Dáil debates

Tuesday, 21 June 2005

4:00 pm

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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Three weeks ago today, on 31 May, we discussed the Leas Cross nursing home and the unacceptable practices that the "Prime Time" television programme exposed there. Today we read that the Health Service Executive is to move all public patients out of Leas Cross and have the nursing home closed. Such a level of activity on the part of the Health Service Executive since the "Prime Time" programme is welcome. However, it cannot disguise the failure of the health authorities to act sooner regarding the home in question. The Eastern Health Board report on Leas Cross of 2 June 2004 — more than a year ago — which my colleague, Deputy O'Dowd, has obtained under the Freedom of Information Act, makes it clear that a consultant's report on Leas Cross was awaited and that future registration of that nursing home would depend on the findings of that report. The report in question was by Mr. Martin Hynes and was commissioned following the death of Mr. Peter McKenna, who was transferred to Leas Cross from St. Michael's House.

At Leaders' Questions on 1 June, Deputy Rabbitte suggested to the Taoiseach that he should make himself aware of the McKenna case. In a newspaper article on 7 June this year, the following was said about the late Peter McKenna.

He'd had a recent stroke. He was blind. And he couldn't communicate. The bottom half of his body was blackened as a result of blood poisoning. When he had arrived in Beaumont Hospital earlier that evening they discovered that he was completely dehydrated. Those supposed to be caring for him hadn't even had the wit to see that he was in terrible thirst.

It went on to say:

When he died, a fortnight later, the catheter was still there, untended, untreated, uncleaned. Almost certainly, it was the failure to deal properly with the catheter that caused the blood poisoning that brought him to die in pain.

Can the Taoiseach confirm that the Hynes report was received by the health authorities last autumn? Can he confirm that the draft report raised serious questions about the level of care in Leas Cross and also drew attention to the unusually high number of deaths of patients transferred to that nursing home from a nearby psychiatric facility? Can he confirm that Mr. Hynes's final report is very critical of the way that the health authorities inspected Leas Cross? Will he undertake to publish the Hynes report immediately?

Photo of Bertie AhernBertie Ahern (Dublin Central, Fianna Fail)
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I will deal with those issues first. I understand that the report was received by the health authorities last autumn and that it was very critical and raised serious issues. All those points that the Deputy has raised are correct.

On the first part of the Deputy's question, I repeat the Government's concern at the situation in the Leas Cross nursing home. The nursing home has been monitored by Health Service Executive staff during the last three weeks, as it was in the period prior to that. The primary concern remains patient safety and the level and standards of care. The HSE has therefore decided to move the public patients and those in receipt of subvention out of Leas Cross nursing home. The executive will consult relatives concerning the movement of patients from the home and will take into account the needs of individual patients. Relatives have their concerns which they have been expressing on the airwaves as well as to the HSE.

The executive will consult private patients in the home on its concerns regarding patient safety, the overall level of patient care and the need for alternative arrangements. The decision to move the patients has been taken following a detailed assessment by the HSE since the time I last reported to the House on this matter. This detailed assessment of the care situation took place over recent weeks and was carried out by a dedicated team, including a geriatrician. That is why the executive has made this decision and is considering action to take the nursing home off the register.

While I understand the points made by the Deputy are correct, I cannot answer his question about the publication of the report. We must take legal advice in this regard. The HSE is taking immediate steps to evaluate the current inspection procedures to ensure there will be a national approach to these issues. A review has already commenced in the eastern region and that will be included in the national process.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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In his Ard-Fheis speech two years ago, the Taoiseach said in respect of those who would put their own interests before the national interest that he would see to it that his Government would use all its power to put the people first. On 1 June, the Taoiseach told the House, "the problem in the Leas Cross case was not a lack of inspections". Are we to understand that the nursing home management was notified of inspections to take place? If there were adequate inspections, why did they not uncover the gross incompetence and appalling behaviour at this nursing home? Why did we have to wait for a "Prime Time" report to have this information published nationally? What does the Hynes report say about these inspections?

The Taoiseach's response in this matter has been to again engage in what has become the mantra for this Government of hand wringing and excuses. Nobody stands up, nobody takes responsibility and nobody is to blame because nobody cares. The complacency and arrogance that have crept into the Government will not wash anymore.

