Ruairi Ó Murchú (Louth, Sinn Fein) | Oireachtas source

I concur with Deputy O'Rourke. We are glad to see this legislation. The nursing home support scheme, or fair deal scheme, needs significant tweaking. More widely, we need not only to support people in nursing homes but ensure we are not impacting on the sustainability of small businesses and small family farms. That is something that has to be dealt with.

The pandemic period has made us look at how we deal with elder care. There have been a number of reports in the last while, including those from the expert panel and HIQA, which stated that nursing homes should not be the only option for older people in need of enhanced care. We are going to need an entire package. We all know that home care packages can be lacking and that has been mentioned in this House from time to time. Multidisciplinary supports are required to facilitate people in later life. Our demographics are going to change and we will have a greater number of older people. They should be able to stay living within their own homes, which is possibly better for them and their families.

Both HIQA and the expert panel agreed that we need reform of nursing home care. We need to look at the way we do it, how we audit systems and the way we situate, organise and construct buildings. We have to look at public versus private provision. As Deputy O'Rourke said, some of our system was not necessarily designed but was the result of unintended consequences from tax breaks. Money went in a particular direction and we ended up in the situation we are now in. A number of nursing homes operated as separate businesses and outside the wider controls of the State or did not have the relationship with the HSE and the healthcare system that we would have wanted. That led to difficulties, particularly at the beginning of the pandemic. That is why a major part of the report of the Covid committee was on the requirement for an inquiry into how we dealt with that period. There needs to be significant emphasis within this House on ensuring draft terms of reference are provided because they are required and we are behind time. That was meant to have been done already. There have been discussions and Government sources have said in the papers that we are moving towards an overall inquiry into elder care, and particularly into how it was dealt with at the beginning of this pandemic. That is absolutely required. We also need a committee to look at the guidance that has been given to us by these reports on how to deal holistically with elder care and produce a system that will deliver for all of us, especially our older people.

We all remember the significant tragedies that occurred in nursing homes a year ago and we had a repeat of that in January. A number of families who have gone through deep trauma and hurt are looking for answers. They will require these inquiries. I have spoken previously to both the Minister for Health and the Minister of State about the terrible tragedy that occurred in Dealgan House, with the loss of 22 residents. That had a significant impact on their families and I commend them for the considerable work they have done in looking for answers. The Minister and Minister of State have met with them and there have been discussions about creating a mechanism to provide them with answers. As much as there needs to be a wider inquiry into the nursing home sector, how we dealt with the pandemic and how we deal with elder care in to the future, we also need a specific public inquiry into what went wrong in Dealgan House and what the lessons are for the future. Everyone needs that. The families are also experiencing difficulties in accessing information from the HSE. I understand that we are in a difficult period due to the recent ransomware attack but this is something I will continue to bring up. I will have conversations with the Minister and the Minister of State about this matter because we have to provide for these families. Beyond that, we need to deliver a fit-for-purpose system and scheme for our elderly across the board. I commend this legislation.

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