Catherine Connolly (Galway West, Independent) | Oireachtas source

I welcome the opportunity provided by Sinn Féin to make a contribution on this. While I support the general thrust of the motion, I have difficulty with some of the calls that are set out in it. I realise that some nursing homes are struggling, without a doubt. There are additional costs, retention and recruitment problems, and a whole myriad of difficulties. I have read the PwC report.

However, I would like to place this in context. I have always deplored what I witnessed first-hand as I sat on a health forum for ten years of my life: the privatisation for profit of our home care service. If this was a start, and this is just a temporary thing - which I am not sure it is - I welcome that as one immediate step, with a view to reversing what the percentages are, because they are absolutely frightening. I look back at the Minister of State's previous comprehensive speech on 16 November 2022. The Minister of State pointed out that at that stage, it was 80%:20%. If we are to take the PwC report, the actual imbalance is even more. It is 84% private and voluntary, with only a tiny percentage of voluntary, mostly for profit, and less than 20% public. That is scandalous. I know the Minister of State agrees with me, and I know she is on record for doing that.

I am here tonight caught, in a sense, because - I say it publicly, and I welcome the people in the Gallery - I abhor a system of care that is based on profit. It has no role in the care of our elderly. That does not mean that there is not a place for small nursing homes. Absolutely, there is always a place for private nursing homes, but the model has to come from the Government, and it must provide the funds and the premises, and reverse this. This was done for an ideology that reduced everything and every type of care to products. It valued the products, but the care was never valued. That is not taking from the wonderful care provided in most of the nursing homes.

The Minister of State said in her last speech, which I appreciate, that the average size of private nursing homes is increasing year on year. She went on to say that the latest figures indicate that the top 15 private providers operate and own five or more nursing homes. These are no small providers. They are operating five or more, and they contribute approximately 40% of nursing home beds. I am quoting the Minister of State's own words here, as she has set it out. It has actually worsened since then.

While I support the call to take some immediate steps regarding the difficulties, I would like that to happen within a framework of reversing this trend. I very much endorse the amendments tabled by the Social Democrats with regard to recommendation 2 of the report of the Oireachtas committee that carried out a review into the impact of nursing home privatisation. They are absolutely essential, and urgently bring forward a statutory right to home care. I welcome that the Minister for Health, Deputy Stephen Donnelly, has set out that the commission of care will be established by the autumn.

What I am particularly worried about is that on the one hand, the Minister of State wants to reverse this trend - I want to work with her - but then on the ground, let us look in Clifden, where there is a promise of a new nursing home. It was to be for 50 beds, and mysteriously this became 40 beds at a time when all of these reports tell us that the population is increasing. Certainly, we are gone back to 40 beds. We have a nursing home in Carraroe. It just got the thumbs-up from HIQA today, and everything about the nursing home in Carraroe was endorsed, except one criterion that was "substantially compliant". That was with regard to care plans. I would have been stronger on that, but it said "substantially compliant". Otherwise, it got the thumbs up. There are seven or eight beds empty in that, within the declared capacity, and the actual capacity is, I believe, much higher. There was no explanation; nothing. HIQA gave it the thumbs up.

I remember years ago I had a petition. I only did two petitions in my life. One was for light rail, and the other was to keep a nursing home open, which was the St. Francis Nursing Home. On the very week that they closed the St. Francis Nursing Home in Galway, despite about 25,000 signatures - they kept the day care part open - there was an announcement from whatever entity the health board was called at that point saying that there was a shortage of public nursing home beds. That is the contradiction in terms that I am watching all of the time.

In my last minute, I will say that we need a completely different model, one that is not based on profit, or based on huge size. If the bigger companies are going for 150 and 200 beds, and the HSE side says, "We only need 40 beds in the brand-new home in Clifden", there is something awfully wrong with this model. Personally, I have no idea. The Minister of State recognises that the model was wrong. I believe it was led by the Progressive Democrats at the time, and the ideology was "private market is best". We know the value of products, but we do not know the value of care. If we are reversing that, I will stand with the Minister of State 100%. Absolutely, if that is what we are doing. However, I do not see a care plan here. I know from the recommendations that we discussed the week before last regarding care generally, that the strongest recommendation in the 13 - I say it was the strongest - was that we should fund more public home care and beds. I would like to see that happening with the plan.

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