Dan Boyle (Cork South Central, Green Party)

The Bill has been described in this Chamber as reforming legislation, but unfortunately it is reactive legislation. The argument for an independent inspectorate of nursing homes and residential institutions has long been made, but is only reluctantly being acceded to. The system that was in place was clearly unsuccessful and the deletion of certain sections of the Health (Nursing Homes) Act 1990 demonstrates the Government has finally come to that conclusion. It is by no means a coincidence that it was a Fianna Fáil-Progressive Democrats Government that enacted that legislation. We are not just talking about the need to establish consistent and humane standards of care for the elderly, but also the philosophy of that care. I wish to speak about measures in the Bill that undermine the premise that care can be provided humanely in the future.

The health boards and their successor, the Health Service Executive, are the last bodies that should have been involved in the monitoring and regulation of residential institutions and nursing homes because they have too many vested interests. Too many compromised interests were involved in such an inspection process. A see no evil approach was adopted because of the need to keep people in residential care in order that they would not become, as obscenely described in debate, bed blockers. On account of that attitude, the economics of health care were paramount in the framing of our policy. We have seen the net result of this in exposures through the national media.

Not only were compromises in place, the resources needed to conduct a valid inspection have not been available since the enactment of the Health (Nursing Homes) Act 1990. We have examples of institutions that were never inspected over many years. Where reports were produced there are damning indictments of the institutions in question, but no actions were taken. On those grounds, the existing system has been an utter failure. It is time for an independent inspectorate to try to correct past mistakes and ensure they do not recur.

I have some concerns about whether this legislation as framed can do this. The establishment of the Office of Chief Inspector of Social Services undoubtedly creates an independent office. However, the remit of that office, which covers residential nursing homes and residential institutions for people with disabilities and children in care, seems very broad. We must ask what resources will be available to an office with such a large remit. If the mistakes of the past are repeated because of a lack of resources, we will continue to have a situation where many residential institutions will not be inspected over long periods. If the House merely replicates the 1990 Act in another form, it does the country a disservice.

The remit of the Health Information and Quality Authority also gives rise to concern, in particular the provision relating to charging for services other than for information given to the Minister, the HSE or other public service sectors. This indicates the philosophy held by the Minister for Health and Children that health and care services can best be provided through the private sector. If we establish a body that is meant to act on largely commercial principles in carrying out its remit of obtaining care standards — care that will, according to the Government, be provided in the private sector — the House will have done a bad day's work.

The Government has failed utterly in the care of elderly people. We have heard that 5% of the elderly population is catered for in residential institutions. Not only have some of this 5% suffered physical and emotional abuse, they have also suffered economic abuse through the manner in which their payments were stopped. They also suffered environmental abuse in terms of their living conditions and the preparation of their food, as articulately illustrated by Deputy O'Dowd.

Questions must also be asked about the Government's philosophy towards the care of the other 95% of our elderly, mainly provided through family or voluntary resources. To a large extent, the Government has failed to come through in this regard. Efforts to be cost effective have led to penny-pinching and a reduction in the home help service. Voluntary bodies have had to pick up the slack and they are largely unsupported in the provision of services that the State should provide. Not only do they provide the services, they must also spend much of their time and resources fundraising to meet their commitments. As long as that philosophy continues, the Government's credibility on the issue of care of the elderly must be questioned.

I use this opportunity to speak on the wider issue of the economic abuse of people in nursing homes, which was one of the triggers for the wider debate. Unfortunately, the debate continues as more discoveries and disclosures are made. A further story is reported in the media today regarding how health boards and the HSE held on to the interest earned from the income of people in residential care. If this debate was not being held in the artificial circumstances of the Order of Business decided before the House rose in December, we would have the opportunity for a direct statement from the Minister for Health and Children on how this anomaly and further injustice to people in care will be corrected. That statement should be made at the earliest opportunity, next week when the House has properly convened.

The report in today's media states that at least €1.5 million in interest withheld for 2005 alone will be returned to people. We know that the situation regarding the moneys of people in nursing homes goes back over 30 years, to the 1970s. If we aggregate the projected interest over a 30 year period — we should remember that interest rates for much of that period were in high double figures — we recognise the need for a serious statement to be made to the House. Members must be allowed to question the Minister on what appears to be the withholding of further information as to the true extent of the problem. Perhaps the Minister or a Minister of State will take the opportunity to comment on the conclusion of this debate. If it was on the record it would allow us have a wider debate when the House properly convenes next week.

One of the aspects of the Bill I found most interesting relates to the Schedule which repeals many of the sections of previous health care legislation. This debate has been informed by the need to discuss care of the elderly so there has been little debate on whether the additional functions of the chief inspector of social services with regard to people with disabilities and children in residential care are adequately covered in the Bill. Unfortunately, this is due to the truncated nature of this debate. Owing to the Order of Business last December, we have no opportunity to have that debate. I ask that the Government give more emphasis to that on Committee and Report Stages. I fear that by passing this legislation we will allow a lack of proper consideration in two areas of care. The nature of this debate means that they are not being properly considered.

On those grounds, although the Green Party supports the establishment of the Health Information and Quality Authority and the Office of the Chief Inspector of Social Services, there are real concerns. There is a need for wider debate and for the legislative process to be worked through properly in this House. Many of us still need to be convinced that this legislation, once on the Statute Book, will deal with needs that sadly still exist in society.

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