Marie Sherlock (Dublin Central, Labour)

My thoughts are also with the loved ones of those on the flight from Ahmedabad to England. I have friends in Ahmedabad and we are very worried about them today. I also offer condolences on behalf of the Labour Party to Deputy Conway-Walsh on the loss of her mother.

One of the most difficult decisions a family will ever have to take is to put a loved one into a nursing home. This decision places enormous trust in strangers to treat that older person with the respect and dignity they deserve in the final years of their life. The brilliant investigative journalism by RTÉ last week showed very distressing scenes in Glasnevin and Portlaoise. In the week since then, all of the focus has been on the very serious failures in HIQA.

There are some good nursing homes out there, just as there are some good people in HIQA. What really worries me now is that the Government somehow believes that if HIQA tries harder, and if the adult safeguarding legislation is brought in to investigate individual complaints after those instances happen, then all will be fine. However, it will not. There are big questions for the Government now about the type of care we want for our older people in this country. Do we want a nursing home system where there is no minimum staffing level? These standards exist in the North and in other countries but they do not exist here. HIQA provides no guidance to nursing homes on safe staffing levels. Will providers whose chief motivation is profit, and there are many of them out there, ensure they have the right number of nurses and healthcare assistants on their premises? They will not.

The PWC report on nursing home staff in 2023 found the staff turnover of healthcare assistants in private nursing homes was as high as 54% in 2022. Even the childcare sector does not have staff turnover figures as high as that. Sitting in the Department of Health since 2022 is a report by a task force put together by the Department which recommends a living wage for all public and private sector nursing home staff. It recommends consideration of a pay agreement for the sector along with other important changes. What has happened since then? Nothing. Many of those workers are still on the minimum wage. Some providers are failing to pay the work permit minimums according to reports I am getting and there is huge frustration among the workers at being forced to work extremely long hours in the sector.

I have to ask the Tánaiste whether he is comfortable that the nursing home sector has become dominated by big business in Ireland. Is he comfortable with the fact that those to whom we are entrusting the care of our people are increasingly dominated by big business? Yesterday my party leader Deputy Bacik spoke of ten investment funds owning one third of all nursing home beds in Ireland. We know from the ESRI research that 20% of smaller private nursing homes closed between 2020 and 2022. We are seeing the growth of nursing homes driven by private equity-owned operators. The reality is that many are owned by what are called "opcos". REITs, which pay no tax, have separate entities to operate them known as "opcos". The reality is that smaller nursing homes are being crowded out. Does the Tánaiste want workers to be properly resourced, to be paid decently and to work in conditions in which they can provide the best possible care? Will he implement the recommendations of the 2022 report? Will he commit to the State playing a leading role in developing residential long-term care alongside smaller private nursing homes in this country?

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