If the Taoiseach believes the Government is in a position to look after the elderly and that it wants them, in many cases, to have the facility to stay in their homes rather than be obliged to go to institutions, why is it that in response to a Dáil question in April last year to Deputy Neville, the then Minister for Health and Children said that 8.8 million hours of home help were provided in 2003 but the HSE's recent national plan makes it clear that only 6.9 million were provided last year and the same for this year? This is an appalling scandal.

Does the Taoiseach agree that the ship of State he is guiding is holed below the plimsoll line and is sinking fast? This type of ineptitude, incompetence, arrogance and uncaring attitude will ultimately bring about his demise at the hands of the people.

Deputies:

Hear, hear.

Photo of Bertie AhernBertie Ahern (Dublin Central, Fianna Fail)
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To take an individual case and build from that, as Deputy Kenny is doing, is an unfair way to portray the health system. I will not get into that. As I said previously, there was a procedure of inspection in place at Leas Cross. I have already explained to the House how those inspections were done. I explained that notice was given when inspections were not of a medical or nursing nature but were to do with the governance of the nursing home. However, this was not the case in respect of many of the inspections that took place. The staff at Leas Cross believe the nursing home management was listening to and taking account of what they were saying. The Hynes report was concerned with an individual case.

Notwithstanding all that, many people in Leas Cross are now upset that the HSE believes they should be moved because it cannot stand over the care issue. This is the right action for the executive to take from a medical point of view and based on a geriatrician's report. I am not qualified or competent to undertake inspections. The HSE has ground rules in place for the conduct of inspections and I am not sure what is the Deputy's point in this regard.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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Will the Taoiseach publish the report?

Photo of Bertie AhernBertie Ahern (Dublin Central, Fianna Fail)
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I have already said that I do not have any difficulty with the report being published if it is legally permissible to do so, but it is a legal issue.

I have already pointed out many times, as the Tánaiste has, that the health inspectorate legislation is in place for governing a properly resourced health inspectorate, for both private and general nursing homes. There are significant numbers of patients in both private and public nursing homes who are being well cared for, well monitored and well assessed. The scare tactic of focusing on one case and trying to frighten all elderly people is unacceptable. Where there is a problem, there are competent staff who do their utmost to ensure the highest standards are maintained. That is the way to deal with these issues.

Photo of Pat RabbittePat Rabbitte (Dublin South West, Labour)
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I want to return to the matter of Garda conduct in Donegal and the Carty report which was completed and submitted in July 2000. This was a report by a senior policeman into the awful, appalling, unbelievable and bizarre allegations surrounding the conduct and performance of the Garda in Donegal.

In November 2001, the Government voted down a joint motion in the name of my Labour Party colleague, Deputy Howlin, and former Deputy Jim Higgins of Fine Gael seeking an inquiry into what was going on in Donegal. Last Friday, we learned from the Minister for Justice, Equality and Law Reform, Deputy McDowell, that the Taoiseach did not have the Carty report. He said the then Minister for Justice, Equality and Law Reform, Deputy O'Donoghue, and he, as Attorney General, did not get the report until January or February 2002. This is the same man who tried to say that Nora Owen and the rainbow coalition were responsible for what happened in Donegal. He now says he and the then Minister did not get the report until the beginning of 2002.

In February 2001, when Deputy Howlin tabled a question expressly on the Carty report and its findings and what he intended to do with it, the Minister, Deputy O'Donoghue, led him to believe that he had received the Carty report and that, by extension, it did not bear out the character of allegations being made about Garda activities in Donegal. The import of the then Minister's statement meant he not only misled the House but that he communicated, as a result of giving the impression he had the Carty report and was taking no action, that the allegations were baseless or exaggerated. Will the Taoiseach defend the actions of the then Minister for Justice, Equality and Law Reform?

Photo of Pádraic McCormackPádraic McCormack (Galway West, Fine Gael)
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Will it be a policy of zero tolerance?

