Paul McAuliffe (Dublin North-West, Fianna Fail)

Like many in the House, my heart was breaking when I watched the programme last Monday. The Beneavin nursing home is literally five minutes from where I live. There are neighbours and friends who have relatives in Beneavin nursing home. However difficult it was for any of us to watch the programme, I cannot imagine how difficult it was for them. I know many people could not bring themselves to watch the programme.

Having watched the programme, there is one area we have to call out very clearly, namely, those with direct responsibility for the neglect and lack of care. They are, in the first part, those people who carried out the acts. When someone is willing to close the door so his or her colleagues do not see that he or she is taking a shortcut, that person knows it is wrong. That person is closing the door. When people are filling out forms that are not correct, they know it is wrong and it is not professional for them to do so. There is a basic lack of decency and human compassion when this happens. There is a basic lack of supervision and management. When there are not sufficient supplies in a nursing home, including basic sheets and incontinence wear, there is a basic lack of management and procurement. The people who are responsible for this are directly responsible.

There is also a basic absence of culture. They say culture is the quickest form of management. Things can be acceptable and unacceptable. In organisations where culture is strong, things will be called out by work colleagues without a manager having to be in front of someone. It was very clear there was no ethos or culture of care in these nursing homes. I say this with great regret because I have been in them. I have seen the people being cared for. I had thought these places were good places for older people. Over the years, I have received many requests for people to get into the Beneavin nursing home because it was seen as a premium nursing home, accessible and providing care locally. This was because the HIQA reports were very positive for Beneavin, unlike Portlaoise. As a family who recently had a relative in nursing home care, I know HIQA reports are important to families when they are selecting a nursing home.

I spoke to a number of families this week, including those who had relatives directly on the broadcast, who were incredibly upset. I cannot tell the Minister of State how upset they were. There were families who were not featured in the broadcast who have great concern and have still received very few answers. There were also relatives who felt they had a positive experience in the home. I was very fearful of traumatising these people or opening up doubts in them, particularly the many people whose relatives had passed away. I spoke to three people this week who had concerns.

One of these was a lady called Christine, whose relative featured in the programme. I spoke to a lady called Patricia, whose relative had passed away but had made a complaint to HIQA last year with regard to Beneavin. I also spoke to a lady called Phil. Each touched on things that are broken in the system.

This week, HIQA provided a briefing for the three TDs in the constituency. It was a useful briefing that provided insight. It acknowledged additional powers and resources, which were given to it last year, and that the inspection report was based on an unannounced inspection. With some reassurance, HIQA announced that there had been two visits by six inspectors in the three Beneavin nursing homes over the last week, but it has not yet contacted the relatives, which is really important. There is no trust in the provider anymore. HIQA needs to step in and explain what it explained to the three local TDs this week. We did not get any sensitive GDPR-related information, but we had contact and an opportunity to question it. Families are entitled to that too.

HIQA pointed out a number of worrying concerns too. There appears to be no baseline staffing ratio, as there is in the acute setting. There is no baseline education or training requirement. In a childcare setting, there is. Why is that not in place in a senior setting? HIQA also pointed out an area which alarmed me, namely, that there are three separate legal entities on the Beneavin site, all of which are under Emeis, but the holding company, which owns multiple legal entity providers, is not accountable to HIQA. That is an area the Minister of State should be concerned about, particularly because the number of these have grown and there are large numbers of nursing homes under a single provider. We have to get around that issue.

I raise the amount of money going into these homes. The nursing home support scheme or fair deal scheme was a positive way of reducing the huge financial burden on many families. Families were paying thousands of euro, and the fair deal scheme prevented that. As a member of the Committee of Public Accounts, this is a procurement issue. We are procuring services from these providers. I understand that millions of euro was going into Beneavin alone every year. Somebody needs to stand over the delivery of that procurance. It is not about standards. Standards and HIQA are important, but if I am the customer procuring the service, I should also be responsible for ensuring that the service is delivered. There should be an independent standards authority. However, the HSE, the nursing home support scheme and, in essence, the Government, are the ones procuring this service. We have to make sure we are getting value for money. I am thinking of all those families.

The way we make this better is by improving what we have. I disagree with some Members of this House who said nothing has changed since Leas Cross. Any basic assessment of the framework would state that this is not true. We now have HIQA. As other Members have said, HIQA does much good work. The methodologies need to be examined. We need to talk more about the basic care and have a greater focus on it, but let us not run away from what happened here. An undercover camera captured what no inspector would ever see and captured behaviour that was effectively being hidden. The people directly responsible for carrying out those services, who manage those services and are paid to run those services are the ones responsible.

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