Pádraig Rice (Cork South-Central, Social Democrats)

The "RTÉ Investigates" programme was shocking, disturbing and difficult viewing. Nobody in this country should be treated in that way. It is clear that the nursing homes in question were understaffed and under-resourced and patients were treated in an appalling manner.

What concerns me and many of us is that this is a repeat of the scandals of the past. What we are seeing is history repeating itself. We saw Leas Cross 20 years ago. Deputies have set out previous scandals. Time and time again we have had failure after failure. I wonder what lessons have been learned. I have absolutely no doubt we will be back here again talking about another scandal because there has been a lack of action for decades on these issues.

HIQA, which was set up in response to Leas Cross, has serious questions to answer on the credibility of its inspection reports. We need to review the powers and operation of HIQA and how and when inspections take place. It was clear from the RTÉ programme that a lot of issues happen at night, and there are questions about whether HIQA carries out inspections at night. That needs to be examined. HIQA needs to examine the minimum staffing requirements and put regulations and rules in place so that nursing homes are well staffed and resourced.

Ultimately, we have an issue with the model of care. There are serious issues with the for-profit model of elder care. International research shows us that there are worse outcomes compared with public and not-for-profit care homes. Over the past 35 years, in Ireland we have had an explosion of the for-profit nursing home care model. In 1990, 32% of nursing homes were private. By 2023, the figure was 81%. There has been a real shift. These are policy and Government decisions to shift from a public and not-for-profit model to a privatised model that is leading to poor outcomes for people.

Across the country,smaller and community based nursing homes have closed in villages and towns across the country. There are ten large investment funds which hold one third of nursing homes and, therefore, a huge amount of control over nursing homes in the State. In 2020, Leo Varadkar and the Tánaiste, Deputy Simon Harris, said that the model had to change. What has changed in the past four years? We now have the most privatised nursing home sector in all of Europe.

There have long been calls for safeguarding legislation. A Private Members' Bill was introduced in the Seanad in 2017, some eight years ago. There were calls for better protections for vulnerable adults. In the meantime, the Law Reform Commission has published a report. Absolutely nothing has happened. There has been a failure on behalf of the Government to legislate, put basic protections in place and protect the most vulnerable adults. The HSE has a safeguarding policy, but that does not apply to private nursing homes. HSE social workers do not have the right to enter private nursing homes, an absolute scandal that needs to change. The Minister of State and Government have the power to make that change. The Government controls the legislative agenda and has the power to pass safeguarding legislation. We have waited far too long. There has been report after report on adult safeguarding and all of the other issues that need to change stacking up in the Department .

Ultimately, most older people want to remain in their home, and we know that. The Tánaiste, Deputy Simon Harris, said in 2017 that he would put this on a statutory footing. It was incredibly frustrating to listen to him say in the Dáil earlier that he is committed to putting legislation on a statutory footing, when he committed to it when he was Minister for Health in 2017. What kind of commitment is it if it takes eight years to do the very basics around home care?

We need a right to, and the regulation and funding of, home care. It seems to me that nothing is happening. As a result, we have the privatisation of nursing home care and people being moved towards nursing homes as the default because the home care system is not properly regulated or resourced and there is no rights-based approach, something which needs to change. In this House, we are constantly talking about productivity in other parts of our State. We need more productivity in this Parliament. We need legislation to be passed. We need a right to home care. We need safeguarding legislation.

I call on the Minister of State to give us a timeline and commitments today on when that key legislation will be passed. It is within the power of the Government to make the fundamental changes that would make a real difference and prevent these scandals happening again.

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