Fergus O'Dowd (Louth, Fine Gael)

However well written and delivered Deputy Kelly's speech was, and I respect him very much as a person, the speech completely misses the point with regard to care of the elderly. The Government has failed miserably and shamefully in its policy on care of the elderly in our nursing homes. There is a great deal of information to back up this statement which has not yet been released to the public, and I have not got it yet. I am speaking of the investigation into 95 deaths of senior citizens in Leas Cross nursing home in recent years. That report currently sits somewhere in the HSE. I understand it has been completed and has gone for "legal advice".

I am concerned that this report may be buried, that other documents are being prepared, allegedly by the HSE, to give its side of the story, and that this report will not be released independently, as it ought to be. I call for the report to be released immediately once it has gone through the legal hoops. It will inform this debate, and if we see the report, the speeches given by Deputy Kelly and others on the Government side of the House may be entirely different in two weeks' time. Leas Cross is the scandal of which we are most publicly aware in this area, but it is not even on the list of bad nursing homes the HSE gave me in 2001. Seven nursing homes, the subject of the most appalling and disgraceful reports, remain open. Nothing has changed under this Government except that more people are being treated badly by it because it will not insist on, and has not yet brought to the House, legislation to change the nursing home regime and appoint a fully independent nursing home inspectorate which will vindicate the right of the elderly and sick to decent and proper care. They get that in a majority of nursing homes, but in a significant minority they do not and will not get that until the law is changed.

The High Court decided that the law was not strong enough, that there is not sufficient power in the existing nursing home legislation to force the urgent and immediate closure of a nursing home. Currently, we can only close nursing homes through a long process that can take years to put through the District Court — so much for this Government and so much for transparency. After the Leas Cross scandal last year the Government and the HSE stated that changes would take place and that all nursing home reports would be placed in the public domain as they became available. However, the first decision made by the HSE with regard to nursing homes was that any information sought about nursing homes must be made through a freedom of information request. Nothing can be brought into the public domain without being subject to the Freedom of Information Act.

I refer to the Information Commissioner's annual report for 2005. On page 22 she states:

In last year's Annual Report I suggested that the Health Service Executive (HSE) should, as a matter of course, publish its reports on inspections of private nursing homes. I recognised that information of this type was of very significant interest to the public. In making the suggestion I was mindful of the provision at section 38 of the FOI Act that the Information Commissioner "shall foster and encourage the publication by public bodies . . . of information of relevance or interest to the general public in relation to their activities and functions generally". I pointed out that such an approach would be in line with the practice in the case of inspections of children's services by the Social Services Inspectorate. [...] In an immediate response to my suggestion, the HSE announced its intention (i) to make all completed inspection reports of nursing homes available on request, subject to FOI legislation and (ii) for the future, "[f]ollowing review and standardisation of inspection report formats and consultation with key stakeholders", to publish all future inspection reports on the HSE website. [...] At the time of writing this Report (February 2006), it remains the case that nursing home inspection reports are not being published as a matter of course. Access to the reports is still dependent on making a successful FOI request.

The Information Commissioner then outlines how long this can take and continues:

The situation may be further complicated by the stated intention of the Minister for Health and Children that the regulation and inspection of residential services for children, older people and people with disabilities should become the responsibility of a new statutory office (Office of the Chief Inspector of Social Services). [...] I am concerned that, pending the enactment of the legislation and the establishment of the Office of the Chief Inspector of Social Services, a decision to publish nursing home inspection reports may be further delayed. I would urge the HSE, in recognition of the very significant interest of the public in these reports, to proceed as speedily as possible with the implementation of the commitment, given in June 2005, to publish all nursing home inspection reports as a matter of course.

Since then, one year ago, the HSE has provided no openness, transparency or accountability. Nothing has changed.

