Thomas Pringle (Donegal South West, Independent) | Oireachtas source

I also support this motion. It is vital that private nursing homes be included within the remit of the Ombudsman if we are to take elderly care seriously. We cannot have two elderly care policies, one public and the other private. All institutions, organisations and companies which provide services for a vulnerable population need the objective and reliable model of scrutiny which the Ombudsman provides. The service users should always have the right to seek accountability regarding those who oversee and manage their care.

It serves to honour and protect the dignity that elderly people deserve in the later years of their lives.

However, a few concerns remain. The remit is narrow as it only applies to nursing homes which are funded by the State through the nursing homes support scheme. Ideally, I would like to see any place that deals with elderly care fall under the remit of scheme but as demand for the fair deal scheme is increasing over time this motion will have a significant impact. I would have a concern that there could be two patients in the same nursing home, one of whom will have access to the Ombudsman and one who does not have that access. In an ideal world, residential care would not be the focal point of our national ageing policy. We will always need nursing homes and everyone is entitled to the option that meets their needs best but many people can live at home and want to do so.

According to the Government's National Positive Ageing Strategy 2013, the stated national policy was to enable people to age with confidence, security and dignity in their home and communities for as long as possible. However, as we have seen with the primary care model and in our mental health policy, resources do not match the intention. According to Age Action, in 2013, out of a total budget of €1.39 billion, 72% was spent on the nursing home support scheme which supports over 22,000 elderly people, approximately 4% of the population aged 65 and over. Only 14% of this was spent on home help services, with 9% on home care packages. Home help funding has declined by almost 12% since 2009 and while the hours may have increased and the number of patients in receipt of hours may have increased, the quality of the time they receive has decreased. Age Action has noted a trend in the admissions policies of nursing homes which have increased the number of low to medium dependency people being admitted while lowering the number of high dependency residents. High dependency residents end up staying in local community hospitals rather than in nursing homes. I wonder if this model has been adopted to manage more people for less hassle and at a lower cost than admitting older, more dependent people into nursing homes. This may especially be the case for private nursing homes too who are run on a profit margin.

While there is statutory support for nursing home care, there is none for home help and this model does not make sense. I acknowledge that the family structure has changed. We do not all live with three generations under one roof and both parents working is the new norm. However, we do not empower people to be carers nor do we support people when they do care for others. Carers have no standing in today's society. The cut in respite care was one example of how the Government treats some of our most valued people and it has continued that trend ever since. County Donegal has the highest number - over 4% - of elderly people living in the community. This is because the HSE in Donegal, to its credit, has supported home care and home care packages. This is the model which should be rolled out across the country because it removes the dependency on nursing home care rather than increasing dependency. It is also more cost-effective and less expensive.

The process will require an individual making a complaint seeking to resolve the dispute with the nursing home in the first instance. The Ombudsman has announced that there will be information sessions for private nursing home owners. However, an information campaign should also target residents of private nursing homes and their families as this legislation deals with very vulnerable people. How can we ensure that vulnerable persons are empowered to speak up against an authority if they do not know their rights and entitlements? Many people are not aware of their fundamental entitlements. They may not be aware of due process and procedure and this is a real concern. Literacy issues when dealing with bureaucracy and a full understanding of how to work around bureaucratic systems has led to numerous breaches of service provision. How are we to empower people to understand the role of the Ombudsman and their ability to access this resource? Will the Office of the Ombudsman be resourced to cater for a rise in the number of complaints that could be received due to this greater awareness? It is important to note the high rate of cases discontinued prematurely and not being upheld. We must ensure that the resources are available to the office to deal with the cases.

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