Tom Hayes (Tipperary South, Fine Gael)

I am very pleased at the opportunity to speak on this Bill. It has been spoken of for a long time and was slow in coming before the House, but it is here now to deal with illegal nursing home charges. It shows that the State is willing to take responsibility for its actions and make amends for what it has done.

As public representatives, we all deal with the needs and concerns of elderly people daily. We are increasingly concerned about their vulnerability as a group in modern society. Care of the elderly is an issue that often seems to come bottom of any list of priorities. That the present Bill has been necessary shows real concern at the potential exploitation of the elderly, internationally and otherwise.

The elderly are very vulnerable for several reasons. One area in which vulnerability manifests itself is older people's capacity to achieve the type of care and accommodation that they want and need to see out their lives. Often the elderly find that they are not listened to nor are their views treated with respect. The dominant factors determining where and how they live become "convenience" and "cost-effectiveness".

The 2004 annual report of the Ombudsman pointed to a range of discriminatory practices that elderly people in Ireland must endure daily. The discrimination identified by the Ombudsman extended beyond goods and services and related to a general attitude that the elderly are a burden. The report of the Ombudsman stated:

Above all they worry about the increasing tendency in society to view them as redundant and wasteful of resources...One of the most distressing aspects of the A and E crisis, as noted by those who witnessed it, was the fact that those who suffered most were often the elderly, frequently robbed of their dignity as hard pressed and otherwise caring staff nonetheless were forced to carry out certain tests and interventions in public areas of the hospital.

Discrimination in the provision of goods and services on grounds of age is illegal under the Equal Status Act 2000, but we must ensure that the law is upheld in this context and that elderly people are aware that they are legally entitled to equality and have avenues to seek redress if their rights are violated.

It is a strange way for a country to treat its citizens given that we all aspire to reaching old age. By 2011, it is estimated that people aged 65 and over will represent 14% of the population compared with 12% now. By 2050, that percentage will have risen to 24%. Discrimination on age grounds is not the only obstacle constantly faced by Ireland's elderly population. As many Oireachtas Members who deal with elderly people regularly will say, elderly people are often fearful of what the future holds.

My colleague, Deputy Healy, referred to south Tipperary. Many constituents have come to us expressing concern about the future of St. Patrick's Hospital in Cashel. I acknowledge the work of the Tánaiste in bringing to fruition a huge hospital plan for the constituency of south Tipperary which involves Our Lady's Hospital and the now South Tipperary General Hospital. However, there is a real fear among staff, workers and the community at large about the future of St. Patrick's Hospital. It is an old hospital with a great history of looking after the elderly. It is hugely respected because of its work down through the years when people were poor and could not afford to be looked after in their own homes or communities. St. Patrick's Hospital took up that challenge. The pride among the workforce of that hospital in the way it looked after the elderly people in our constituency is recognised by anybody associated with the health service.

The downsizing of the hospital would have a detrimental effect on our community. I urge the Minister of State to bring to the attention of the officials of the Department and anybody else concerned with this issue that the people of South Tipperary need not only the continuation of the hospital but its development. There are few hospitals here that have the record of this small hospital in looking after people. It is a flagship and could be held up as an example in any debate on hospitals and looking after the elderly. I urge the departmental officials, the Minister of State and the Tánaiste to take cognisance of what I have said and to highlight the need for this hospital for the people in my constituency.

If an elderly person wishes to remain in his or her home, the State must endeavour to facilitate this. A key plank of such an approach would be giving proper value to the important role carers play in our society. In this context, a more flexible approach to the habitual residency clause is needed. I know of one person in South Tipperary who left her job and family in America, came home to look after her elderly mother and was refused the carer's allowance. I have written to the Department and have fought this case. I am extremely disappointed that this woman who left her family and returned here did not get the carer's allowance. The State is now paying a large amount of money to support her mother simply because we could not change the rules in regard to this individual. It is quite unfair and draconian to do this to do somebody while she cared for her mother. I appeal to the Government to consider these people who are quite willing to look after their folks in their homes but because they have lived and have property in another country, they are not looked after.

The need to promote the highest standard of professionalism in our hospitals is crucial. Care of the elderly is a specialised area and nursing homes need to be staffed by health care professionals with a knowledge of geriatric health. As many nursing staff as possible should possess a diploma in geriatric nursing. The Health Service Executive needs to inform nursing homes of nursing seminars, up-skilling programmes, etc. These events are taking place but nursing homes are not being adequately notified. That is a very important point. Nursing home proprietors should have incentives for nursing staff to be up-skilled. Non-nursing staff of nursing homes need skills also and these opportunities should be made available to them.

Staffing ratios in nursing homes also need attention. Last year the INO repeated its call for a review of staffing levels and conditions of accommodation for older people in public nursing homes and cited some shocking ratios. It is important staffing ratios are determined by the Health Service Executive. Other important areas to be considered in respect of nursing home regulations include the need to give priority to social interaction, nutrition and hygiene, especially dehydration as an older person can become dehydrated in a short period.

There are many wonderful nursing homes here and it is unfair that some horror stories can taint the whole sector. The best way to preserve the integrity of the nursing home sector is to ensure the conditions under which a nursing home receives its licence are rigorously enforced. There is a case to be made for creating a new monitoring body to deal with nursing homes, particularly new ones. The Government bears a crucial responsibility in respect of care of the elderly. I hope it takes its role seriously and that this Parliament does everything it can to uphold and value the rights of the elderly. I hope this Bill will go some way to address the wrong done to the elderly by the State over many years and that we will learn from our mistakes and ensure nothing similar to the illegal nursing home charges scandal happens again.

The housing aid for the elderly scheme has provided great assistance to many elderly people over the years. Costs have risen dramatically, including oil and energy costs. There is a great need for people to have their homes insulated, particularly the older homes. In next year's budget a massive increase should be given to the housing aid for the elderly scheme. It is crucial and has played a vital role in the quality of life for many people. I urge whatever Department is responsible to take that on board because it is a hugely important scheme providing great benefit to many people.

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