David Cullinane (Waterford, Sinn Fein) | Oireachtas source

I am sharing time with Deputies Patricia Ryan, Martin Kenny and Martin Browne.

Yesterday, I outlined what the various sections of the Bill did and my views on those. I now wish to deal with some of the recommendations of the review of the fair deal scheme. The Government needs to consider these. The review made 32 administrative recommendations, but there has been no update on their implementation. Thirteen pricing recommendations were made and we need a report on their implementation. Twelve recommendations were made on a future model of social care. There should be a report on their implementation. A great amount of work must be done on a new model of social care.

The pandemic has shown up many failings in clinical governance and oversight, the lack of integrated systems and, in some cases, a lack of knowledge about the sector on the part on the HSE. At a meeting of the Oireachtas Committee on Health a number of weeks ago, HIQA stated that, in its opinion, the HSE did not have knowledge of the private sector from which it was purchasing services. HIQA was referring to nursing homes among other elements. That is a problem.

There are poor standards and a lack of authority for safeguarding. The Government says that it is committed to ensuring the latter and putting safeguarding on a statutory basis. That must be a priority. We must also consider strengthening HIQA's powers over public and private nursing homes. HIQA has stated that its powers are a blunt instrument and do not provide enough flexibility to work with nursing homes and approved centres for older people and people with disabilities on making necessary improvements. Similar to the Health and Safety Authority, HIQA wants the power to issue what are called improvement notices. That would be important.

Young people with disabilities, including some children, have been placed in centres for older people. This matter was the subject of an "RTÉ Investigates" programme some time ago and needs to be addressed.

We must deliver a high-standard and fully public model of care for older people. The statutory home care scheme needs to be expedited. It was reported at the end of last year that the scheme had been pushed to 2022 because the IT system and a new assessment process had yet to be developed. Once again, IT systems were a problem. Thankfully, the problem was not one of cybersecurity in this instance. Rather, our healthcare system does not have a modern IT infrastructure, which impacts on the State's ability to respond to new systems, policies and processes when it needs to.

I support the Bill insofar as it goes. The welcome development in the Bill is the three-year cap on assessments of transferred assets to protect the viability of family farms and businesses. The Minister of State, Deputy Butler, and I share the same constituency and we have attended many meetings of the Irish Farmers Association and other farming representative groups down the years, often at election time when we are in the cut and thrust of debate. This was one of the issues that arose time and again and what the Bill intends to do will help to resolve it. I commend the Minister of State on introducing the Bill.

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