Fergus O'Dowd (Louth, Fine Gael)

Not one of the two Ministers of State from the Department of Health and Children addressed the key issue of Leas Cross and Professor O'Neill's report on it. Their speeches were the reiteration of recycled words which mean nothing. The truth is that until legislation covering nursing homes, promised as long ago as 2001, is introduced, we will not be able to provide our elderly people in nursing homes with the protection they need. All the waffle from the Ministers of State does not address the key issue. There were no words of condemnation from the Government on what happened at Leas Cross. There were no words of concern about the deaths at Leas Cross. There was no concern that on average people in other nursing homes lived up to 44 months after entering while in Leas Cross the average was seven months. The Government is inept and it does not care. It has been in power too long. It has failed to implement the changes it promised and it does not have the guts to take on the bureaucrats who are trying to hide this report and prevent it from coming into the public domain.

I understand there are precedents for bringing into this House reports that may allegedly cause problems. Deputy Paul McGrath reminded me of the report into the Dublin and Monaghan bombings, which was published through a committee of the House. Other examples include the Kelly Fitzgerald report and the Ferns Report. The Leas Cross report is about people who died, many of whom were moved to this facility from the care of the State in St. Ita's Hospital. Others were moved to Bedford House. Their deaths are a grave concern to everybody involved.

Professor Des O'Neill has described the report as a damning indictment of the system and of the Health Service Executive. The Government has failed miserably and utterly in discharging its statutory duty of care and protection to these most vulnerable people. This country consists of two Irelands. One of these is the wealthy Ireland comprising the business people who can support the Taoiseach by giving him money and the developers and politicians who appear at tribunals. The other Ireland, the hidden, dark side of our country, is seen in the many selfish people who are concerned only with looking after themselves and in the lack of care and respect for elderly people. This is not to say that many good people who work hard do not place family members in the care of nursing homes.

Professor O'Neill's report identifies the issues clearly and accurately both in terms of administration and in regard to the absolute system failure in the Health Service Executive northern area. The truth contained in this report is crying out for recognition because it is the voice of the people who have suffered. It is what we must listen to and know. It is what is being hidden, what the Government does not intend to publish because it lacks the will, courage and interest. The reality is it could not care less. Thankfully, this report will see the light of day because we have an Information Commissioner who put pressure on the system and the Government, even though that Government changed the law to make it more difficult for the truth to emerge. The truth will out and the longer the Government continues in office the more negligent it will be because it still has not produced the necessary legislation.

Our motion refers to the failure of the Government and the broken promises of the Taoiseach and the Minister for Health and Children to introduce legislation in this area. In a debate in 2001, the then Minister of State promised such legislation but nothing has been done. Concerns were expressed in the Dáil by Deputy Kenny early in 2005. Of particular concern was the case of Mr. Peter McKenna who was admitted to St. Michael's House against the wishes of his family. How could this happen? Why was no way found to meet the needs of this family who felt so strongly that their relative should not be put in this home? Where was the energy and drive to question and address the situation in Leas Cross? Where is the effort to protect and support such people?

We know from a recent episode of "Prime Time" that the family of Peter McKenna has had little satisfaction from the HSE. The Minister, Deputy Harney, met family members and offered her support. Will she now take the necessary steps to ensure they get comprehensive answers from the HSE and St. Michael's House? Will the Minister take responsibility and appoint a third party to assist them in their efforts?

I have files of information that leave me in no doubt there are other nursing homes in which the same problems exist as those in Leas Cross. It is strange, however, that when I wrote to the Department of Health and Children some years ago on this issue, it seemed to have no files. On 31 May 2001, when I was a Member of the Seanad, the then South Western Health Board wrote to me in reply to a request for information under the Freedom of Information Act in relation to copies of nursing home inspections where significant breaches of the regulations were noted. Some 12 nursing homes are mentioned in this letter but I will refer to only four of them, Bedford House, Fairways, Rostrevor and Rathfarnham. Almost five years later, three of those remain open and still represent cause for concern.

I called for an investigation into Bedford House in this House some time ago. It was giving rise to concern at that time and the situation remains the same. I am in possession of a file on the facility, which runs up to 2005, and it is clear no changes have been made to address these concerns. The law requires every nursing home to have a matron or other similarly qualified person in charge who must work full time in that home. However, the matron at Bedford House was, at the same time, also in charge of another nursing home in Castlebellingham in a different health board area. How did this happen? How can the Minister of State stand over his speeches today when he has failed to investigate such basic issues, which the health board identified five years ago?

When I received the file on the Fairways nursing home, which I have in my possession, it was closed. I examined some coroner's reports relating to deaths that took place there, which I have in my office and will be glad to give to the Minister of State. Before that nursing home closed it was bought by a couple who put a Montessori teacher in charge of the residents. The home was run for some months by that person who had no medical qualifications. A report on one death indicated that the health board insisted on the appointment of a matron and a suitable person was eventually appointed. The Department's inquiry must include an investigation of this issue. The coroner's reports also showed that files on all the patients in this nursing home were destroyed. These events took place under the Minister of State's watch.

The Minister of State's promises are seen to be absolutely hollow when one considers the case of Rostrevor nursing home. The then health board went to the High Court to close this home because of its deep concern for the quality of care it provided. The court said the board did not have the power in law to seek its closure through the court. The judge's decision was that the law was not strong enough to offer that type of protection. The health board had to return to the District Court and approximately one year after the initiation of the prosecution, it secured a fine of €8,000 against the nursing home. I am not sure how long the Minister of State has been in office but the law was shown by the High Court, more than a year ago, as inadequate to allow the State to close down a nursing home that was acknowledged as appalling and unacceptable.

