Marian Harkin (Sligo-Leitrim, Independent) | Oireachtas source

This motion from Sinn Féin, which I fully support, calls for a full public inquiry into the deaths of residents and the quality of care in nursing homes during the Covid-19 pandemic. The purpose of any public inquiry is to establish the facts in regard to the specific circumstances. Those circumstances include the fact that more than 2,000 nursing home residents have died due to Covid-19. That means more than 40% of Covid-19 related deaths occurred in nursing homes.

Those facts, along with the many different media exposés of totally inadequate care, neglect and, in some cases, abuse of residents, certainly make the case for a public inquiry. We must establish the facts. We must look at the context and evaluate the role of the many actors involved in the care of people in nursing homes. That includes the HSE and its response. It includes the management and staff of nursing homes. It also includes the supports that were provided or not provided by the various State actors. It includes the role of HIQA.

It includes the role of hospitals in discharging persons back to nursing homes and-or the protocols around patients from nursing homes with Covid-19 accessing acute hospital services.

I wish to clearly state that I am not pointing the finger of blame at any group, sector or individual. The purpose of a public inquiry would be to establish responsibility. It would not be to prejudge or make assumptions about the public or private sector, but to consider the evidence and only then arrive at conclusions. Having held such an inquiry, we would then need to put legislation in place to ensure proper adult safeguarding. All residents should have direct access to safeguarding social work services and all primary care services. I agree with the report, which states that HIQA must be empowered to oversee and enforce safeguarding legislation. There also needs to be a legal right of entry and powers of investigation for the appropriate authorities.

Care Champions have reported more than 500 serious safeguarding concerns in nursing homes over the past 14 months. They emphasise that not all nursing homes are negligent, but some are, and that is what we are highlighting tonight. I have received substantial documentation from bereaved families of the Ballynoe nursing home United for Justice group. They outline their key concerns, of which there are many, including a lack of infection control, serious neglect of residents, a lack of adequately trained staff and minimal communication with families during the Covid outbreak. In truth, it is hard to read, but for the residents and their families, it was a terrible time. Perhaps the most powerful point in the documentation that the group sent to me is where the families say that a public inquiry and HIQA investigation would not just be for them, but for the other families around Ireland who were looking for answers. It is also needed for the safety and well-being of nursing home residents in future.

Another important element of this motion is how it would place long-term residential care facility visitation guidance - I emphasise the word "guidance" - on a statutory footing and give interim authority to HIQA to enforce it.

Of all the emails about Covid that I received as a public representative during the pandemic, the most heart-rending were from family members who could not visit for months on end and, in some cases, whose loved ones died as they watched through the windows. I am not minimising the challenges faced by those who manage nursing homes. Those challenges were significant and, in some cases, it was a matter of life and death. However, if we had visitation guidance - I again emphasise "guidance", not definitive rules and requirements, as we could not have those - on a statutory footing, there would be some clarity. It would take some of the awful responsibility off the shoulders of management at some nursing homes.

For all of us receiving emails and phone calls, the pain, grief and unanswered questions of so many families cannot be ignored. This motion contains many proposals that would help to answer a number of those questions. It contains other proposals that, if implemented, would help to safeguard some of our most vulnerable people in long-term care.

Before I finish, I wish to emphasise that many nursing homes and staff gave their all during the pandemic. They left no stone unturned in trying to protect their residents - their families, which is how they viewed them. I spoke to many of them during the pandemic as they struggled to ensure the best possible outcomes, be that through sourcing proper PPE or ensuring sufficient staffing levels. Many Deputies have spoken about the challenges nursing homes faced in this regard. People also tried to ensure access to acute hospital care where needed. Many staff and managers had sleepless nights and long days while trying to manage during the pandemic. Very few people in this Chamber would want to exchange places with them, given what they went through day in and day out. Tonight, we are speaking in a wider context and of the need for a public inquiry and subsequent legislation where appropriate, but it is important to recognise the reality of what happened, the good with the bad and the bad with the good.

I have raised the issue of the discontinuation of the temporary assistance payment scheme, TAPS, to nursing homes. As the Ministers of State will be aware, every cent that is spent is itemised and accounted for. In my view and that of many in the nursing home sector, that money is still necessary in order to continue protecting residents and workers.

We are still awaiting a report on the proper funding of nursing homes. It is essential, as we cannot deal with one part of the problem while ignoring the rest. Nursing homes need to be resourced properly. The Covid-19 pandemic has cruelly exposed the fact that some need urgent investment. In the context of this debate, though, I support the call for a public inquiry while recognising the significant efforts made by many to protect our vulnerable people in nursing homes.

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