Beverley Flynn (Mayo, Independent)

I also welcome the opportunity to speak in this debate. Everybody in the House recognises that patient safety and care should be at the centre of our health policy. Like other Members present, I welcome the publication of the Leas Cross report. We were all shocked when this matter came into the public domain last year. It caused much concern not just for the patients of Leas Cross but for patients of nursing homes across the country because of a lack of confidence in the nursing home inspectorate system. While I welcome a number of changes that have occurred over the past year, as we all know there has been considerable media comment that despite the improvements in the inspection system it is still not all it should be. I welcome the introduction of a new national training programme for inspection team members and the hiring of 32 elder abuse officers. I also welcome the fact that under the new Health Bill 2006 the social service inspectorate will be put on a statutory basis. That is critical.

In my limited time I will deal with some specific issues. As we discuss patient safety and care the inequality of the subvention rate across the country amazes me. I have mentioned this time and again in this House and at the Joint Committee on Health and Children. I mention it because it has a critical part to play in patient safety and care. Many patients, particularly in the west, are not receiving the standard of care they should because of the inequality in the subvention system. In the past I have mentioned that in my county one cannot get enhanced subvention. It has been discontinued for new applicants since the spring. The maximum subvention one can get in County Mayo is €190.50 per week, compared to €850 which patients in the east can get. That is a scandalous gap of almost €700. Are we saying older people in the west are not entitled to the same standard of care as those in the east? The Minister for Health and Children has acknowledged, at the Oireachtas Joint Committee on Health and Children, that it is inequitable and discriminatory, and she has said she intends to do something about it, as has Professor Brendan Drumm.

If a person is unable to get a bed in a public facility and qualifies for the maximum subvention but cannot afford to pay the balance between the subvention, combined with his or her pension, and the cost of a private nursing home, what is he or she to do? We have acknowledged that the person is entitled to the maximum amount of subvention and care available, but he or she cannot afford to pay. This scandal has gone on for too long and must be rectified as a matter of urgency. Enhanced subvention could be reintroduced immediately. Although the Minister allocated an extra €20 million in last year's budget to deal with this issue, that money had been spent before it was announced and it made no difference in subvention rates. I welcome the commitment given by the Government in the social partnership agreement Towards 2016 and I have spoken to the Minister for Health and Children about this. The commitment will be that the level of State support for residential care should be indifferent to whether a person is in a public or private facility. I agree fully with that, but we are a long way from it. Although it will cost a large amount of money to implement it, if we are serious about patient care and safety it must be done as a priority. I have already mentioned that the €20 million from last year was inadequate and I ask that enhanced subvention be restored as an interim measure.

I have a number of other important policy points dealing with patient safety and they were part of the ten-point plan to deal with the accident and emergency crisis. People have referred to contract beds. There is not one contract bed in County Mayo. When I last raised this at the Joint Committee on Health and Children I was told that negotiations were ongoing, however nobody could tell me how many contract beds would be allocated to the county or what stage negotiations had reached. I was told they were due to end shortly, but we are still waiting. The home care package initiative is fantastic and I welcomed it wholeheartedly when it was introduced. However, while 500 home care packages were announced nationwide last year, only five of those were available in County Mayo. How can that be a real option for an elderly person? How can we be serious about caring for people in our community and providing adequate patient care if only five are available in a county of 110,000 people where we have already acknowledged that approximately 16% of the people are over the age of 65? I am glad to say that has improved.

As a result of my bringing the matter before the Joint Committee on Health and Children approximately 60 home care packages are available for 2006, but that is still inadequate. The majority of people in my county receive a maximum of approximately five hours of home help per week. If we are serious about a policy of patient care and safety we must ask ourselves, despite the extensive resources being spent on health, whether that is adequate.

I was going to mention a sad case in an acute hospital I dealt with recently, but I do not have time. If even some of those issues, particularly on looking after the elderly in their own homes, the home care packages and the contract beds, or only equalisation of subvention rates, could be resolved it would be a major step forward.

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