Liam Twomey (Wexford, Fine Gael)

We want to stop that. We wish to see control going back into the political institutions to protect patients. What good is it for the Taoiseach to talk about a referendum to protect children's rights under the Constitution when the same Government cannot protect the rights of elderly patients, which are already enshrined in the Constitution? The reason these cannot be protected is either that the Government is not enforcing the law in the way it should or it does not care.

All the legislation that should be introduced to protect patients is not being produced. The Minister will know from when she was Tánaiste that under the programme for Government the social services inspectorate was a priority in 2002, after it had found its way into the health strategy Quality and Fairness — A Health System for You in 2001. Yet here we are, five or six years down the road with little progress.

I have heard references to the term "successive Governments" with regard to illegal nursing home charges. We knew this would be a priority issue from 2001, yet nothing was done. The Government spoke about it every year. It referred to it in 2002 when it made up its programme for Government and it was mentioned again in 2003 when the first reports emerged of what might be happening in Leas Cross and similar institutions as it became a Government priority.

We can almost be guaranteed that events will continue as they have with HIQA, the Minister's idea for protecting patients. I do not agree with this and I do not believe it will protect patients the way the Minister claims it will. The social services inspectorate section of HIQA, if given the proper legislation, could protect patients, yet that will not see the light of day with the Government. That is a most damning indictment. It is important the patient safety authority which Fine Gael is talking about is established.

The appendices to the Leas Cross report show how senior management in the HSE tried to justify their actions: "At no stage during my tenure was the quality of care relating to patients in Leas Cross mentioned or reported to me personally". These are the words of a former chief executive officer of the health board. It was stated that nobody informed him or her that there was a problem in Leas Cross. This is the first question for the detective sergeant who goes in to interview that CEO when looking for the paper trail. Another former deputy chief executive officer stated the Northern Area Health Board management were satisfied that they had put a robust system in place that could adequately deal with issues arising in the course of inspections.

Both the official report and the appendices show that a large number of inspectors were clearly concerned that the information they were writing in their reports was not finding its way up the line. There were individuals further up the line who may or may not have been passing on this information.

Will the Minister provide the Garda Síochána with the details of all the individuals who were part of the nursing home inspectorate of this health board area in the past four years? Where are all the senior individuals in the nursing home inspection unit of the Northern Area Health Board now? People retire and people move on but have there been attempts by the HSE to scatter these people across the system or persuade them to take early retirement to avoid embarrassment for the Minister in the course of the next couple of months? The Minister needs to pre-empt a Garda investigation and bring this debate back into this House.

She has failed badly in her protection of patients. She has not dealt with a whole list of issues. Will the Minister continue with the 5% ruling which means taking an elderly person's house when they require private nursing home care? Why is she failing to publish a policy on funding care of the elderly? This Government has abandoned all its priorities with regard to the protection of patients. The Minister should begin an inquiry into the care of elderly patients because she is failing them in every single aspect. She is failing to provide a policy to fund their future care, even though she will be on the radio to tell us all how more nursing home care will be required for the increasing elderly population. The only care option currently being provided is private nursing home beds and this is the sector where the failings are most serious. It was damning of the Minister's tenure when the private nursing homes organisation took it upon itself to implement a set of standards for private nursing homes because it knew the Minister's inaction was dragging them down. She has refused to deal with the minority of nursing homes that are failing patients in a most dramatic way. It is time for the Minister to take stock and to protect patients. She must stop thinking the only action the Government needs to take is to throw a few trinkets at everybody at budget time and to announce grand schemes. She is supposed to be protecting patients but she is not doing so.

Last Friday, the day after the Leas Cross report was published and a few hours after Fine Gael submitted its Private Members' motion, the HSE issued a press release stating that what was needed was a patient safety agency. There is no great belief that either the HSE or the Minister will protect patients; the HSE is simply responding to what is stated in the media and this needs to stop immediately.

The Minister must put her legislation to protect patients in order. She should follow Fine Gael's lead, change the way she is trying to set up HIQA and its remit and focus more on a patient safety authority which would concentrate on the needs of patients. It seems HIQA is all about processes and saving money. Much of the work of HIQA is to do with costing drugs, diagnostics and treatments to decide whether or not they will be given to patients. The manner in which elderly people in nursing homes are being treated does not bode well for the rest of the patient population if the Minister continues with this line of thinking. She needs to take some advice from the Opposition and set up a patient safety authority before she goes any further.

With reference to what has happened in Leas Cross and to the Peter McKenna and PJ Walsh inquiries, the Minister should institute a Dáil inquiry and bring governance of this country back into Dáil Éireann. There should be a proper discussion in this House about how this misery and terror happened to elderly people in one nursing home and is happening and has happened in the past in other nursing homes. The Minister needs to move quickly on this issue but I do not think she is doing so. Those of us on this side of the House are extremely disappointed because this issue has been raised consistently. In July 2005 during the course of a "Prime Time" programme, the whole country witnessed shocking abuse of a proportion of elderly people. They questioned whether this could really happen in Ireland's health care service.

Does the Minister now regret that somebody of the integrity of Professor Des O'Neill was asked to write the report? A person of his integrity would never write a report to merely satisfy his political masters. He would write a report that would have an influence on patient care and this is what was delivered. What were the legal impediments to the Leas Cross report that prevented the Minister from publishing it for so many months? Why did she keep it on her desk and tell us there were legal problems but as soon as they were exposed, the report was published within three weeks? This is important from the point of view of her governance. She should not collude with some of her senior managers to cover up what is happening within the health services and dress it all up with media-friendly advice that everything is hunky dory and rosy in the health care service when we know that serious problems exist. That cover up is a national disgrace and a national scandal. It is time for the Minister to be more proactive in protecting patients and to tell us what is happening in the health care service. I hope the Minister will take some of our concerns on board.

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