John Moloney (Laois-Offaly, Fianna Fail)

I am responding on behalf of my colleague, the Minister of State, Deputy Áine Brady, who cannot be here this evening. I thank Deputy Ó Caoláin for raising the matter.

I am sure all Members of the House will join with me in expressing concern at the incidents highlighted in the "Prime Time Investigates" programme last night. The central focus of Government policy for older people who need care is that they should be able to receive high-quality care and they should be at the centre of all decisions regarding their care. The key element that must exist between the provider of care, whether public or private, and the recipient of that care is trust. This is fundamental to any service, but particularly health or personal social services, whose recipients are likely to be vulnerable. As an immediate response, the HSE is investigating the cases raised in last night's programme and is now reviewing all service delivery under its auspices to ensure that proper standards of care are being met. The executive will terminate contracts and change providers in cases in which this is necessary.

I emphasise, however, that in the vast majority of cases the HSE works in a close and beneficial partnership with high-quality home care providers in the non-State sectors. The HSE also has complaint mechanisms and an elder abuse network. In responding to referrals, the HSE provides a discreet and confidential service which may include counselling, mediation and anger management, as appropriate. Anyone who encounters elder abuse or inadequate care should report it to a GP, a HSE social worker, a public health nurse, a member of the Garda Síochána, or anyone they trust. The introduction of the nursing homes support scheme and the bringing into force of new regulatory standards for the long-term residential care sector demonstrates the priority the Government places on high-quality services for older people. Notwithstanding the severe financial pressures of recent times, there has been an expansion of the home care package initiative nationally through the provision of an additional €10 million in 2010 and a further €8 million in budget 2011. This year we protected the levels of other community-based supports for older people, such as home help, meals on wheels and day or respite care, and we also intend to do so in 2011.

With regard to the possible regulation of home care services, the July 2008 report of the Commission on Patient Safety and Quality Assurance recommended, among other things, the extension of any licensing systems in health care to the primary, community and continuing care sector. More recently, in July 2009, the Law Reform Commission published a consultation paper entitled Legal Aspects of Carers. This considers the legal issues surrounding home care and makes several provisional recommendations in the area of standards and regulations generally.

The Department of Health and Children accepts the need for a more standardised approach to the regulation of home care generally, whether by statutory or non-statutory providers. The HSE and the Department have progressed various improvements in home care provision overall during 2010, especially relating to the governance of services. These measures will be published and implemented in 2011 and include national guidelines and procedures for standardised implementation of the home care packages scheme, quality guidelines for home care support services for older people and national guidelines for the home help service. In addition, the HSE published its public procurement framework for home care services on 22 October last and is progressing this important measure, in conjunction with the other measures I have outlined, to ensure best provision to clients. Approved providers must meet and be monitored on a range of standards such as vetting, training, elder abuse protocols, supervision and client feedback.

As indicated to the House in a reply to a parliamentary question on 22 June last, the question of possible changes to legislation, including regulation and inspection, for the area of home care for older people generally is under consideration. The Department is examining the regulation of this sector in the overall context of the licensing of health care providers. Legislation is currently being prepared in this regard, taking into account the recommendations of the Commission on Patient Safety and the Law Reform Commission. The Government is determined to do everything possible to protect all older people in care. Our approach is to progress the various initiatives I have outlined, while examining the options and implications of introducing statutory regulation. I assure the House that the Department of Health and Children will work closely with relevant statutory and non-statutory organisations to take all measures necessary to ensure quality standards for all people receiving home care.

See this speech in context