers told us repeatedly that the establishment of an independent inspectorate was in the pipeline, yet it was delayed for years.

One of the main functions of the social services inspectorate is to support child care services by promoting and ensuring the development of quality standards. However, although action for the elderly was promised for the past four years, responsibility for the elderly was placed on the long finger. If the Minister of State is really concerned about this matter, he should give the House a commitment to bring about improvements. Earlier, Deputy Rabbitte sought to ensure that the necessary legislation will be enacted before the summer recess. Deputy O'Dowd supported his request. We are prepared to wait until July, if necessary, to ensure that this important legislation is passed.

Independent inspections might well result in damning reports on standards in many of the State's public nursing homes, including nurse-patient ratios and the comfort of accommodation for older people. These facts may lie behind the State's reluctance to establish an independent inspectorate, but they must be faced.

Questions regarding the physical structure of nursing homes, as well as allegations of abuse and neglect, need to be addressed as a matter of urgency. Last night's special "Prime Time" investigation graphically highlighted these matters. The horror story of Leas Cross Nursing Home requires attention and action. We have had some comments from the Minister of State, but who will fund such action? Is the general public aware of the helpline to make complaints about nursing home care, and does the helpline operate across the country? I would like the Minister of State to respond to these points.

What we saw in yesterday's television programme was not just a case of elderly patients being stripped of their dignity — we saw a regime in operation that is putting the health and even the lives of vulnerable, elderly patients at risk. The Health Service Executive must take the necessary steps to rescue patients from these conditions, either by transferring them to other locations or by taking over the running of the home. I welcome the Minister of State's comments in that regard. For some time now there have been grave concerns regarding decisions taken by health boards, and now by the Health Service Executive, to privatise health care for people with intellectual and psychiatric disabilities. I refer specifically to decisions taken to discharge such residents from St. Ita's Hospital, Portrane, to Leas Cross nursing home and, pending transfers, to Blackrock, County Louth, and Stamullen, County Meath.

Mrs. Annie Ryan, who has been a great campaigner on behalf of people with disabilities, has put forward a range of queries which I now put to the Minister of State. What measures are in place to ensure the establishment of standards of care, the maintenance of these standards and their monitoring in private nursing homes? What arrangements are in place for the provision of advocacy for each resident who lacks capacity to make personal and health care decisions, or to manage property and affairs? In the event of failure to deliver the service in accordance with its contract with the HSE, what measures are or will be available to the Health Service Executive to protect this group of citizens who have hitherto been in the direct care of the State through the health authority?

The residents of St. Ita's were covered under the Mental Treatment Act 1945 and, as outlined in last night's television programme, they have been relocated to nursing homes where there is no independent inspectorate and where the conditions as outlined in the programme are appalling. That needs to be addressed. Many people are unhappy with the manner in which psychiatric patients and people with intellectual disability are being placed in nursing homes without proper care provided.

There has been no shortage of promises from the Government regarding the needs of the elderly, but turning these promises into reality has proved more difficult. The Minister of State said a good deal about the elder abuse prevention programme promised more than 12 months ago by the Minister of State who at that time had responsibility for services to older people, Deputy Callely. There are various types of abuse that older people have to endure and we know what they are.

The Health Service Executive has informed me that within the Limerick community care area, which was the responsibility of the Mid-Western Health Board — Deputies from the area should take note — a pilot project was initiated to investigate the issue of elder abuse and how it should be dealt with. In the short period of that pilot scheme, 98 cases were brought to the attention of the health board, with 79 being actively addressed. What happened? The pilot stage was completed in November 2003. To date, the Health Service Executive is awaiting approval from the Department of Health and Children to formalise the service through the appointment of the relevant personnel to re-establish this important service. This is a further example of the Department's lack of commitment to the elderly.

Actions speak louder than words, and we are looking for action, not promises made by the Minister of State and his predecessors, promises which were not delivered on.

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