Duncan Smith (Dublin Fingal, Labour) | Oireachtas source

We too in the Labour Party welcome this Bill. Transparency in healthcare is vital so that we as legislators know the areas that need improvement and can take action more swiftly, when needed. Amending the Health Act 2007 to give the Chief Inspector of Social Services new powers and to make amendments to existing provisions relating to enforcement, and the collection, sharing and publication of key data on nursing homes and complaint processes will provide the transparency we need to make informed decisions. It is particularly important in the context of our ageing population.

Safeguarding our older persons is an important responsibility. The new powers provided to the chief inspector in the Bill, which include issuing compliance notices as a complement to other important powers of the Act, the ability to enter and inspect a premises that is unregistered if there are reasonable grounds to believe the business of a designated centre is being carried on in line with the existing provisions in the Act for the entry and inspection of registered centres and a reduction in timelines for existing important provisions initiated under section 51 of the Act to expedite enforcement actions, are all significant steps in the right direction for safeguarding. The new functions provided by the Bill for the chief inspector to collect key data on nursing homes, the sharing of the data with the Minister, HIQA and the HSE as appropriate, and the publication of this data at aggregate level can be an important push towards change in how the nursing home sector can be managed and resourced. The Bill also introduces new regulation-making powers for the Minister for Health to prescribe the arrangements for the collection, sharing and publication of the data. This creates the ability for the Minister and his Department to take part in the type of long-term planning the sector desperately needs. I hope the Minister will utilise this mechanism to its utmost.

I have broader concerns, however, that the Government has been found lacking in its support for our older citizens and that an agenda for divestment over investment in long-term care, which has been prevalent since it took office, has been extremely damaging. Older people deserve proper care, support and the ability to live a happy and fulfilled life. We absolutely need to ensure nursing homes our citizens go to are of a standard we would expect for ourselves, for any of our family members and indeed for any citizen. This is vital. However, in doing so we cannot ignore the huge public appetite for people to want to age in their own homes as has been revealed in numerous surveys and is apparent in Government policy. Along with this type of legislation, we also need the Government to improve and resource our home care policies and home care resources.

I am deeply concerned following the ESRI report released earlier this year that found that 15 large private groups now control 39% of the almost 32,000 nursing home beds in the country. Caring for our older citizens should not be a profit-driven machine. The ESRI report concluded that it is vital as the needs of an ageing populations grow and evolve that policies harmonise financial incentives for nursing home operators with resident's needs. It is really as simple as that

The Bill is important in that the powers given to the Chief Inspector of Social Services point in the right direction. These types of measures are aimed at protecting residents and, of course, staff in nursing homes.

There is a huge problem with the number of nursing homes that have been coalesced into these large private groups. I have spoken about this many times, including on national media. The industry will say it that does not matter what the name is above the door but for me it does. The outsourcing and privatisation of our nursing home sector is not something that should expand. We need to see it rolled back and see greater State ownership and involvement. While I welcome the provisions of this Bill to improve regulation we need to see greater steps in the provision of new nursing home beds and nursing home care from the State. The State has the responsibility to prioritise the well-being of our older people. These individuals have contributed their entire lives to our society and deserve proper care. That is why we need to invest rather than divest, not only in nursing homes but also in our home care workers.

There are concrete steps to be taken alongside this legislation to ensure our older citizens are being looked after such as making working in a nursing home a more attractive job prospect for young people and young workers, ensuring better pay, conditions and clear career progression. The Labour Party is also calling for the appointment and resourcing of a commissioner for older people and ageing to address the urgent needs of our older citizens.

I have touched more generally on what has happened with regard to the privatisation of the sector more widely. It has led to increased problems with no continuity of care or indeed continuity of home care. We also have yet to see the delivery of a statutory right to care, which the Government promised. This is extremely important. The Bill relates to nursing homes but we have situations in the home care sector where an individual will have to have providers changed on them and the previous provider will provide list of things that will be done in terms of care in the home but when that individual gets a new provider, the list changes because there is not a statutory right to care and it is ultimately down to providers to state what element of care they will provide. It is quite frankly something that cannot continue.

I previously welcomed that the commission on care has finally commenced, which is important, but there are issues right now.

More importantly, they have been evident in the current model of care for a long time. There is an opportunity to make real progress in the sector, with a Government that is willing to make not only the right decisions, but also decisive ones. If we get statutory home care right and remove the policies of divestment and instead invest all across our care sector, including in nursing homes, together with a number of smaller facilities, we can bring more balance to the healthcare system. By doing so, we would take pressure off the hospitals that are beyond tipping point at this stage.

The Bill amends the Nursing Home Support Scheme Act 2009, which established the nursing support scheme under which financial support is provided to those availing of long-term residential care needs. The Bill changes the definition of those eligible to be considered as a family successor to a family farm or productive business assets to include cousins, great-nephews and great-nieces and great-grandchildren. This is something we need to examine further, in terms of the implications of these provisions. There are positive steps in the Bill and I hope better transparency and accountability will stem from it. The Government needs to do better more broadly regarding care for our older citizens.

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