Seymour Crawford (Cavan-Monaghan, Fine Gael)

I welcome the opportunity to speak on this important motion regarding Who Cares? - An Investigation into the Right to Nursing Home Care in Ireland by Ms Emily O'Reilly, the Ombudsman.

I watched with horror the "Prime Time" programme in which the Ombudsman tried to put across the failure of the Government and the Health Service Executive to co-operate with her investigation while, from another studio, the Minister for Health and Children, Deputy Harney, refused to speak about the facts, dwelling on the present rather than the past. Clearly, by agreement with RTE, the Ombudsman was refused the right to reply. This seems to be the type of agreement the Minister is able to extract from RTE. The same happened several months ago when she sat in RTE listening to the first-half debate on "The Frontline" and was then allowed the freedom to answer without debate in the second.

The Ombudsman's report, unfortunately, bears out the facts that many in this House have been raising for some years. I will never forget the case in which a relatively young woman in her early 70s and her more elderly husband, both diagnosed with Alzheimer's disease, had to be put into a private nursing home as no other accommodation was made available for them. All their family members were married with their own family structures to maintain, leaving them in an extremely difficult position as the cost of care came to €900 a week for each parent.

I remember another case where I persuaded an aged lady to sell off a portion of the family property to fund her in a private nursing home. When she ran into some health difficulties in that nursing home, the services were not even prepared to listen to her immediate friends. When they brought in their own family doctor, the person was rushed to hospital. Unfortunately, the situation was too late and the poor lady passed away. Although the hospital and post mortem findings were quite significant, the subsequent inquiry never communicated with the friends responsible for calling the doctor concerned. They were not allowed advise the inquiry of what really happened. Subsequently, the inquiry went nowhere.

Why was the Ombudsman obstructed by both the Department and the Health Service Executive? Will the Minister explain why some cases are settled on the steps of the courts? Does the State believe settling individual cases by way of compensation is less costly than going to a full hearing? Considering the number of cases taken, why will the Minister not allow one case to proceed to legally clarify the position in this regard?

In May 2002, a close friend was placed by the health authorities in a private nursing home because no other bed was available. Her old age pension was part of the funding to that home. Her neighbour who went into a public nursing home later, however, received a refund under the refund scheme. No wonder there are legal cases.

There was a total failure in the legislation to clarify what people were legally entitled to or otherwise. There was a total failure by the Government to bring forward the necessary clarification in the law to ensure everyone was treated fairly. The subvention scheme which was available in the early part of the past decade was unclear. I dealt with nursing homes in the former western health board area which had received patients from the north-east health board area. Nursing home management simply could not understand the different regulations that were used between the two different areas.

When nursing homes increased their charges, the Health Service Executive under the Minister, Deputy Harney, refused to increase the subvention before the long-promised nursing home support Bill was introduced. This has resulted in nursing homes following patients for debts they never personally incurred because it was the health authorities that placed them in those homes, not a relative. Can one imagine a person 101 years of age being threatened with court proceedings?

For years I have called for the eligibility for health and personal social services Bill to be introduced to bring clarity to what people are entitled to and eligible for. I call again tonight for this Bill to be introduced as a matter of urgency. So far the nursing home support legislation has been of some benefit to families; this year it will come in at the proposed cap of €970 million. However, the Health Service Executive is winding down some of its public health beds with the ratio turning much more to the private sector. Our aging population is entitled to know what the future holds for them.

The Minister may believe she is above questioning by the Ombudsman. She will, however, soon be accountable to the people. Fine Gael believes this report raises important issues concerning the Ombudsman's independent role and how she discharges it. From time to time, there may be conflict between the Ombudsman and the Health Service Executive. However, the Minister for Health and Children, her Department or any other agents of the State must not be allowed to frustrate statutory investigations. The Minister must advise us on this.

Fine Gael believes the law should be clear and that State agencies should be implementing the law as it is rather than as they would wish it to be. Legislation must state clearly what it intends instead of being open to interpretation. If resources to meet statutory duties are not available, legislation should be amended to reflect that practice.

While I accept the eligibility for health and personal social services Bill is at an early drafting stage, there is no excuse for the continuing delay in its publication.

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