Tom Kitt (Dublin South, Fianna Fail)

I welcome this special debate on Second Stage of the Health Bill 2006, which provides for the establishment of the Health Information and Quality Authority and the Office of the Chief Inspector of Social Services. It is important that the House devotes time to this key issue. All Deputies are concerned about events which have come to light, specifically those in the Leas Cross nursing home, as highlighted by RTE's "Prime Time Investigates" programme. They must never be allowed to happen again. The House also heard Deputy O'Dowd relate disturbing details concerning another nursing home. I look forward to all the matters he raised being thoroughly investigated.

The Minister for Health and Children, Deputy Harney, and her Minister of State, Deputy Seán Power, who is present, have drawn up reforming legislation, including the Bill before us, in the area of elderly care. While I accept the Bill is overdue, the Minister is anxious to get it right. The office to be established under the legislation will have statutory functions which will ensure uniform standards of quality and safety throughout the health service.

As the Minister noted yesterday, the provisions on whistleblowers are a key feature of the Bill which will protect those who report medical and welfare malpractice. The Taoiseach and other Ministers have been asked about whistleblowers legislation on many occasions. The Government's commitment to deal with whistleblowing on a sectoral basis is reflected in the Bill. Employees who disclose and highlight wrongdoing will be protected, thus strengthening the system and adding another layer of protection for patients. Some of the incidents raised earlier by Deputy O'Dowd will be covered by the new provisions on whistleblowers. The legislation also introduces a new registration process, a matter I propose to address later.

The Health Information and Quality Authority, HIQA, will have an extensive role which will include undertaking investigations as to the safety, quality and standards of service where the Minister believes there is a serious risk to the health and welfare of a patient and carrying out assessments of health technologies, including drugs and medical devices. In light of the many reports Deputies hear concerning errors in prescribing drugs, it is welcome that HIQA will assume a function in this area.

The key provision is the establishment of the office of the chief inspector of social services, an HIQA employee with independent statutory functions and responsibility for inspecting residential centres, both public and private. The chief inspector will have responsibility for ensuring that all nursing homes, including the centre in Cork to which Deputy O'Dowd referred, and public and private homes for people with disabilities and children are registered. The office will also have the power to inspect special care units for children. It will oversee the performance of the Health Service Executive in respect of standards in fostering and pre-school services and the boarding out of elderly people. The chief inspector will have extensive powers in carrying out inspections and may enter a centre, examine records, take copies of documents and other relevant items. He or she will also have the power to investigate, where required, and staff of a centre may be interviewed in private.

In addition, residential centres will have to be registered by the chief inspector and it will be an offence to operate without registration. Registration details will be available to members of the public on the Internet, a further important development in terms of transparency. The chief inspector may cancel a registration if standards are not met and seek an urgent cancellation of a registration before the District Court if he or she believes there is a risk to life or a serious risk to the health or welfare of residents of a centre. This is strong legislation which responds to an urgent need.

This debate gives the House an opportunity to examine the broader issue of how society treats elderly people. The Government has honoured its commitment to promote care for older people through budget increases for pensioners and initiatives such as the free travel and free fuel schemes. People live longer — in many cases into their 80s and 90s — and the vast majority of older people live healthy and independent lives in their own homes. More than 21,000 people, or approximately 4.6% of those aged 65 years and over, live in long-term residential care centres. It is predicted that the number of those in residential nursing home care will increase to 44,000 by 2036 and 61,000 by 2050, a reduction in the proportion of those needing such care from 4.6% to 4%.

The Minister for Finance, in launching the national development plan, noted that Ireland's demographics offer us an opportunity to complete major infrastructural developments and improvements in our social services, the latter through important social inclusion measures announced at the launch. He also pointed out as the population will be much older in 30 or 40 years from now, we need to complete this work at this time when resources are available and demographics are right.

Our focus must be firmly set on giving older people the opportunity to live independently in their homes for as long as possible. The Government has correctly invested heavily in community and family support systems. These initiatives will mean that more older people who require low or moderate levels of care will be able to stay at home for longer. I agree with the Minister for Health and Children that past policies addressed the needs of older people from a dependency perspective but that the focus has changed to promoting independent, healthy lives for older people. Increased pensions, free travel and free fuel are not hand-outs but rights to which older members of society are entitled, having worked hard, made sacrifices in more difficult times and helped build the strong economy and society we all enjoy.

