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

This is a very important debate on which we must seize the opportunity to bring about change. The way older people are treated in our society is not great and has disimproved, not least as a result of what happened with Covid. We still await the announcement of the inquiry into the deaths of all those people, the majority of whom were aged over 65, who died of Covid, mostly in our nursing homes. A total of 37% of those deaths were deemed to be excess deaths, that is, deaths of people who would otherwise not have passed away. There is something wrong with the way we treat older people in our society and with the way they are cared for.

At the heart of this debate is a denial of an entitlement to care in a public nursing home, whereby persons who had that right had to go to a private nursing home to get their care, which they had to pay for. That is what happened. It was wrong and it should not have happened, but it did. The Government has to address that wrong, and I would support a proper and appropriate analysis over the next three months, which the Government is looking for, to ensure the correct decisions are now made.

A family were told to bring an umbrella as their relative died behind a glass window in a nursing home. Nine members of the family stood outside that window and saw their loved one pass away while nobody inside went to help that dying person. Twenty-three people died in Dealgan House nursing home, as the Minister well knows, given he met the families, but yet he has not yet agreed to a special inquiry into deaths in that home and other homes about which he has been notified. He has a lot of work to do, and I must say, I was not particularly impressed with what he said in his opening remarks.

This is an opportunity for the Minister to do what he said he would do and what I said I would do in supporting the Government in respect of the programme for Government. He needs to follow up on those commitments, one of which relates to keeping people out of nursing homes in the first instance. He needs to follow up on the home care system, which will keep people in their homes, looked after and cared for by people who are qualified and appropriately paid. It is time for him to appoint a commissioner for ageing, something Age Action Ireland is fighting for but which he has not conceded.

We need to fight ageism in our society because it is rampant, in this House and in other places. It can be seen in the way older people are treated in many places in our society. An independent commissioner would be in a position to vindicate the rights of older people, which nobody right now is doing. We need to vindicate the rights of older people in regard to housing, living in place, transport needs and dealing with illegal nursing home charges, which other Members mentioned and which the Government committed to removing for people who currently are being forced to pay them.

The Department of Health is doing nothing about that. A commissioner for ageing could look at commissioning independent research. It could look at the rights of older people over 65 years; advocate for older people; mediate in disputes; and do the research that is needed.

When will the Minister give more powers to HIQA to investigate individual complaints? Nursing home reports are full of references to complaints made by individuals which HIQA cannot follow up. Who is looking after these older people in cases where they are being abused? Who is vindicating their rights? It is time for the Minister to do that. It is not acceptable that the present situation can continue.

Dementia care is a huge issue. It is something everyone in society is aware of. We have hugely important community resources dedicated to looking after people with dementia. I would like to see a lot more of them and many more supports going into them. The housing adaptation grant is there to help people live in place. It is an annual allocation made through the Department of Housing, Local Government and Heritage. It is not always spent. The Minister needs to look again at the housing adaptation grant and to increase it exponentially and ensure that people who need their homes adjusted are able to live in place.

At the heart of all this is pressure on families and especially on older people. People have gone to court. The Attorney General has made a very fine professional argument but it does not matter how many lawyers, politicians or Ministers make arguments in fine and well-versed language. That does not get away from the fact we are not doing enough to help older people. There is an opportunity now to plan for transformational change in the coming three months and transform the services which exist for older people.

I want to speak up for those people who have had to go to court to fight for their legal right to take the challenges that had to be taken because the HSE, in the case I am aware of, will not vindicate their rights until forced to do so. On historic challenges, I will speak about a man - I will use his first name which was David - who died about nine years ago. He died in a ward in Cherry Orchard Hospital in appalling, shameful circumstances. He had a disability. It was not immediately before his death but during his care there that he was tied to a toilet and was found covered in his own faeces. He could not move. He was treated appallingly by some staff there. The recommendation from the HSE when it closed the AIDS unit he was in was that he would go to a special centre that care for people with the illness that he actually had. The HSE did not do that. It said it would not do that - we have the reference to that - but that he would be looked after in a ward for older people. That was totally inappropriate and wrong. He was treated appallingly. The family fought and I fought with along them. We had meetings with CEOs, acting heads and God knows who. Eventually, we got the HSE to agree that a doctor would carry out an inquiry. Unfortunately, the doctor had to resile from that work in the course of his investigations. Then they could not get any doctor in the whole of Ireland to look at this case for some strange reason. They were going to Scotland to get someone to do the inquiry but then got a private company of specialists in Ireland to carry out the inquiry into how David died. That inquiry vindicated what the family was saying. It vindicated in full that he was abused, that all his needs were not being met and that what happened to him was wrong. However, the HSE was not happy with that and it sought a further independent inquiry from the United Kingdom. That took place and it absolutely vindicated the family which had to go to litigation to fight for their rights. At the end of the day, there was a court case which took years. It was historic in that sense. This was because a person was abused. The family fought for their rights and they were put through hell to get there. Thankfully, the family has closure in that respect.

There are many problems outstanding in our nursing homes. Our bigger nursing homes are taking over. Smaller ones are closing. We have a duty to try to keep the smaller ones open. Many of the smaller ones are closing because they are in old buildings and they are fire hazards. I am talking about smaller homes of usually under 30 beds. If it is possible to keep them open the State could give them a low-interest rate loan to do the repairs or improvements that are needed. There could be co-operation between a number of smaller homes in different counties in the purchase of equipment and the provision of services. Many excellent staff in smaller nursing homes are leaving to go to bigger nursing homes. The reason is they get more pay and a bigger challenge. Were there to be some sort of involvement by the HSE, where it would appoint specialist people who would work in the public sector and provide services specifically to the smaller nursing homes, it would make a huge difference in keeping these homes open.

This Government has done many good things. The budget, in particular, improved the pension for older people, which is very welcome. The extension of the free fuel scheme to those under and over 70 years will benefit more than 80,000 people. Many good things have been done but much more needs to be done. In the coming three months, I suggest this is a key point to deliver on the promises that have been made.

When he concludes, I ask the Minister to update the House on how he will deal with the Covid inquiry. Will he agree to meet the Dealgan House residents again to update them? He is well aware of their situation. Will he comment on the issue of keeping smaller homes open, which is hugely important?

There are different figures for the money owed to these people, of between around €8 billion to €12 billion or whatever. Many of these people have passed, sadly, and are not with us. At this stage, I would like to see very significant investment and improvements in services for older people and to see us use the money wisely to fulfil the promises which the Minister made. We can work with Age Action Ireland, ALONE and other services to put implement the promises made but which need to be delivered. I understand the Minister's care commission may not commence until at least next year but that is too late. People want the commission of care now. They also want to see the promised improvements in the care of older people now.

The ombudsman for older people is the person who will vindicate the rights of all older citizens into the future. I ask the Minister to consider that as part of this package and make an immediate start on that. There is an ombudsman for older people in Wales and Northern Ireland and I understand the annual budget is €2 million. That is not a lot of money and it would make a huge difference in vindicating rights.

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