Seymour Crawford (Cavan-Monaghan, Fine Gael)

I thank my colleague for sharing his time with me on this important issue. The Leas Cross scandal and similar issues cannot be swept under the carpet. It is vital that the report into that scandal should be made available. Were it not for people such as Deputy O'Dowd and Deputy Twomey and our party leader, Deputy Kenny, this issue might never have come to the surface and information on the terrible conditions in that home might not have been revealed. I congratulate those in the media who were prepared to expose this issue.

The main issue with which I want to deal is how provision will be made for the needs of the elderly in the future. I am very fortunate, as is the Ceann Comhairle, that in County Monaghan we have facilities such as St. Mary's Hospital, which is owned by the Health Service Executive and, fortunately, it is not under the same management as some other institutions in County Monaghan. St. Mary's Hospital is excellently run, as is the Sacred Heart Home for the Elderly in Clones, the nursing home in Ballybay and most of the other private nursing homes in the area.

Elderly people and people with disabilities are important members of society and we cannot allow them to be treated other than in a proper manner. A proper nursing home inspection system must be put in place. At a meeting yesterday we discussed EU inspections of products imported into this country and were told that the next inspection would take place on a date next January in order that everybody would know when an inspection of Brazilian beef would take place. The only way in which nursing homes can be properly inspected is for inspectors to be able to visit them at any time, day or night, to ensure a proper service is being provided for the patients. Nothing less will suffice.

It is vital that such an inspection service is put in place to ensure that the necessary service is available to patients at all times in all nursing homes. Whether patients are in public nursing homes or in private nursing homes, as are the majority, it is vital, given the amount of money being spent and allocated to these institutions, that the best service possible is available. Care must be taken to ensure that fire safety measures, including fire drill, are up to standard, as is required in other private businesses. We must also ensure that pest control measures, a refuse service and all such services are adequate.

I wish to deal with the issue of the facility to make complaints. I was contacted by a family member recently who advised me that if the family made the slightest complaint to the nursing home in question, they found they were no longer on speaking terms with the staff and the family were asked not to cause any further annoyance. This family were paying for their loved one to be cared for in that nursing home. There must be a clear line of communication and assistance between those in charge of administrating subvention payments and such matters and the patients and their family members. If a personality clash arises between a patient and nursing home staff, the patient should have an option to move to another nursing home.

In the case I dealt with, the nursing home concerned was glad when a difficult position was dealt with and the person concerned is now happy being cared for in another nursing home. Such personality clashes can arise. A proper structure must be in place in nursing homes whereby people can feel free to make a realistic complaint and be confident it will be dealt with.

The administration of drugs and medicines must be clearly defined. Most nursing homes deal with this matter very well but it must be properly organised. Patients must have the right to refuse treatment or, in consultation with relatives acting on their behalf, to seek the best advice on proposed treatment.

Nursing home staff should also discuss with residents their dietary needs, including the variety and types of food they require, as food is an important consideration. I know of a person who went into a nursing home four and half a years ago and people thought she would not be still there in a few weeks' time or at most a few months' time, but with good care she is still there and living a reasonably active life. It is important for such residents to have the variety of food they require and their dietary needs are cared for in a reasonable way.

I wish to deal with nursing home subventions. There are various problems in this area in the north-east region, one being the lack of funds. In the early 1990s, a number of patients in the area were provided for across the Border, as that opportunity was presented, and as a result we seem to have a low quota.

A case involving a 90 plus year old patient who applied for subvention payment was brought to my attention recently. This lady lives in an ordinary cottage which she does not own. She was refused subvention because she said she did not have any money or accounts and those administrating the scheme did not believe her and sent her back her file. This lady lives on her own. She has had to pay taxi fares to go to her doctor and has incurred other expenses. It is not difficult to understand how she has no money. Fortunately, for the time being she has been able to go back home and is being looked after by her loved ones.

This type of attitude towards the elderly must be seriously examined and investigated. Sadly, this lady had no one to do a whip-round, she will have to stay at home until such time as some of us can negotiate on her behalf with the staff in the office administrating the scheme and argue that she has a valid case in that she does not have much resources and needs support.

The Government has been in office for nine and a half years and it is time such issues were dealt with. There is also the issue of the home help service. The Ceann Comhairle is aware of a case in his home town where a person has the services of a home help for two hours compared with having received the services of a home help for 12 hours when living in Donegal. There must be some degree of responsibility and realisation that people who need this service cannot live on fresh air. They need proper and substantial help if they are to be able to live at home and not in nursing homes.

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