Following the increases in pensions and the carer's allowance announced in the budget, I welcome the strong focus on older people in the new National Development Plan, 2007 to 2013. A sum of €9.7 billion will be invested in the older people programme, of which €4.7 billion will be allocated for the living at home sub-programme with a further €5 billion allocated to the residential care sub-programme.

The national development plan correctly recognises that older people are one of the main groups at risk of social exclusion, while the partnership agreement, Towards 2016, sets out a vision of how older people can maintain their health and well-being and live as long a life as possible in an independent manner. The plan deals with important areas of support for older people, including social housing, essential house repairs, improvement in primary health care facilities, the rural transport initiative, education and training and support through community organisations to improve the security of older people.

Recently, I had the privilege of officiating at an event organised by Roscommon Home Services, one of many voluntary, not-for-profit organisations doing tremendous work in communities. Established a number of years ago, Roscommon Home Services recruits and trains local people and has approximately 200 employees on its books who provide a range of support services for people in their homes, particularly elderly people, in counties Roscommon, Mayo, Leitrim and Galway. A reasonable, nominal fee is charged for these services which assist elderly people in home management, cleaning, gardening, social care and general elderly care. In many cases, the older person is simply delighted that someone calls to do some work and have a chat. This vital aspect of the tremendous work being done in many communities is not always recognised. There is less community activity in many parts of the country because people have less time to converse and interact. In this case, however, it is the kind of service I strongly commend. The Government is anxious to support this kind of work through Pobal in particular.

As regards the living at home programme, the use of community and home-based care will be maximised and will complement the role of informal care, including family care. Under the national development plan, home care packages will deliver a wide range of services which will include the services of nurses, home care attendants, home help and various therapists, including physiotherapists and occupational therapists. The support scheme is also available to older people who have been admitted to long-term care and who now wish to return to the community. The packages will be delivered by the HSE, voluntary groups and the private sector.

Community intervention teams will assist in preventing avoidable hospital admissions and the facilitation of early discharge from hospitals. These teams will operate in addition to existing mainstream community services. Day care services will continue to be expanded.

Some €5 billion will be invested in residential care over the period of the plan. The increasing older population will require more residential care places to be met by public and private providers. It is proposed to develop community units, each with a capacity of about 50 beds, at a number of locations in Dublin, Cork and other sites around the country. The range of services includes convalescent care, respite care and long-term care. As I stated earlier, Government policy for the elderly has long been to support older people to live in dignity and independence in their homes and communities for as long as possible and to support appropriate long-term care where this is no longer possible.

I wish to deal with another area that is close to my heart and comes within my remit, which is the question of new technology and older people. Other Deputies will share my interest in this matter because technology can be of great benefit to older people. Since taking over responsibility for the information society in the Department of the Taoiseach, I have prioritised a key objective of giving older people the opportunity and encouragement to use modern technology. The use of modern technology is an important means of improving the quality of life for older people and we must involve older people as important members of and participants in what is termed the information or knowledge society. The Internet is part and parcel of the lives of our younger population, but since its arrival many older people now have opportunities for a new level of self-development and fulfilment. The lack of these opportunities had held many people back before now but they currently have the facilities that can enrich their lives, especially as they face into their autumn years. They will have the chance to pursue a niche activity or interest that was not possible when the barriers of communication and personal circumstances confined them to a narrower world.

Health experts tell us that the key to physical health is often more to do with mental attitude and well-being. As more and more people are living alone, communication via a proper communications infrastructure is an important foundation on which to build a good quality of life. Before the advent of the information age, people who are physically restrained had to live with the frustration of an agile mind as old age set in. The ability to communicate more widely is now a key to their happiness and quality of living. This is where access to all modern communications technology, including the Internet, has great potential for improving the situation in people find themselves. Such access also allows their creativity, experience and wisdom to be of value to themselves and those who care for them. It can be a great comfort and support for many carers to communicate with other carers, share their experiences, learn from others and add to the store of knowledge about the circumstances with which they must cope.

