Fergus O'Dowd (Louth, Fine Gael) | Oireachtas source

I welcome the debate and congratulate Deputy McNamara, on his performance as Chairman of the committee, his fairness and the way he dealt with the issues. I also pay tribute to all those families who have lost loved ones in nursing homes or outside them to Covid-19. The Irish Timestoday published the pictures of 100 people who are deceased. Some of those families have contacted me. It is a deeply difficult moment for them and we have to acknowledge that.

I acknowledge the fantastic work that nurses and home care assistants have done in nursing homes and hospitals. Without them, the situation would have been much worse than it turned out to be. Doctors and healthcare professionals were unstinting in their care, dedication and commitment. I want also to mention the Army and the Defence Forces, which were very active behind the scenes and which were very helpful. They are the unsung heroes, in many ways, because of what they have been doing. Perhaps we ought to encourage them and allow the Minister for Defence to talk about all the fantastic work they have done. I am not forgetting about agency nurses. Agency nursing is a very difficult profession because it is uncertain and the pay is not always adequate. They too did fantastic work, as did all the support services in the State and the public generally.

They were all the good things that happened and they make us stronger, not weaker. They make us want to respect and will, hopefully, inspire young people to get involved in the caring careers. In this pandemic, which came on us all throughout the world out of the blue, the response has been fantastic. There are, however, serious issues and Covid has not gone away. I agree with some speakers that the threat is ever-present, and I believe it is growing. Covid is again stalking, regrettably and sadly, our nursing homes. Let us examine those nursing homes and see what they are composed of. There are 585 nursing homes and 31,969 beds. Of those nursing homes, 115 have one or more restricted conditions, meaning they do not meet the full requirements of HIQA. An unbelievable percentage, 34%, of premises are not compliant. Perhaps the most frightening statistic of all is that 195 of those nursing homes are not compliant in fire safety. That is a very serious issue.

All those facts are contained in the HIQA annual report for 2019. That was last year but it was published in August of this year and it is the latest report we have. We do not have many of the other figures that are due to be published by the authority soon. These serious issues in the market must be addressed. Of the investigations that HIQA carried out in respect of dementia, only 49% of the homes were fully compliant. A total of 19% were moderately non-compliant, while about 5% had serious non-compliance. For everyone who lies in a bed in a nursing home tonight, that is a poor return for their €1,000 a week for their care. There should be 100% compliance in all these issues and it is entirely unacceptable that this is the situation.

Many of those who work in nursing homes are poorly paid and have poor conditions of service. Many of them are recent immigrants and have no proper sick pay. They are vulnerable workers, have poor accommodation and many of them have to work in more than one location to make a living. Their status in our society is too low and it is not acceptable. There is a deep flaw at the heart of our long-term care and it is how we treat the people who work there. Nevertheless, nursing home owners are well paid and the top 12 or 13 make hundreds of millions of euro every year. It is interesting that 22 nursing homes changed hands in the past year, and it is people from outside of Ireland coming here to invest in the industry. That raises a big red flag for me. I agree with the view that we cannot allow the privatisation of nursing homes and care of the elderly to continue. We must reverse that, as we are doing with respect to housing, and ensure that the HSE and the State step in. We cannot have the exploitation of people, as is happening in what I accept is a small minority of nursing homes.

Today in the courts, in a case involving Oaklands Nursing Home in Listowel, which had six Covid-related deaths recently, the HSE and HIQA outlined that there were seven inspections this year. The most recent one on the HIQA website, at 7 p.m. today when I looked at it, took place on 18 June. We are now in November. This was when the pandemic had hit and we all knew what had to be done, but what did not happen? There was no person in charge, no social distancing, no clinical oversight and the food and nutrition were not adequate. There was no appropriate and proper medical management. The staff were wearing no surgical masks. There was no management system in place to provide safe, appropriate and constant care, and there was poor and unacceptable infection control. I reiterate that the date of that inspection was 18 June. The draft report was issued to the nursing home on 9 July, with a deadline of 30 July to comply. The chief inspector was not assured by the documentation supplied, but HIQA waited until today to go to court to take over that nursing home and six deaths occurred there. Something is rotten at the heart of this system that allowed that to continue. It is not for me to lay the blame but to explain the facts as I read them. HIQA does a fantastic job and I will not take from anybody working there, but it is entirely unacceptable that this level of abuse of patients was allowed to continue for so long.

I warn those watching the debate that the virus is again stalking our nursing homes. We must act now as a community. I acknowledge the work that Dr. Tony Holohan is doing and I reiterate what NPHET is saying. We are at a turning point now. In fact, the curve has turned upwards, not down. In New York, schools are being closed and people are being told not to travel at all for Thanksgiving, while in the UK, there are tens of thousands of cases every day. We are at a very difficult point and must fully ensure that no effort is spared in helping these people, particularly in nursing homes. One of the problems with the virus is that it has a severely negative impact on residents in nursing homes because meaningful socialisation has stopped.

There is a very significant increase in mental health issues. The incidence of dementia, depression and anxiety among residents has increased exponentially. Loneliness, as we know, is also a problem. Families who have loved ones in homes cannot see, visit or hug them. That is hugely damaging to those relationships because it prevents families from expressing the love and care they have for their loved ones. I accept that the current situation is extremely difficult for everybody but we need to put much more help in place for people in those situations. In terms of media advertising, there should be advertisements for helplines, particularly for families of people in nursing homes. Many of them are old and feeble themselves and they need that support. We must do more for people at this difficult time, when more that 2,010 people have died of Covid, the majority of them in nursing homes. As I said, the virus has not gone away. In fact, it is surging again.

I thank the Minister of State, Deputy Butler, for listening to my concerns whenever I have met her to discuss them. I extend the same thanks to the Minister for Health. There must be an inquiry into Dealgan nursing home. There are two nursing homes where events have given cause for serious concern during this awful pandemic, the latest being in Listowel and the first being the Dealgan home. The latter is the only nursing home where there were practically no staff in place because most were out sick or had left. Awful things happened there and the families need the truth about it. The truth must be found for them and I believe the Minister of State is committed to finding it. What happened is entirely unacceptable. We have talked about it before and we will talk about it again. I urge the Minister of State, if she can, to tell us what she is going to do about it. It is three weeks since we had the meeting about it and the families want an investigation into what happened.

The country has come a long way and we are now at a crossroads. The danger is that the virus is on the rise again. Our nursing home residents are extremely vulnerable in the short, dark, dank days and long nights we are facing into now. I urge absolute vigilance at this time of serious risk for people. In particular, there must be more action and greater commitment from HIQA in respect of nursing homes.

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