Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

Ar son Teachtaí Shinn Féin ba mhaith liom tacú leis an rún seo in ainmneacha na dTeachtaí Fhine Gael agus Lucht Oibre. This is a timely motion in the wake of the report by Professor Des O'Neill on the scandalous neglect of vulnerable people in the Leas Cross nursing home. The publication of the report is a further damning indictment of successive Governments and health board or HSE bureaucracies that presided over a system that allowed the old and the vulnerable to be treated disgracefully in nursing homes. There is no doubt that inadequate staffing, inadequate care and, most seriously, inadequate vigilance by State authorities led to the deaths of patients in Leas Cross and in other nursing homes.

The terms of reference given to the author of the report, Professor O'Neill, were flawed as they only provided for a documentary inquiry. The relatives of the deceased were not given the opportunity to participate even though they have valuable evidence to give about the treatment of their loved ones. Some of them have given moving and harrowing testimony in the media. Others have stories to tell also and have a right to see them placed on the record and outside the glare of media if they so choose. The Minister for Health and Children should provide a forum for the relatives to make this evidence available.

In the wake of the initial exposé of the scandal of Leas Cross, both the Minister for Health and Children and the Taoiseach promised a nursing homes inspectorate. This has not been delivered. The Government also needs to implement the recommendations of the National Economic and Social Forum report on the care of older people. It needs a clear strategy to end the over-reliance on private nursing homes for the care of older people and to ensure that all those who wish to be cared for in their own homes can be facilitated with the full support of all relevant State services.

We have waited for years for the Health Bill to put the health information and quality authority and the social services inspectorate on a statutory footing. When all those structures are in place, the Government must ensure their effectiveness. Otherwise, we will simply be creating further layers of bureaucracy. Whatever body has overall responsibility for patient safety must be independent and must cover all care settings. The MRSA and Families group has highlighted the fact that different regimes for infection control and prevention operate in public hospitals, private nursing homes and other sites where residential care is delivered. This must be addressed as a matter of urgency. Consistency is needed across the board.

A lack of accountability in sections of the medical profession and a lack of vigilance by the State authorities led to the ordeal endured by women in the Our Lady of Lourdes Hospital in Drogheda in the 1970s and 1980s. The women affected are still seeking justice and the full truth. The Leas Cross scandal occurred in the past decade. While the further measures introduced in the wake of Leas Cross to address patient safety are welcome, the question must be asked how many other similar cases of neglect were going on throughout the county at the same time as Leas Cross. How many deaths are attributable to such neglect? We may never know.

The motion mentions the case of the late Pat Joe Walsh who bled to death in Monaghan General Hospital because a diktat from on high decreed that a life-saving operation could not be performed on him in that hospital. I extend continuing sympathy to his family, which is now contemplating legal action. This is yet another family who feel driven to resort to the courts to get justice because of the treatment of a loved one within the health care system. It is a disgrace that they should have to do so.

What is the Government's response to the case of Pat Joe Walsh in its amendment to this motion? It asks the Dáil to "recognise that high patient volumes are needed for specialist services to achieve the best clinical outcomes". With all due respect, I do not have to be a Deputy for Cavan-Monaghan to identify that as a pathetic response. The systematic cutting of services at Monaghan General Hospital has led to the deaths of patients, including that of Pat Joe Walsh. The policy of over-centralisation of hospital services is based on a skewed interpretation of the training requirements of medical staff, the demands of insurers and the interests of medical professionals concentrated in the larger hospitals. It is being driven by the Government and the HSE.

In the north-east region we are promised a new super hospital sometime in the future. In the meantime, local hospital services are being cut. The Teamwork report is the same strategy of over-centralisation wrapped in a new package and it has been comprehensively rejected by those in my constituency. I reject that report and restate Sinn Féin's demand, in common with campaigning communities, for our local hospitals to be given the rightful place in the health and safety of patients.

See this speech in context