Photo of Pat RabbittePat Rabbitte (Dublin South West, Labour)
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Will the Taoiseach say the Minister similarly misled him and the Cabinet at the time, that he had the Carty report in his possession and that it did not bear out the grave character of allegations of abuse and dereliction of duty of the Garda in Donegal?

Photo of Bertie AhernBertie Ahern (Dublin Central, Fianna Fail)
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I do not know when the Minister, Deputy O'Donoghue, got the report.

Photo of Pat RabbittePat Rabbitte (Dublin South West, Labour)
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The Minister, Deputy McDowell, gave us that information on Friday.

Photo of Bertie AhernBertie Ahern (Dublin Central, Fianna Fail)
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I did not read the contents of the report——

Photo of Pat RabbittePat Rabbitte (Dublin South West, Labour)
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There is no way one could read everything the Minister says but he told us on Friday——

Photo of Rory O'HanlonRory O'Hanlon (Cavan-Monaghan, Ceann Comhairle)
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The Taoiseach should be allowed to continue without interruption.

Photo of Bertie AhernBertie Ahern (Dublin Central, Fianna Fail)
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I will not rehearse the details of last week's debate. I will answer questions with regard to when the Minister got the report and who acted on the report but I will not attempt, off the top of my head, to discuss the details of when the report was passed over. It is impossible for me to do so.

Photo of Brendan HowlinBrendan Howlin (Wexford, Labour)
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No answers, that never happened before.

Photo of Pat RabbittePat Rabbitte (Dublin South West, Labour)
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It is a first that the Taoiseach can think of no defence.

Photo of Bertie AhernBertie Ahern (Dublin Central, Fianna Fail)
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I am not going to try to answer.

Photo of Pat RabbittePat Rabbitte (Dublin South West, Labour)
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Either the Minister, Deputy McDowell, is telling this House an untruth or the Minister, Deputy O'Donoghue, told this House an untruth regarding a grave matter which goes to the cornerstone of our democracy. I ask the Taoiseach as head of the Government to answer the question. I put it to him that both Ministers are now being untruthful, that the Government possessed the Carty report and that the Government is doing what Deputy Martin when Minister for Education and Science did by dumping on the senior Garda authorities because it needed to provide a fig leaf as to why it resisted an inquiry into Donegal. It had the report, minus the appendices, all along. The appendices comprised the witness statements but the substantial conclusions of the inspector which were submitted to the Minister for Justice, Equality and Law Reform bore out the gravity of the allegations with regard to Donegal. As Minister for Justice, Equality and Law Reform, Deputy O'Donoghue sat on it and covered up and used it in this House as and when it suited him. The Government voted down the request from this side of the House for a joint motion on an investigation into the events in Donegal.

The current Minister for Justice, Equality and Law Reform has the cheek to allege inside and outside this House and on radio that, somehow, those whose knees were under the Cabinet table of the rainbow Government were responsible. He gets away with this in some sections of the media. It is almost beyond belief that the man who says he did not receive the report until 2002 can say his predecessor in office from 1994 to 1997 was responsible. It is disgraceful. If former Minister for Justice, Ms Nora Owen, was implicated in this manner and the Taoiseach and his colleagues were on this side of the House they would hound her to resign. It is a disgraceful dereliction of duty. The Government did not anticipate that Mr. Justice Morris would get to the bottom of the matter.

Photo of Bertie AhernBertie Ahern (Dublin Central, Fianna Fail)
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As I said, I am not going to get into the issue. If they did not do so last week, both Ministers are capable of answering the question of when they had the report. I am not going to speculate on that. Deputy Rabbitte knows——

Paul McGrath (Westmeath, Fine Gael)
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The Taoiseach could ask them.

Photo of Brendan HowlinBrendan Howlin (Wexford, Labour)
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Two versions of it were on the record.

Photo of Rory O'HanlonRory O'Hanlon (Cavan-Monaghan, Ceann Comhairle)
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Allow the Taoiseach without interruption.

Photo of Bertie AhernBertie Ahern (Dublin Central, Fianna Fail)
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——that for several years, complaints were heard in the Department of Justice about events in Donegal.

Photo of Pat RabbittePat Rabbitte (Dublin South West, Labour)
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It did not have an official report from the Garda.

