Joe Costello (Dublin Central, Labour)
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I welcome the Minister of State, Deputy Parlon, although I would have preferred the Minister for Health and Children to have been here so that she could hear first hand what is going on in the nursing homes for which she has responsibility. The next of kin of two of my constituents recently received curt letters from St. Margaret's nursing home telling them that two elderly people would have to leave the home. The letter states:

Dear X

It is with regret that I am giving you notice to find alternative accommodation for Mary.

The Health Service Executive have been informed of this decision and will help you find alternative accommodation for Mary.

If I can be of any assistance please contact me on (01) 8322212.

Your Sincerely

The signatory of the letter did not identify his or her role or position in the nursing home. It was a simple, typed circular letter with blank spaces in which the Christian names of the addressee and the patient could be hand written. It was not even a decent mail merge. There was no explanation as to why the elderly patient had to leave so abruptly. There was no reference to Mary's husband who has multiple medical problems and who has been living in the same nursing home for the past seven years. There was no expression of appreciation for those who had been resident in the nursing home for years and who had handed over their savings and pensions or for their families who visited them there regularly.

Landlord and tenant relationships are regulated by law. The landlord is obliged to specify a period of time as statutory notice before he or she can ask the paying tenant to leave. Apparently, no such rights are available to patients in nursing homes.

My constituents are husband and wife. It appears that one may be allowed to stay and one may have to leave. That gives rise to problems. If it is the case that the HSE has instructed the nursing home to take a particular course of action — we have seen reports in the media on this nursing home and on others in respect of which the HSE is suspending their activities — then it should explain that to the patients and the next of kin and ensure a patient-friendly approach is taken when dealing with the problems. In any set of circumstances, the HSE should supervise and ensure the actions of a nursing home are carried out within proper agreed parameters.

Will the Minister for Health and Children spell out the particular circumstances surrounding the removal of these and other patients from St. Margaret's nursing home which has a total of 26 patients? So far, we have been told ten public patients will be moved but there is no sign of private patients being moved. What exactly is the situation? What steps will be taken by the Minister's Department to facilitate these patients, who have been asked to move and whose next of kin have been informed, in new accommodation? Will she indicate what steps she proposes to take to ensure this does not happen again? It causes enormous distress to patients and family members who do not know what is going on in that particular nursing home. They do not know why their next of kin is being moved out at short notice.

The nature of the letter written is an absolute disgrace. We need a decent dignified service and the Minister of Health and Children is responsible for ensuring that. I hope the Minister will take that on board and that we will get a comprehensive answer on these matters.

Tom Parlon (Laois-Offaly, Progressive Democrats)
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I am taking this matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney. I thank the Deputy for raising the question as it provides me with an opportunity to outline the background to the current situation in regard to St. Margaret's nursing home and the action taken by the Health Service Executive.

Government policy is to develop and improve health services in all regions of the country and to ensure quality and patient safety. The safety and well-being of older people living in nursing homes is of critical concern. Quality care and patient safety come first and all patients should receive the same high standard of quality assured care. The present standards for nursing homes are set out in the 1993 Care and Welfare Regulations. Under section 9 of the regulations, regarding the discharge of patients from a nursing home, the legislation states: "Where the registered proprietor or the person in charge intends discharging a dependent person, they shall inform the person and the person nominated to act on the person's behalf, the date of the proposed discharge, the reasons for the discharge and give fourteen days notice to make alternative arrangements."

On 22 November 2006, the HSE suspended new public admissions to St. Margaret's nursing home near Rivermede in north County Dublin. This followed a series of inspections by HSE. The home was found to be in breach of the 1993 Care and Welfare Regulations. The imposition of such suspensions is in line with recent public assurances by the HSE that, where concerns are raised by inspectors about a private nursing home, no beds will then be contracted by the HSE with that home until the issues are rectified. Furthermore, the home has been advised not to take in privately referred admissions during this period.

On 8 February 2007, ten residents were asked by the owners of the nursing home to find alternative accommodation. It is important to note that it was the home and not the HSE which made this decision. The HSE set up a multidisciplinary committee, which met on 12 February, to work with patients and relatives to find alternative accommodation. It will continue to work with patients and relatives and is due to carry out further inspections on the home in the near future.

It is also important to note that the HSE inspection team carried out a risk assessment in this nursing home and the current assessment is that there is no immediate risk to any resident in this home.

An expert working group chaired by this Department developed and published, in January 2007, draft standards which will apply to all residential care settings - public, private and voluntary. The draft standards have been formally referred to the interim health information and quality authority, iHIQA, which will initiate a short, focused consultation process and then finalise the standards for use in the inspection process to be carried out by the social services inspectorate. The interim health information and quality authority has already established a group to finalise the draft standards and it held its first meeting on 30 January 2007.

As I have already mentioned, the Nursing Homes (Care and Welfare) Regulations 1993 outline the standards that currently govern private nursing homes and inspections are carried out based on these standards. These regulations apply to private nursing homes only and do not apply to public nursing homes at present. However, as I outlined previously, when finalised the new standards will apply to all residential care settings.

In addition to the work undertaken on the draft standards by the Department of Health and Children, the HSE has also taken steps to improve nursing home inspections. A working group was established in July 2005 by the HSE to examine the issues of inspections and registrations of private nursing homes and to standardise the inspections process nationwide. A HSE working group produced a report in July 2006 on nursing home inspections and registrations which currently underpins the inspection process. Since July, the inspection reports have been made available on the HSE's website. In addition, all inspections are now unannounced and nursing homes are now inspected at least twice a year.

It is clear that this Government is committed to ensuring that residential care for older people is safe and of the highest quality. As I have outlined to the House, the Department of Health and Children and the HSE continue to work on a number of fronts to advance this critical objective.