Pat Buckley (Cork East, Sinn Fein)
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I am here to speak on behalf of family members regarding the CareChoice nursing home in Ballynoe in County Cork. I wish to refer to some of the correspondence I have received and then the Minister of State, Deputy Rabbitte, will know exactly where I am coming from and how frustrated the families are. I was told that the following are some of the concerns families have regarding the CareChoice nursing home in Ballynoe in County Cork. During the Covid-19 pandemic in 2020, it was stated that this home was well managed in respect of infection control as well as the maintaining of communication. The provision of updates to family members was also very good. Families, however, have concerns regarding how this nursing home in Ballynoe was managed from Monday, 14 December 2020. Many of these concerns are reflected in what has been expressed by other families who lost loved ones in this and other nursing homes in the county.

Concern has been expressed as to why, on Friday, 14 December 2020, the director of nursing left her position, two senior clinical nurses left their positions and the assistant director of nursing also stepped down from her position in this nursing home. There were also misgivings regarding the residents having been moved out of their rooms without families being aware of this development. Some residents were moved several times. To this day, some families do not even know what room or part of the nursing home their loved ones died in. Equally, disquiet has also been expressed that some families were informed that their loved ones had tested positive for Covid-19 while others were not. Some found this out accidentally from a carer during a phone call, while others only found out when their loved ones died. Some families also have questions as to why their loved ones' remains were not released to the funeral home until two days after their deaths. In addition, some of the families are also concerned about the lack of communication, phone calls not having been answered, promised phone calls having not been received from the director of nursing and that medical updates on their loved ones were all similar and standard updates. In one case, a family member was given a medical update by the director of nursing on another resident and not on their family member.

More concerns were raised about the obvious lack of staff from Sunday, 31 January 2021, and about the impact this had on the care and well-being of the residents. The families were also extremely concerned, shocked and upset by what was revealed by the whistle-blowers at a later date on the "RTÉ Investigates" programme. Major concerns were also expressed regarding how residents were cared for. Families also learned that on Tuesday, 2 February 2021, a staff member contacted HSE and the Minister for Health, Deputy Donnelly, begging for help and for someone to come and save the residents. No one came in and lives were lost that could have been saved with the proper help. This plea for help should have set alarm bells ringing, but the HSE handled this situation by emailing the home.

Before staff made this call, there were five deaths. On Tuesday, 2 February 2021, the day of the call for help, there were three deaths. After this date, there were a further 19 deaths in the home. There was a total of 27 deaths, 22 of which were over a 12-day period between 31 January and 11 February 2021.

The lack of response and help from the Government has forced families to go to the courts to get access to their late family members' records which the nursing homes are refusing access to, and also to get this Government to put in place a public inquiry that is needed into these deaths. There is concern that private nursing homes do not come under the Freedom of Information Acts and that private nursing homes are a law unto themselves in regards to accountability. A HIQA report request by the Minister of State at the Department of Health, Deputy Butler, has caused concern and upset to families, as when the families saw a copy under the Freedom of Information Acts it was heavily redacted. The question is, "Why?" What is being held back from the families and what has been covered up?

These are the concerns of some family members. They have not got accountability. They have not got the responses. What they are looking for is an independent public inquiry, specifically, on Ballynoe nursing home or the nursing homes in east Cork. I await the Minister of State's response.

Anne Rabbitte (Galway East, Fianna Fail)
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I thank Deputy Buckley for raising the issue. I am taking it on behalf of the Minister of State at the Department of Health, Deputy Butler.

I would also like to take this opportunity to reiterate my sincere sympathies to all those whose loved ones passed away in nursing homes, the one the Deputy raises here but nationwide as well, during the pandemic.

I want to emphasise that quality care and patient safety is a priority for the Government, and the delivery of safe, high-quality services is of paramount importance and focus. Nursing home providers are ultimately responsible for the safe care of their residents.

The Covid-19 pandemic has presented one of the greatest and most wide-ranging public health challenges internationally in recent history. International evidence shows that the virus disproportionately impacts older people, and people living in long-term residential care facilities have been identified as particularly vulnerable to Covid-19 by the World Health Organization.

Recognising the particular vulnerability of nursing home settings, the State quickly put in place a comprehensive package of supports for nursing homes in line with the National Public Health Emergency Team, NPHET, recommendations in early 2020 and many of these supports remain active. These include more than €145 million provided under the temporary assistance payment scheme, TAPS, with outbreak assistance extended up to December 2022. Other supports included: free personal protection equipment; Covid-19 regional response teams; public health and infection prevention and control advice and guidance; accommodation support; and serial testing for staff. Nursing home residents were also the first to be vaccinated under the State vaccination programme.

