William Aird (Laois, Fine Gael)

I am here today following the disturbing revelations uncovered by the "RTÉ Investigates" programme concerning the residential nursing home in Portlaoise.

We must be absolutely clear that what was exposed was not just one failure in one private institution. Rather, it was a systemic failure of oversight, communication and, ultimately, duty. Frail and vulnerable old people were left in unacceptable conditions while warnings were ignored. Despite HIQA issuing poor reports over the past year, admissions to this facility continued. That raises immediate and serious questions. How many of these admissions came directly from local hospitals? Were local HSE managers, particularly community-based managers, aware of the severity of the situation? Why was there no communication between HIQA and the HSE? We must face a difficult truth. It appears the HSE has washed its hands of the responsibility of the clinical care of older people in private nursing homes. It appears that as soon as a person enters the private system, he or she vanishes from the radar of all public health infrastructure. That must end. We need to reassert HSE responsibility for the clinical care of all our older people in long-term care. The long-term care needs of older people must be overseen by the doctors and nurses in the HSE regardless of where they reside.

I wish to be clear that this is not an attack on the hardworking local staff working there, many of whom I know personally in Portlaoise. It is a call for structural change, which was already recommended by the Covid advisory group. At a national policy level, there are several immediate steps that must be taken. We must redouble our efforts to provide robust clinical oversight of the private nursing homes by the HSE and enact safeguarding legislation first proposed in 2017 without further delay. If a company director presides over neglect, he or she must be held accountable, up to and including criminal liability where appropriate. The safe staffing framework phase 3, which sets out the minimum staffing levels and skill mixes of nursing homes, must be implemented. The care of vulnerable older people should never be left to the mercy of profit-driven motives.

We must also rethink the infrastructure of residential care. Why are we still building massive institutional settings for older people when we have moved away from that model for people with disabilities or mental health conditions? The Department of Health has been sitting on draft design guidelines for smaller, homely, community-based nursing homes. These guidelines must be adopted and enforced. We must be honest about the consequences of continuing to favour large corporate homes. We must push for smaller community homes, which can be viable with proper supports. We must accelerate the introduction of the homecare legislation and the roll-out of the housing support grants. It is a must and needed immediately. The choice between limited home help and institutional care is not good enough. The Minister of State knows that. Older people deserve real options to live with dignity, independence and safety.

I have been a public representative in Portlaoise since 1979. When I was first elected, on my watch, we had the general hospital in Portlaoise, St. Vincent’s community nursing unit, Abbeyleix community nursing unit, St. Brigid’s hospital in Shaen and Mountmellick primary care centre. I have to say that I never received a complaint, not once. I served on the local health committee, the Laois health committee, the Laois and Offaly health committee and the Laois Offaly, Longford and Westmeath committee. I always say it - and I would say it if he was sitting where the Minister of State is sitting today - that the Taoiseach of this country did one of the greatest things in banning smoking in public places. The worst thing he did, which was worse, was disbanding the health boards. I was a member of the health board when he disbanded it. Everyone, of all political persuasions and none, who was on the health board that day said it was the worst decision ever made. What has happened ever since? We have gone downwards and downwards with crisis after crisis. We have another crisis here today. That is why I am asking the Minister of State to go back, exactly as he has said in the Chamber today, and relook, rethink and ensure our older people are looked after.

There are things we can do immediately. We can have a look at the homecare packages. We can do that with immediate effect. I know 99% of the people I have represented all my life always wanted to look after their parents in their own home. That is always the first thing. We can do that. I am pleading with the Minister of State to please act on this. None of us want to have to look at what we have seen on the television the other night again.

I wish to say one thing for all the Members’ attention. I was in attendance when the nursing home opened. If any Member would like to go to look at it, it is the most beautiful building, all decked out inside and everything. I never once thought I would come back and watch on television what was happening further up the corridor.

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