Photo of Emmet StaggEmmet Stagg (Kildare North, Labour)
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The Government still voted against it.

Photo of Bertie AhernBertie Ahern (Dublin Central, Fianna Fail)
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Several complaints were made over the period. The Ministers have given chapter and verse. I will not discuss when it began. Deputy Rabbitte is aware that it continued for a long time. The 160 complaints which are now the subject of litigation and the Morris tribunal did not commence on a particular date, as the Deputy would like to put on the record. The point, however, is that this Government established the Morris tribunal.

Paul McGrath (Westmeath, Fine Gael)
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As well as the Flood tribunal.

Photo of Pat RabbittePat Rabbitte (Dublin South West, Labour)
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The Taoiseach should not be talking rubbish.

Photo of Bertie AhernBertie Ahern (Dublin Central, Fianna Fail)
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The Opposition, while in Government, had an opportunity to establish whatever tribunal it wanted. It did not do so. Deputy Rabbitte is aware of this. Allegations and complaints were made.

Photo of Brendan HowlinBrendan Howlin (Wexford, Labour)
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The sworn evidence of Secretaries General is being contradicted.

Photo of Rory O'HanlonRory O'Hanlon (Cavan-Monaghan, Ceann Comhairle)
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I remind Deputy Howlin that his leader is entitled to hear an answer to his question without interruption.

Photo of Bertie AhernBertie Ahern (Dublin Central, Fianna Fail)
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Deputy Howlin has an interest in this matter because he has been involved in it all the way. He can use another occasion to make his speech. The fact is——

Photo of Pat RabbittePat Rabbitte (Dublin South West, Labour)
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The people of Donegal have suffered enough.

Photo of Bertie AhernBertie Ahern (Dublin Central, Fianna Fail)
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——that this Government established the Morris tribunal and has done everything to unearth and act upon all the difficulties in the Garda Síochána in Donegal.

Photo of Brendan HowlinBrendan Howlin (Wexford, Labour)
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The Government did nothing.

Photo of Rory O'HanlonRory O'Hanlon (Cavan-Monaghan, Ceann Comhairle)
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The Taoiseach without interruption.

Photo of Bertie AhernBertie Ahern (Dublin Central, Fianna Fail)
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One cannot move away from that. Questions may be asked in terms of files or dates but this Government has acted on the issue and made the credible and necessary decisions.

Photo of Pat RabbittePat Rabbitte (Dublin South West, Labour)
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It certainly did not take on board any of the recommendations.

Photo of Bertie AhernBertie Ahern (Dublin Central, Fianna Fail)
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The Government is legislating, based on both Morris reports, to ensure these events are not repeated. That is a fact.

Photo of Joe HigginsJoe Higgins (Dublin West, Socialist Party)
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Reports on the recent High Court judgment concerning the future care of the autistic teenager, Lewis O'Carolan, highlighted the intense suffering of his parents, his own difficult position and implications for the parents of other children in similar circumstances. They also highlighted the need for specialised intervention at this stage of Lewis's life. The acuteness of his behavioural problems arose because of the unavailability at an earlier stage of appropriate intervention and training which could have radically modified the severity of his behavioural problems, thereby making life much easier on his parents and him.

High Court cases have been taken because the State has failed parents in these difficult circumstances. However, the High Court opinion that an offer of a place in the Woodlawn facility in north Dublin was objectively adequate does not meet the urgency of Lewis's situation. Appropriate intervention is needed and is a different matter. The only appropriate facility with the capacity to remediate the earlier inadequate facilities provided in this State is in Bangor, Wales.

Independent Deputies met the O'Carolan family and experts in autism to discuss the situation in depth. Deputy Gregory has assisted the family for a number of years and is well acquainted with the matter. We ask the Taoiseach that the State short circuit the long history of this family's difficulties and make the funding available for Mr. O'Carolan to attend the Bangor centre. The family has announced that it and its supporters intend to embark on a fundraising campaign to ensure he attends the centre. It would be obscene for a family in this situation to be forced to travel the highways and byways.

