Dáil debates

Tuesday, 27 June 2023

Nursing Home Care: Motion [Private Members]

 

10:15 pm

Photo of David CullinaneDavid Cullinane (Waterford, Sinn Fein) | Oireachtas source

The Minister's contribution was disingenuous in the first instance. It was disappointing to many providers who are listening, and not just those in the Public Gallery, but many who are depending on the Government to act and to deal with the very real crisis that many of them face. It was also unnecessarily hostile in places given the motion does not criticise the Government at all and was, in fact, an earnest attempt on our part to ask and, indeed, to put pressure, rightly, on the Government to act to ensure sustainability.

The most recent HIQA this report in 2022 stated that there was a net reduction in the number of registered beds by 168. I just want to spell out a number of issues for the Government so that there is complete clarity on what I want to see and on how I see this sector growing and developing.If I was starting today, I would build more public capacity. I want a very ambitious public building programme introduced by the Minister of State with responsibility for older people, whose contribution, by the way, was much more conciliatory and focused on the solutions.

If the Minister was to announce 1,500 beds tomorrow, it would take three or four years to build them and even that would not be enough. The reality is that whether I, the Minister or anybody else in this Chamber likes it or not, we are dependent on private and voluntary providers to provide care for people that we love, and 80% of that capacity is in the private and voluntary sector. The vast majority of them provide this very good high-quality care.

References were made to HIQA. For many of these facilities, while the authority can be very challenging, these providers nonetheless understand that it has a job to set very high standards. When we set high standards, which we should, it comes at a cost. Costs are increasing because of regulation but they are also increasing because of increased food, energy and staffing costs. We have to deal with the reality of the here and now.

The Minister was engaged in a straw man argument in talking up the big institutional investors that are buying the smaller and family-run providers. That is happening but he said it did not happen on his watch. He has to ask himself who created the circumstances and the conditions to allow that to happen in the first place. It was not me. This Government, and successive Governments, have questions to answer there but we have to make the sector viable now.

Of course we have to increase public capacity and to do more with home care, but we have to make it viable now because far too many nursing homes are closing. There is no point in the Minister putting his head in the sand and hoping that this problem will go away because it will not. He is hearing first-hand what is being told with regard to the extent of the crisis.

The Ministers quite rightly spoke about the additional funding that was made available for PPE, oxygen and the temporary assistance payment scheme, TAPS, and the temporary inflation payment scheme, TIPS, all of which I welcomed. It must be borne in mind, however, that this was for the people who are resident in those homes. That is why the money was made available and, of course, it was a support for those who are providing the care as well but it was essentially for the residents.

Our motion calls for a collective pay agreement to ensure a living wage at the very least in that sector. I have made it very clear to private providers that if we are going to increase funding into the sector, and I would want to see increased funding for the National Treatment Purchase Fund, NTPF, to make the sector viable and to deal with the additional and rising costs; there has to be a quid pro quoin ensuring that there are fair wage levels. This is because one of the problems affecting the sector at the moment is that it cannot recruit and retain staff while competing with the HSE.

I have also proposed a review of the pricing mechanism that is archaic and does not work. It is for another year. We need a modern pricing mechanism that works. That is not what the Minister was talking about earlier when he was saying that we cannot interfere with individual pricing allocations. Nobody is saying that we should do that. We are saying that we must overhaul the overall pricing mechanism. Incidentally, if I was to do that, it would be done to retain those intergenerational family providers who are providing the best of care for older people in this State and to keep them in business. The final point I will make to the Minister-----

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