Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

I support the motion tabled by the Fine Gael Deputies and I commend their initiative. The Government's amendment, quite simply, is not adequate. It rows back on the commitment given by both the Taoiseach and the Tánaiste last year in the wake of the Leas Cross nursing home scandal. Both the Taoiseach and Tánaiste clearly committed to an independent nursing homes inspectorate. There can be no question about that and people will recall one of the most revealing moments in the "Prime Time" documentary which exposed the disgraceful ill-treatment of elderly and vulnerable people in Leas Cross. One of the Leas Cross staff was secretly filmed after a visit to the home from the health board's inspector. She said: "They were just concerned with the paperwork".

The health board and later, the Health Service Executive inspectors, failed to protect these elderly people and that is the bottom line. I have no doubt that some improvements have been made in the inspectorate regime for nursing homes, but why did these elderly people have to suffer, and why did we have to wait until it was exposed in the media before action was taken? It is estimated that at least €500 million of public moneys has been ploughed into nursing homes since the tax reliefs were introduced in 1997. The owners of Leas Cross benefited from this tax break, but we have not been told by how much.

Sinn Féin believes this money should be spent, not on subsidising private facilities, but on public health and social services including nursing homes for the elderly and greatly improved care and support for them in their homes and in other community settings. Today the Dáil took the Report Stage of the National Economic and Social Development Office Bill. The National Economic and Social Forum comes into its remit and on Monday of this week it issued another very important report, which has not received the attention it deserves. I have no doubt the Minister of State has taken the time to consider it, but the report is entitled Care for Older People. Describing the barriers to the development of community services for the elderly, it refers to "perverse investment incentives". The present official funding of services is not consistent with the policy objective of encouraging community based responses, says the report. Considerable resources are invested in nursing home care responses, some of which are unnecessary and inappropriate.

This reinforces the point about the use of tax subsidies for private nursing homes. It is little wonder that the scandal of Leas Cross and other homes has occurred. The NESF report quotes from the report of the working party on services for the elderly, from 1988. That identified lack of co-ordination of services as a key concern. That lack of co-ordination, sadly, today remains largely as it was back in 1988.

The Government amendment refers to the social services inspectorate and speaks of extending its remit and recommendations. If that is the case, then it should extend them in line with the recommendations in this area in the NESF report. The remit of the social services inspectorate, it says, should be extended on a statutory basis to include all care settings for older people — residential, community, home-based, private, State-owned or whatever, with the necessary trained staff and financial resources.

It says inspection findings should be published, with sanctions for non-compliance with standards. The principles of autonomy and person-centredness should inform the development and implementation of standards. These should be clear, adequate and developed in consultation with users. Standards of care for older people and acute hospitals, says the NESF, should also be developed. It recommends the proactive development of higher standards to move care towards quality of life measures. It says standards need to be developed across all service levels, from front line service delivery, organisation of care, planning integration and strategic development.

Will the Minister of State say whether the NESF report will be left to gather dust, just like its predecessors on equality in hospital care and on social housing? I appeal to the Minister of State that this must not be allowed to happen. Older citizens and those in need of care within nursing home provision all deserve better.

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