Rathfarnham nursing home was another facility that was significantly breaching the regulations in 2001. Last year, a medical doctor who inspected the home wrote to the health board that he could no longer stand over the continued operation of the home because of the quality of care within it. This is the home where two patients were buried without death certificates. A successful prosecution was brought against it for breaches of the Food Hygiene Act. This facility must be investigated with the same level of forensic analysis as Professor O'Neill used in examining Leas Cross.

The message for the Minister of State and the Government is that there has been a consistent systems failure for some years, both legally and practically. The law does not allow the Minster of State at the Department of Health and Children to close a bad nursing home. There are many nursing homes similar to Leas Cross. I have a list of nursing homes where time and again the inspector recommended a nursing home be closed and requested legal advice. This recommendation and request is repeated year after year. These homes happen to be in the Kildare area. I do not mean to imply anything by this because I do not know their names.

There was a case in Kildare of a nursing home with no food. The same occurred in Kilkenny — not a packet of cornflakes, a bowl of porridge nor a pint of milk. This is what is going on. I only know all this because I used the Freedom of Information Act.

The Government knows what is going on because it changed the law. It changed regulations to make it more difficult for people like me to get information on nursing homes. The Government is hiding behind bureaucracy, failing in its duty of care and failing to provide transparency and openness. On moral issues of care and concern, looking after those most vulnerable, it has utterly failed.

One can study any county and find the same failures. This is not to say that there are no excellent nursing homes. We should support those homes and put them up in lights. People should see inspectors' reports on the Internet which will indicate which homes offer the best quality care.

There are many fine nursing homes. There is one in my county of Louth. Every year they invite the whole community to come in, and they have families visiting and a band playing. They encourage intellectual activities and provide physiotherapy. Nowadays many nursing homes are full of people staring into space owing to a lack of stimulation. Such homes lack services. People are left to rot and die in many cases because the effort is not expended to provide services like plant therapy, gardening and pet therapy. How many old people would find a pet a comfort? We are failing in our duty of care. We are utterly, totally and abysmally failing.

The message is clear: "Prime Time", RTE, The Sunday Independent, The Irish Times, the Irish Independent and the Irish Examiner take up these issues when they can, provided we are not in a crisis, like tonight, over other issues. The focus is once again on the quality of care provided to the elderly and the lack of action, care and concern from this Government.

I recently received a complaint about another nursing home. It was a sad case because the lady involved, who had suffered a stroke, was forced from her bed to have a shower. She was brought down to have a meal while very upset and, unfortunately, passed away. The staff were told not to mention the incident to anyone.

There are people in distress in many nursing homes as we speak. I know of another home where a patient was visited by a nurse. The nurse noticed that his leg looked bad, it was going black and gangrenous. She recommended he be taken immediately to a hospital. His leg was amputated and he would have died if he had merely stayed in the home.

Questions hang over the medical profession — not whether they are failing to do their best, but what criteria are in place. What standards do the Irish Medical Organisation and other professional bodies apply regarding checklists for doctors working in nursing homes? There is an issue that arises often relating to drugs not being signed off by a doctor. Often the doctor lives some distance from the nursing home and a repeat prescription is provided, but the patient is not always medically examined.

There are issues relating to the role of nurses. Medical professionals are excellent in most cases but not all. I would like to hear from those working in the homes mentioned, those who have not done their jobs. The extension of this law requiring greater transparency on nursing homes is a good thing.

Inspection reports are published on the Health Service Executive website. I will not name the homes involved, there are not many of them, but I am pleased that the practice has commenced. There were 27 patients in one of the homes mentioned. The first sentence states the inspector agrees the number of residents can be increased to 29. That sounds fine until one reads further on. It is stated that there are not enough staff on duty in the home and more trained personnel are required, especially at night. This is contradictory. How can a nursing home increase its number of patients while those patients are not receiving the quality of care they require?

I have grave concerns because I do not see any quality control. Other reports are a complete whitewash. Homes with 100 beds, similar to Leas Cross, are covered in a single page stating it meets most, not all, the legislative requirements. That is not a satisfactory inspection report, especially if it is not signed. There is not enough detail. I acknowledge that things are changing slowly but we need much more action.

The issues have not changed in five years. This Government has neglected its duty of care to the elderly and has not addressed the issue tonight. Government speakers have mentioned neither Leas Cross nor Professor Des O'Neill. This Government is offering only silence, stonewalling and secrecy on the issue of nursing home care and care of the elderly.

The report by Professor Des O'Neill is in the hands of the HSE at the moment. One of the people in charge of examining that report is named in it. I do not think that person should be involved in deciding whether the report should be released, however tangentially he or she is mentioned. This must be addressed immediately because it is unacceptable.

The public will not allow this Government's failure to continue. Unless this legislation is brought in immediately, vulnerable people in nursing homes throughout the country will go without protection. Many cannot speak for themselves, many suffer from Alzheimer's disease and many have no relatives visiting them. The change must come.

I acknowledge that a Bill is coming before this House next week offering voting rights to prisoners and I have no problem with that. However, I have a problem with the fact that this legislation on nursing homes does not predate that Bill. It is far more important to give priority to proper care for the elderly than to voting rights to prisoners, although I do not have a problem with the latter.

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