Since the start of the pandemic there has been significant and ongoing consideration of the impact of Covid-19 and the evolution of the response to it, as evidence and knowledge emerged, and as national and international understanding of the virus evolved. Throughout, this has included a specific and sustained focus on older persons, in particular, those resident in nursing homes. Various examinations and reports with a focus on Covid-19, its impact on nursing homes and the pandemic learnings that can inform future policy, regulation and the model of care for older persons have been undertaken.

In particular, the independent Covid-19 nursing homes expert panel was established in May 2020 to examine the complex issues surrounding the management of Covid-19, and to provide real-time learnings and recommendations to inform the ongoing approach to the management and mitigation of risk to older persons resident in nursing homes as the pandemic evolved.

The Taoiseach has indicated that a comprehensive evaluation of how the country managed Covid-19 will provide an opportunity to learn lessons from our experiences in dealing with a pandemic. This will help ensure that we are in a better, stronger position if another pandemic or another similar-type emergency arrives. Separately, the Minister has also asked his Department to consider the options available for undertaking a potential review of the management and impact of Covid-19 in nursing homes, taking account of the experience of, and learnings from, other review processes undertaken in recent years.

Pat Buckley (Cork East, Sinn Fein)
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I tabled a parliamentary question on this as well. It states, "Separately, the Minister for Health has stated that he believes that a review of the management and impact of COVID-19 in nursing homes is warranted".

The Minister of State, Deputy Rabbitte, mentioned in her response the €145 million provided under the temporary assistance payment scheme. Some €145 million is spent and 27 families in this nursing home still have not got a response to any of their questions. Having the HSE investigate itself is like the Garda investigating the Garda; it does not work.

These families tried their best to be diplomatic. They tried to engage with the Minister for Health. The families mention that Ballynoe is in Cork, the Taoiseach's county, and yet he has not met with these families and the families of other Cork nursing homes. There is a lot in this.

What I am calling for here is that the Minister with responsibility for this issue engages with the families and also listens to them because I know what they want. All they want is answers. The redacting of information under the Freedom of Information Act for family members must be soul destroying when they are only looking for simple answers as to how their mother died, where did their dad die and whether it was in the same room as they were all the time. These are simple questions.

When one gets people so angry on this, it also gives it an air of suspicion, and the more one covers it up the more suspicious people get. That is why these people and these families asked me on their behalf.

We are coming into Christmas and here we are talking about Covid and deaths of elderly people and the most vulnerable again. All these families want is answers and they are asking for an independent public inquiry into what happened in this nursing home.

Anne Rabbitte (Galway East, Fianna Fail)
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I, again, thank the Deputy for raising this matter and being the voice of the families on whose behalf he stands here before us.

I understand the significant particular impact that Covid-19 had on families who lost loved ones in nursing homes. My colleagues, the Minister, Deputy Stephen Donnelly, and the Minister of State, Deputy Butler, have met with some of these families and have heard first-hand of their experiences. We all remember how difficult that period was when visiting had to be restricted and when normal grieving and funeral processes had to be set aside.

One of the most important things we can take from experiences over the past two years is our learning and our understanding of the challenges facing the nursing home sector and how we can enhance and strengthen the quality of care. The independent Covid-19 nursing home expert panel produced a substantial package of 86 recommendations. These included: immediate actions required at the time for ongoing protection and support for nursing home residents during the pandemic; and medium and longer term recommendations in relation to broader systems reforms to enhance and better integrate nursing home care and older persons care more broadly.

Many of the short and medium-term recommendations have already been implemented and progress has been made on reform, including the draft legislation to provide HIQA with the new enforcement powers published in October. The patient advocacy service commenced roll-out in private nursing homes in November 2022 and amendment regulations have been published to standardise and enhance requirements for a complaints process. The findings of the first National Nursing Home Experience Survey were published in November 2022 and give us essential insights on the views of residents and their families.

I confirm that the Minister, Deputy Stephen Donnelly, and the Minister of State, Deputy Butler, are fully committed to further reform to ensure an improved quality of service and experience for individuals using health and social care services into the future.

I wish to conclude by offering my sympathies to the families that the Deputy speaks about.