Gerald Nash (Louth, Labour) | Oireachtas source

I appreciate the opportunity to speak on this important motion. According to the Health Protection Surveillance Centre, more than 2,000 residents of nursing homes have passed away because of Covid-19, a number that accounts, in real terms, for over 40% of Covid deaths in Ireland to this point in time. This has been a massive issue in our society over the past year and a half. As the Minister of State and others have said, our thoughts are with those who are mourning the loss of their loved ones.

We must not forget that what might be described as a hands-off approach to nursing homes was to some degree prevalent at the start of the pandemic. HIQA provided the Department of Health with a list of what it described as nursing homes it believed would be at high risk at the beginning of the pandemic. What is even more concerning is that we do not know what follow-up the Department had with this list. Did the Department provide the list to NPHET in order that it could advise? It is clear that the Department of Health did not request that HIQA begin any preliminary assessments of these facilities, as no inspections were carried out at the beginning of the pandemic.

I agree that a public inquiry into these Covid-related deaths is required. It is now necessary. This is not the first time I have said that and I am not the only one who has said it in this Chamber, in the media and elsewhere. Many people require answers as to the State's interventions into the nursing home sector during the pandemic. I am calling again for a specific commission of inquiry under the Act into the circumstances of the deaths of 23 people in the Dealgan House Nursing Home, Dundalk. Each and every resident who died there was a mum, a dad, a grandparent, a much-loved aunt, uncle and friend. Their memories and human dignity insist that we know why and how they died.

Their families and loved ones have a right to know. Society has a right know. For well over a year, I and others have worked closely with bereaved, and by now, frankly, exhausted families, to try to piece together what happened more than 12 months ago at Dealgan House Nursing Home last March and April. Families, who have suffered enough, should not have to be charged with hunting down information through freedom of information requests to the HSE, the Department of Health and HIQA to try to establish what happened to their dead loved ones. We now know that Dealgan House Nursing Home was in chaos from at least early April 2020. We know that now but nobody informed the families. For the nursing home and the agencies, family members were an afterthought, if that.

Material secured by freedom of information requests and through parliamentary question replies to me and to others show massive staff shortages and absences, as a consequence of Covid-19, from 18 March. The picture on 6 April showed that at that stage, only six out of 22 nurses were available to lead the care of 84 residents. The director of the home wrote to the then Minister for Health, Deputy Harris, on 12 April stating that there was on occasion, "one nurse on night duty, dealing with 80 residents, some of whom are very ill". That illustrates the problem.

We know that HIQA was made aware of serious stuff shortages from 6 April.. Additional staff were provided by the HSE but too few initially. HIQA and the HSE, at the most senior level nationally and regionally, the then Minister for Health and the RCSI Hospitals Group were all aware of the grievous situation unfolding. All took some action, in time, but the fact is that we still do not know the full and unexpurgated truth about what happened at Dealgan House Nursing Home or in other care facilities.

Ultimately, many deaths later, in the context of Dealgan House Nursing Home, the RCSI Hospitals Group had to take operational control of the situation as it was so bad. This was an absolutely unprecedented move; a public hospital group taking full operational control of the management and operation of a private care facility. This is not normal in anyone's language.

In all our engagement with the HSE and the families, we still do not know with any certainty the threshold that was reached that prompted this unprecedented action. We need to know. Dealgan House Nursing Home is unique in that it was, and still is to the best of my knowledge, the only facility taken over by the State to ensure that the minimum standard of care could be provided to sick and vulnerable citizens when it could not provide the standard of care that was required and that should be demanded.

This demands our attention as lawmakers. It demand not just inquests from the coroner but a full commission of inquiry under the Act to shine a light and let the air in to get answers to the questions we all have, and ultimately, to understand what needs to change to make sure that what happened in Dealgan House Nursing Home will not be allowed to happen to anyone ever again, under any circumstances.

Nursing homes across the country are rightly concerned about the tapering of the temporary assistance payment. The decision to cut the level of financial support will have significant impacts on the money available to nursing homes that are still dealing with the impact and fallout of the Covid-19 crisis.

I note that in her closing remarks earlier, the Minister of State said, "The Department is continuing to look at options which may be available to the State to listen to the voices of those who have lost a loved one." In my view, that needs to be formal process. Absolutely, the voices of those who have been affected and those who lost loved ones need to be heard. That needs to be done formally and not by some kind of tokenistic exercise, well intentioned as it might be, to hear the stories of those who have lost loved ones. We need a full, formal investigation or commission of inquiry under the relevant Act to get to the bottom of what happened specifically in Dealgan House Nursing Home, and indeed, where the case arises elsewhere.

More than that, I believe the Minister of State will agree that we need a national conversation about elderly care. Older people have given much and continue to give much to our society. They have to be treated well and looked after. If this pandemic has taught us anything, it is that we need to flip the conversation on to how we can keep older people in their homes for longer.

We need to have a conversation about the model of care that is developed to look after the interests of older citizens into the future with dignity and confidence. It should be a respectful model of care with a range of different options they will have to choose from in terms of what works best for them and their families but primarily for them as citizens with rights whose dignity should be respected. That will mean investment in a public model of care.

What has happened over the past 20 years since the introduction of attractive tax breaks by the former Minister for Health and Children, Mary Harney, is that people with little interest in the care of older people, initially people who were working and investing in a range of different activities across this society and country, decided they would invest in private nursing homes. Effectively, the State co-opted out the care of our older citizens to these private companies, which by and large do not respect the rights of workers. We know about the low levels of pay and poor working conditions in the private nursing home sector and that it is particularly hostile to the organisation of trade unions, with which it should be working in the best interests of the staff and in developing good models of care for older people.

I am grateful for the opportunity to discuss this really important issue for many thousands of people across this country this afternoon. I look forward to the Minister coming forward as quickly as possible with proposals about how we can hear from the families in a formal way about their experiences. That should involve a formal commission of inquiry, specifically into the events in a nursing home in my constituency of Louth, namely, Dealgan House Nursing Home, but potentially widened out to other areas that also need the attention of this House to make sure we remember with dignity those who lost their lives and give them the dignity they deserve, and to make sure we can learn lessons about what happened over the last year or 18 months and apply them to developing a better, more inclusive and dignified model of care in the future.

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