Let us examine the case of the report on the Woburn nursing home in Cork, the only HSE inquiry I could find. I received this as a result of a freedom of information request. It dates to February 1996 and deals with complaints made about the home and submissions made in favour of it. The inquiry team received 15 complaints but proceeded with only five. Some 14 favourable submissions were received and all were processed. Why were these submissions treated differently? The reason is that there is no whistleblowers charter and no protection for people who wish to make a complaint. On page 11 of the report there is an account of a meeting with Councillor O'Leary and Deputy Batt O'Keeffe, now a Minister of State and one of the people who brought this case to the attention of the relevant bodies. One person was represented by a solicitor who:

raised the issue of confidentiality from the perspective of people making submissions from the Inquiry Team and the consequences of such submissions for those persons. The Chairman indicated that anyone who wished to make a statement to the Team could do so, but that in the interests of natural justice, the person against whom any allegations or complaints were made would have to be furnished with a copy of such allegations or complaints and the identity of their authorship indicated to that person. The Chairman also stated that the Team was legally inhibited from offering any indemnity against the consequences of any submission made to it. Furthermore, if any person, in the course of making a submission to the Inquiry Team, implicated themselves in wrong-doing then it would be a matter for the Chief Executive Officer and/or the appropriate Professional Body to take whatever action was deemed necessary.

If one wishes to put a complaint against a nursing home on the record one is not protected by the Government. No legislation exists to protect whistleblowers. Where 15 complaints were made, only five were subsequently substantiated because of the fear of legal action. It is unacceptable that no protection is offered to those who wish to tell the truth about the appalling level of care in our institutions. Despite the fine words and money spent on care of the elderly, there is emptiness and hollowness at the heart of Government policy. People are still dying because they are not properly cared for but nobody in Government is committed to changing this. Government Members stand utterly condemned for the continuing lack of action, one year after these matters were brought to their attention.

Some 25,000 people reside in nursing homes and there are ten cases of nursing homes comparable to Leas Cross. I do not know the results of Professor O'Neill's inquiry but I am concerned about what it will reveal. I have evidence of appalling practices in nursing homes and we need an inquiry into these. The HSE is aware of these and I will be happy to provide further details. I refer to doctors and nurses working in nursing homes that are the subject of bad reports and serious concern at the HSE. It is time for these doctors and nurses to speak up, expose the practices and clarify their role in the examination of these patients even though whistleblowers legislation that would protect them has not been passed.

I have been informed that information on a nursing home in Cork, which I am pursuing through the Freedom of Information Act, has been refused to me. I must wait three or four months while the case is referred to the Information Commissioner. Will the Minister for Health and Children and the CEO of the HSE agree to publish reports and information as promised? The Information Commissioner stated that this must happen and was assured it would.

I commend the HSE for the investigation of one particular nursing home. This reveals that there was no nurse on duty for 21 nights in March 1995, no nurse on duty for 20 nights in April, 16 nights in May, 16 nights in June, 21 nights in July, 22 nights in August, 15 nights in October, and 16 nights in November. The Health Service Executive has had that information for ten years, and yet there has been no change. I understand that the home in question has since closed. However, throughout the country, in a minority of nursing homes, that situation is being replicated. The Government has done nothing to protect these people. I recently mentioned a nursing home in north County Dublin. I was informed by staff that patients did not have their own clothes, or if they did, they rarely got them back. They might be left wearing a garment for a week and they were not being properly fed. There are nursing homes in this country where inspectors found no food. That appalling and disgraceful situation must change.

There is not too much time left for the Government before it faces the people. I will ensure that all the information I have is put into the public domain so that the Tánaiste will have to answer clearly, openly and honestly. The fact is that they have done nothing, and that is unacceptable. The voice of the elderly is mute. We have excellent advocates for care of the elderly, but at the heart of Government policy is an appalling neglect of such people. I hope that this publication from Professor O'Neill, which may start a debate, will be released immediately so that it might inform us of the truth. The other homes, which I can indicate to the Tánaiste with no difficulty, should also be examined and investigated. That is the only way for us to achieve change.

The Government stands utterly condemned. Its words regarding the great things it is doing and all the money it is spending are hollow, since ultimately it is not looking after the elderly. They are dying before their time in appalling conditions in some nursing homes, and the Tánaiste has done nothing to change that. The Government and the HSE have known about it but have not acted to protect people.

See this speech in context