Alan Dillon (Mayo, Fine Gael) | Oireachtas source

I thank the Minister for Health, Deputy Donnelly, for the opportunity to speak on this issue, which has raised some really complex matters. The debate refers to people who really require access to care. They are some of the most vulnerable people in our society. My main concern is that these issues have been ongoing since first reported by the Office of the Attorney General in 2004. The high cost of nursing home care was highlighted at the time along with the lack of transparency in the pricing and payment systems. It also highlights the significant difference between the costs of different nursing homes with some charging significantly more than others for the same types of services. As a result of legal action taken at that time, public nursing home charges were stopped and funds could not be reclaimed until the President refused to sign the new legislation. At that stage a redress scheme was put in place for the repayment of public nursing home charges. The report at that time noted there were difficulties for older persons in securing funding for their care, with many having to sell their homes or use personal assets for their care. Where was the Department of Health in terms of its duty to our citizens?

Despite the introduction of a number of measures, including the fair deal scheme, many nursing homes continue to be criticised for the lack of transparency when it comes to their fees and charges. Some families are reporting that they were unable to get the full extent of the costs until it was too late. Issues remain with the pricing framework, which is based on guidelines, including for the variation in the costs of care and services between different nursing homes. This needs to be addressed. Concerns continue to be raised about the quality care in nursing homes and the question of increased regulation of the industry to ensure residents receive high-quality care. This needs to be investigated further. Staffing levels also continue to be an area of focus in nursing homes when it comes to the provision of adequate care in this area. For example, are we introducing minimum staffing levels to ensure residents receive proper care?

Issues were also raised within the Attorney General's report that highlight the need for increased oversight and regulation in nursing homes, as well as increased transparency and accountability in billing practice. The report also highlights the need for greater transparency for our elderly and families in the context of care homes, and especially those families who have limited financial resources.

The impact of Covid-19 has been particularly difficult for older people and recent reports have demonstrated this. It has been very challenging for those who live on their own and those who reside in nursing homes. Learning from this, the Government needs to assess how we care for older people and examine alternatives to meet the diverse needs of our older citizens. I ask that we would move swiftly with the establishment of the commission to examine care and supports for elderly people to ensure that this is not delayed any further and to continue to demonstrate our seriousness about protecting our most vulnerable people.

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