Seán Ryan (Dublin North, Labour)

The delay in the publication of Professor Des O'Neill's report into the number of deaths at Leas Cross nursing home is unacceptable. Relatives of those who died in Leas Cross are entitled to see for themselves the full findings of the report. We know the report was concluded as far back as April of this year and there is simply no excuse for further delaying its publication. For the Minister for Health and Children, Deputy Harney, to state the HSE should resolve its difficulties with Professor O'Neill is not good enough. She is the Minister and has direct responsibility to ensure nursing homes are safe and well run.

The sections of the report quoted on "Six One News" last Thursday certainly vindicate the content of the "Prime Time" programme of last year. They confirm that there were very serious problems in Leas Cross. We also know from a number of HSE reports and from replies to parliamentary questions to the Minister for Health and Children that serious problems and discrepancies were by no means confined to Leas Cross. This has been brought to the attention of various Ministers over the years. These discrepancies pertain to hygiene problems, staff levels, the maintenance of accommodation, poor record-keeping and the lack of equipment appropriate to clinical practices.

I could elaborate further in this regard but what is of real concern to me is that so little has been done to deal with these problems since they were first raised in this House. For example, on the day following the "Prime Time" programme of last year the Taoiseach assured the Dáil that legislation to provide for the establishment of a nursing home inspectorate would be enacted before the end of the year. Commitments were made as far back as 2002 but we are now talking about 2007. How serious is the Department about bringing forward legislation to provide for the inspectorate, which inspectorate would have improved the conditions in which people were cared for at Leas Cross?

This is no way to treat older people who rely on care in nursing homes or other institutions when they can no longer be cared for at home. The only way to ensure the highest standards are in place and are being implemented is through the establishment of a statutory inspectorate with strong enforcement powers. The present arrangement, whereby the HSE is inspecting itself, has proved to be ineffective and not in the interest of the patients.

I have a brochure from the Leas Cross nursing home which dates from 2004. One would think it was a brochure for a four or five star hotel. It outlines the rates and the medical services provided and it refers to a 24-hour doctor service and to 24 beds which were ring-fenced for residents of St. Ita's Hospital, Portrane. I refer to this in the context of a case raised by a constituent of mine. The constituent stated her 91-year-old uncle was a resident in Leas Cross from December 2002 until his death in July 2004. She visited him three to seven days per week to look after him and acknowledged the changes that were taking place during the period in question. She wrote to the Northern Area Health Board and subsequently to Professor O'Neill about the matter. She referred to the lack of care, her uncle's fears in respect of another resident, his being knocked down on the ground and the fact that, after suffering from a broken hip, he was left in bed in pain and was not seen by a doctor until 3.50 p.m. three days later. She outlined the delay in securing an X-ray. A doctor in Beaumont Hospital stated her uncle was suffering from malnutrition. These are the facts. This lady and the relatives of the 103 residents who died at Leas Cross are entitled to see the report as quickly as possible. It is up to the Government and the HSE to deal with this matter.

The Northern Area Health Board, in its letter, acknowledged that the nursing home accepted that there had been a breakdown in procedure in respect of the care of the man in question and that it was committed to improving its protocols and procedures to ensure patients would be dealt with in a timely and appropriate manner. This was ongoing. People were making complaints to the health board at the time in question. The health board also confirmed that the nursing home had prepared a new policy to ensure that difficulties experienced by the man in question would not arise again. The health board's letter concluded that its team would continue to monitor the measure put in place by the management at Leas Cross. It is clear that, well before the "Prime Time" special, relatives and friends of residents in Leas Cross had concerns, which they brought to the attention of the health board at the time. The HSE must be brought to account, since it has questions to answer. That legislation on an independent inspectorate has not been prioritised reflects the Government's lack of concern for one of society's most vulnerable groups, those no longer able to continue living in their own homes owing to age and infirmity. The failures in the nursing home sector are well known. What else must come to light for the Government to take action? That it knows of the problem but is failing to do anything about it shows a lack of priority. The current inspection process is unsatisfactory, but at least it provides some information about nursing homes.

In previous debates, I stated there was absolutely no reason for inspection reports not to be routinely made available on the Internet. Some progress has been made on that in recent weeks, but the information provided is totally inadequate in detail and substance. The current social services inspectorate has been operating on a non-statutory basis for ten years. We need legislation to put it on a statutory footing and the health and equality laws to ensure proper quality standards in all nursing homes, private and public. Nothing less is acceptable.

The motion before us calls for the publication of Professor O'Neill's report and the establishment of an independent inspectorate. I have listened to the various contributions, and no one in the House could disagree with that. It is therefore disgraceful that the Minister and the Government should decide to table an amendment. The people need the right services available for their elderly relatives and friends. Part of the problem in moving forward is publication of this report. Let us publish it and allow the Minister to introduce the statutory inspectorate for which we have been calling and regarding which the public has been given commitments for the last four or five years. Let us see action in that regard for the sake of the elderly.

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