Last week, I heard in the Committee of Public Accounts that €250,000 per year is required to cater for young offenders in five of the facilities belonging to the Department of Education and Science. These are necessary facilities. However, it would cost less to cater for a child in Bangor. I ask the Taoiseach to step in and determine whether the funding may be provided. Approximately 20 other children with a similar severity of autism could also be assisted. Can the Taoiseach respond positively to this tragic situation?

Photo of Bertie AhernBertie Ahern (Dublin Central, Fianna Fail)
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I do not wish to rehearse a court case. Both sides brought evidence before the court and a judgment was made. I was deeply distressed after hearing the O'Carolans discuss their son's condition. Everyone would be so affected. I do not doubt that it is extremely painful for the parents to see their autistic children in distress on a daily basis. Every parent wants his or her children to reach their full potential regardless of needs or disabilities.

As I understand the case, it is regrettable that an agreement acceptable to the O'Carolan family was not possible. The professionals involved believed that the care plan proposed by the Woodlawn centre and offered by the State was the best option for Lewis. The court, after considering the multidisciplinary service available at Woodlawn, arrived at the same conclusion and the case has been adjudicated.

The State proposed that an integrated education and health related support service be made available to Lewis on a residential basis at the Woodlawn centre in Lusk. The centre provides assessment, care, rehabilitation and education for individuals who have learning disabilities or other difficulties including behavioural problems. It currently offers a residential service to young people who range from 14 to 22 years of age. An individual education plan will be drawn up for Lewis to be delivered by a specialist teacher with the support of a special needs assistant and where appropriate, support from nursing staff, care assistants and teachers. Lewis will also have access to occupational therapy and speech and language therapy. Staff working with Lewis will receive the support they require through training for their roles and regular review meetings will take place with input from the staff to facilitate the delivery of services.

I understand the services available in Woodlawn can meet all of Lewis's needs. That was the case put forward by the State in the court case. We have invested significant resources in recent years to improve services for people with special needs. I will not say they are perfect as they constantly need more resources for staff and to achieve best practice, but we improve each year with regard to education, health, residences and staff.

The State did not seek costs from the O'Carolan family despite the fact it won the case as we would rather not be in this position in the first place and it is a pity these issues end up in court. I have more detail on the case, but the outcome of the judgment is that it is genuinely believed Woodlawn can provide the service to the O'Carolans.

Photo of Joe HigginsJoe Higgins (Dublin West, Socialist Party)
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That the High Court awarded costs to the family today underlines the point that this facility only became available or offered at the time of the litigation. Woodlawn is the best option available to the State in the State but it is not the best option available. We must take the evidence of his extraordinarily dedicated parents, the evidence of parents in similar circumstances and those teachers and carers for autistic children who know the situation well. The conclusion they have drawn is that we, the State, should fund this child to go to Bangor for perhaps 18 months for the care they believe would radically transform his life.

We need a national diagnostic and assessment centre for autistic children with extremely challenging behaviour. The Irish Autism Alliance is pro-active in investigating the establishment of a facility similar to Bangor here. It is hoped the State will commit funding to that. I again ask the Taoiseach to examine the human suffering in this situation and the position of those closest to and familiar with it, and in quiet reflection come up with the funding to send this child and others who need similar care to this facility.

Photo of Bertie AhernBertie Ahern (Dublin Central, Fianna Fail)
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I appreciate the case Deputy Higgins makes on the needs of the O'Carolans' son and I am not arguing against that. I do not wish to re-run the court case that has examined this issue and it is a pity these issues end up in court. The amount of assessment, care, rehabilitation, education occupational therapy and speech and language therapy required in this case make it complex. As I outlined, the case put forward by the State for the Woodlawn centre in Lusk is that it has the required staff to carry out on a proper basis the tasks necessary for this and the other cases there.

The point was made about developing and enhancing the services and examining international experience, and that is why this Government increased resources for disabilities services so much. Deputy Higgins will appreciate this case has gone through it. I understand the staff at Woodlawn, which is part of St. Joseph's intellectual disabilities services, and those putting forward the State's case believe they can help. I join in what the Judge stated in court that it is hoped that Lewis will have an opportunity to use the facilities at Woodlawn and that they will be effective.