I launched the access, skills and content information society, an initiative introduced to tackle the digital divide in society, to attract more people to use technology for their own benefit. The programme is specifically targeted at older people and those with disabilities. It is designed to support projects that focus on creating meaningful content, as well as the skills necessary to access and use that content. Such content can be of value to people who benefit from participation in networks or partnerships, whether they consist simply of improved contact with family members, access to information, supply of goods and services, education, research, or in the pursuit of an interest that may have been curtailed due to location or mobility constraints. The initiative has been a great success and I will continue with it this year by issuing a call for proposals from interested groups next month.

Technology has many applications. In the health area, for example, developments in medical technology have been astonishing and have contributed hugely to the increasing survival rates of older people. Technology has also changed the way in which education can be delivered and has made it possible to access a rich variety of educational content in a manner that meets individual needs in terms of time, presentation and resources. In that respect, it has opened up new windows to those for whom more conventional and traditional facilities might not have been suited.

The Internet has opened up access to a variety of sources of useful information and knowledge, so that people can gain access to lifestyle advice to suit their particular needs and circumstances. It allows people to develop old or new interests, gain new skills and establish their worth and contribution to society. In these ways, they are getting new opportunities for participation as valued members of society and can even contemplate new careers in later life. In terms of cultural and recreational activities, especially niche interests and activities that do not have a significant local presence, participation in on-line communities of interest opens up possibilities of self-realisation for all age groups. Fundamentally, modern communication technologies have made it possible for everybody to enter into mutually beneficial partnerships and relationships that promote greater independence, self-esteem and, ultimately, a better quality of life.

Happily, older people today enjoy robust health for many years into their retirement. Catering for the needs of the elderly is therefore not specifically a health issue. It has more to do with the quality of their lives and their self-esteem. Access to the rich resources now available 24 hours a day, seven days a week, has opened up tremendous possibilities. Through the access, skills and content initiative, I hope to continue to promote those values and show how technology can work to liberate people, rather than generating fear and mistrust.

Projects are under way to examine how ambient technology can be used to promote independent living. However, it is also important to remember that people need to feel part of a community, to feel that their existence is valued, and for them to be respected for what they are as well as for what they have contributed to society throughout their lives. Through technology-enabled networking, being part of a community has taken on a new complexion and has made it possible for more vibrant communities of people who share common interests or circumstances to help each other and to continue to develop as human beings. I wanted to put on the record my views on how technology can be of great benefit to older people. Having spoken to members of active retirement groups, I know they are finding the use of new technology to be extremely beneficial.

I welcome this legislation which will allow for a fully independent inspectorate for all nursing homes for older people, both public and private, as well as for centres for people with disabilities and children. The Bill is central to the Government's reform programme for the health service as we strive to achieve a safer health and social services system.

Whatever Government is in power, we must continue to give people an opportunity to pursue independent, healthy lifestyles. While we all agree on that point, we must also recognise the serious flaws in nursing home legislation in the past. The Bill before us is significant in this respect. The quality of service and care in the vast majority of nursing homes is good. In our family lives we have all had experience of such care provided by management and staff of many nursing homes throughout the country. It is in the interest of nursing homes, as well as patients, that we should get this legislation through the House as quickly as possible.

The matters raised this morning by Deputy O'Dowd were shameful. It is important to use this legislation to root out those who have been involved in such activity in nursing homes and other institutions. Those who genuinely care for the elderly should be allowed to get on with their work. Many Deputies have rightly recognised that a large number of dedicated people are providing tremendous care. The Minister for Health and Children and the Minister of State, Deputy Seán Power, deserve credit for bringing forward the Bill. It is one of many reforming measures they have introduced.

This is a difficult area for a ministry to get right all of the time. Dreadful mistakes have been made, which must be recognised. I commend RTE's "Prime Time" in particular for what it exposed with regard to Leas Cross, and we have had other reports since. All of these cases should be thoroughly investigated and all of the facts made fully known. The Bill will ensure, through the transparency measures and the strict regime involved, that those situations will not arise again.

I commend the Bill to the House and I commend the Minister and the Minister of State for the work they have done. I urge them to continue to bring this legislation through the House. As Chief Whip, I will certainly play my part to ensure we get it through as quickly as possible.

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