Kieran O'Donnell (Limerick City, Fine Gael)

I thank all the Members. Some 40 Members spoke in this debate. People were very constructive. Like everyone else, I was shocked by the programme. It was wanton neglect and abuse. I thank the Members for their very constructive engagement.

I will attempt to cover the areas that people brought up. What we saw happening on the programme was pure wanton neglect and abuse of older people. It is as simple as that. We have to make the system better and more robust. How do we go about doing that? As HIQA itself has acknowledged, we have to look at whether the processes can be improved. Every system can be improved. That will involve looking at processes. There are things we can do like making reports in real time. At the moment, the reports that are published are historical. To make them up to date would be a very straightforward thing.

I also want to see the safeguarding legislation. The programme for Government commits to bringing a policy on safeguarding to Cabinet. That will include bringing forward safeguarding legislation. I am utterly committed to that. We are actively working on it. It is a priority for Government for the Minister, Deputy Carroll MacNeill, and I to bring it to Cabinet and to put it in place. We also have to look at how we regulate the groups. The parent companies are not regulated by HIQA. We need to change that. That is a procedural thing.

I will refer to something that came up in many of the contributions. What we saw in the two nursing homes on the "RTÉ Investigates" programme was horrific but, while I commend RTÉ on the programme, there are an awful lot of very good nursing homes out there. People are delivering a great service in their communities.

Sláintecare came out of the health committee. It was a cross-party document adopted by Government. It was about bringing care back to the home. The programme for Government commits to bringing forward statutory home care. It is a priority for me as Minister of State. The first step is bringing forward legislation on home care providers. Such providers are not currently regulated. Thereafter, we must look at how we define statutory home care and then put a statutory home care scheme in place. This is something I am passionate about and that we are very much committed to. It has come up repeatedly. People prefer to live in their homes if at all possible. Nevertheless, there will always be a requirement for long-term residential care. We have to ensure we have a system in place that is properly regulated and that ultimately provides good safe care to older people.

A couple of other points came across as well. At the moment, HIQA goes to the District Court to impose fines on providers. We are very open to giving HIQA the power to impose fines directly. These are matters we will look at. We are considering all aspects. HIQA is also doing a review itself.

Deputies Barry Ward and Máire Devine brought up two cases. I ask them to report those cases. If people are being abused, they should report those cases to HIQA and the relevant authorities and nothing less. I welcome that the subjects of the RTÉ investigations have been referred to An Garda Síochána. I expect that the chief inspector in HIQA will use the full powers available to him. We have to ensure that what happened to older people here can never happen again.

One of the key elements of statutory home care is home care hours. We have significantly increased the funding in recent years. We have virtually doubled it. However, I take the point with regard to delivering an enhanced service. I have met with the HSE directly to see how we can speed up the provision of service to people who are on waiting lists. That is very important.

One of the other features that came across was the design of nursing home settings. The Department of Health has a body of work under way on the design of nursing home settings. I very much wish to progress that.

Deputy Toole brought up the issue of safe staffing. Apart from the safeguarding, there is work ongoing in the Department with regard to a safe staffing framework. We are due a final report very shortly. I very much want to work on and expedite that because it is very important. With regard to safeguarding, the health (adult safeguarding) Bill is on the legislative programme. We want to progress that.

One of the other items that many speakers brought up was the provision of community nursing home beds. We are undertaking a capacity review in respect of public nursing home beds. The programme for Government commits to increasing the number of public nursing home beds. We are working through and finalising a capacity review. I want to enhance the provision of community nursing home beds the length and breadth of Ireland.

We will always have a mixture of community, voluntary and private homes. That is why regulation is so important. It is also highly important to note that there is a very good standard of nursing home care across all sectors. What we saw in the programme was the complete opposite.

It was pure neglect and abuse of older people. It is something that I feel very strongly about and that we cannot tolerate in any circumstance.

This has been very traumatic for the people in the two nursing homes and the wider nursing home body and the very good and dedicated staff and providers elsewhere. What has to come out of this is a stronger, more robust system. We have to look at HIQA's current powers in respect of the day-to-day operation of nursing homes. It has publicly acknowledged that we need to review the process. How can we improve the system such that what happened, and what we saw on the "RTÉ Investigates" programme, never ever happens again? That is something we are committed to as a Government.

Furthermore, we have an ageing population, as people have said. That is something we should celebrate. People are living longer, but with that comes challenges. The Government in the past year set up the commission on care for older people. That is chaired by Alan Barrett and is due to report. The first element of its report will be about the existing services and whether they can be improved. That will include the provision of nursing home care. I met with the commission some time ago. I very much want to see the report and the commission's recommendations. Once the commission on care reports, a cross-departmental group will be established under the auspices of the commission to consider whether supports for positive ageing across the life course are fit for purpose and to develop a cost implementation for options to optimise these supports. The commission on care has a key role to play.

Following the programme, I had engagement with HIQA and the HSE in terms of their safeguarding teams. They have been into both nursing homes and they will engage with all nursing homes throughout the group. They have put directors of nursing into both nursing homes. Ultimately, out of this absolutely terrible situation for people in both these nursing homes, the Residence in Port Laoise and Beneavin Manor, we want to get a better system in terms of the regulation of nursing homes to ensure that all older people, wherever they are in a nursing home, get a standard of care they deserve. It is something that in my role as Minister of State with responsibility for older people, along with the Minister, Jennifer Carroll MacNeill, we are determined to achieve, with Members' help.

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