Fergus O'Dowd (Louth, Fine Gael)

It was sent on 31 May 2001, long before the Minister of State was appointed to office.

The fourth, eighth and ninth nursing homes on the list are Bedford House in Balbriggan, Rostrevor nursing home and Rathfarnham nursing home, respectively. In the 12 months since the Minister of State was appointed, the case against Rostrevor nursing home has concluded successfully with the courts imposing a fine of €8,000 on the home's operator. In the second case today's issue of The Irish Times features a report on the Rathfarnham nursing home. A letter dated 30 June 2005 from a doctor who was on an inspection team which visited the home states:

As a member of the inspection team of this nursing home in the past 12 months, the only possible outcome is the non registration of the above nursing home. My conscience would not allow me to consider any other alternative. As a medical doctor I stand over the reports I have already signed regarding this home's non registration. My medical integrity would be at issue were I to decide otherwise. I have no difficulty making myself available giving evidence as to the breaches I noted on my inspection visits in the district court should the proprietor appeal.

These remarks, made in June 2005 and after the Minister of State's appointment, relate to a nursing home which was regarded as a problem home in 2001. The Government's lack of interest and failure to take action on foot of promises it made in 2002 to change the nursing home regime have resulted in people suffering unduly in nursing homes. Many hundreds of such homes are excellent and have the highest possible standards but those to which I referred are not the only ones with appalling standards. The job of the Government is to protect the weak and elderly and it has singularly failed to do so. For example, it has failed to amend legislation to address the nursing homes which were mentioned in 2001, were still causing problems in 2005 and, to the best of my knowledge, continue to be a problem in 2006. The Government has shown a complete failure of intent and commitment.

How do we know some nursing homes are so bad? We find out through the Freedom of Information Act. Unfortunately the Health Service Executive is treating the Act as a barrier to getting information on nursing homes. Time and again one must submit an application and €15 to secure information. I asked the Health Service Executive, through a parliamentary question, to provide me with the number of successful convictions secured against nursing homes in the past ten years. The reply I received stated that I should seek the information under the Freedom of Information Act. The Health Service Executive is rapidly becoming the "Health Secrets Executive". There is no transparency or openness about the manner and means in which nursing home procedures are dealt with.

I was told by the Health Service Executive when I rang today that, despite the written promises I received from the Minister of the day last year following events at Leas Cross, which indicated that nursing home inspection reports would be placed on the HSE website as soon as they were available, one can search its site as much as one likes but one will not find transparency or information on any nursing home inspections that have taken place in the State since the Leas Cross case. This is another case of the Government failing to deliver its commitment to change and the Health Service Executive failing to provide true, honest and open information to Deputies who seek it. Members of the Oireachtas are the least of those who count. The people who count in this regard are patients in the nursing homes and their families who are being denied access to this information. The Minister of State, as I have shown, has failed in his job. Over the last few days I have met people who work in different nursing homes in my constituency in north County Dublin. The most significant legislative problem people face is that the Minister has failed to protect the whistle blower. I know nursing home carers and nurses who feel if they took their requests to the Health Service Executive they would not be protected and would lose their jobs. They have told me there are still appalling situations in nursing homes. One of them, which would concern us all, is that when people die in a nursing home they are not properly laid out and no respect is shown to the bodies before they are placed in a coffin. Another is where if residents are able to go to the toilet their bodies are not washed by the staff afterwards. In other cases clothes are recycled. People may have just one outfit and clothes in the nursing home are given to everybody. There is no compassion, concern or commitment to look after those people by the people who operate those nursing homes.

I repeat that the vast majority of nursing homes are excellent but those that are not are appalling hell-holes in which people are treated like animals. The Minister has taken no action to change that situation. The case of the Rosstrevor nursing home shows that unless the legislation is changed all the inspectors in the world will change nothing. The High Court found that the legislation the Minister promised to change almost a year ago, and which the Government promised to change four years ago, is not strong enough to close an appalling nursing home such as Rosstrevor. The Minister has the legislation to change the nearest chipper were mouse droppings found in it. What about the elderly who are being abused in some of these nursing homes? The Minister offers them no protection. This Government has failed to protect those people, a shameful situation which must change.

The law requires that within two months of a person's admission to a nursing home a contract of care be signed by the nursing home and the patient. Thus the needs of the person and the provisions of the nursing home are written down and signed off by everybody concerned. However, the Health Service Executive has no contracts of care with patients in private nursing homes. In many cases it is hard to escape the view that people are dumped there and that nobody cares about them, least of all the health board that placed them there. That is a shameful situation and one about which the Minister could command knowledge. The least he could have done when he got his job was to call in the nursing home inspector and ask to see what is happening in his constituency. I have facts on bad nursing homes in the Minister's constituency and would be glad to give them to him. They are not good, but he has done nothing about it.

I challenge the medical profession to come clean with the knowledge it has. I refer to members of the medical profession who are registered owners of nursing homes. I ask that Bedford House and its operation over the past few years be examined by the media. There is an important issue there. If somebody who has a special oath and commitment to the medical profession runs a nursing home, it should be the best place.

The fundamental issue is transparency and openness. I do not know who wrote the Minister's script. The work I have done tells me that throughout the country, in each former health board region there have been thousands of breaches of the regulations — many minor, some not so minor and many of them major. This has been the position over the last few years it continues. There has been no change in the law and that is where the Minister has failed. Time and again the nursing home inspectorate suggests things should change and then says it is seeking legal advice. Year after year the legal action fails to happen and the problems continue.

I have done much work on this and all my spare time goes into it. The Minister's job is to spend all his time at this work and if I were marking his card I would give him zero because while there are many changes he could have made he has done nothing. I challenge the Minister to bring in the legislation he promised, to protect the elderly, the weak, the sick, the infirm, the sufferers of dementia and the psychiatric patients put into nursing homes. The Minister has a duty of care to them. If they were children people would be screaming outside the House demanding change and the Minister would have acted. Perhaps because they are old people they may not be as valued or as emotive an issue. Old people are valued and important in our community and we must show them great respect and honour. What happens to people in the worst of our nursing homes, and what we do to address it, will be a judgment on all of us and on the integrity of our health service. The Minister has failed in his statutory duty and should resign.

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