David Norris (Independent)

I welcome the Minister of State back to the House, refreshed after our short break. In 1990 the Health (Nursing Home) Act was passed by the Oireachtas, coming into force in September 1993. This was intended and proclaimed to be a radical improvement on the old system. The Ombudsman's report contradicts this, however, claiming that the Department and the health boards operated the new system in a way that was against the interests of patients and deprived them of their own money, a serious charge. She also stated that the Department was perfectly aware that its approach was legally unsound. This puts into context the remark on the other side of the House before the break that this was the best kept secret in the Civil Service. It is difficult to believe the political masters of the Civil Service were unaware of the situation, which was so widely flagged and so clear to the Ombudsman.

The doubtful practices listed include the making of regulations containing provisions which are likely to have been against the law, including at least one instance in which the likely invalidity probably had been known in advance. That goes back to the matter I have just raised. Also mentioned is the inclusion in a regulation of a provision which, it appears, was intended from the outset would not be applied. That sounds like sharp practice. A further doubtful practice was the unreasonable prolongation of discussions with the Ombudsman about practices which it appears were known from the outset to be invalid or incorrect. That is unjustifiable prevarication and it is totally disingenuous.

Finally, there was the failure of some health boards to alter practice, even where the legal advice was that the practice was incorrect and where the Ombudsman had expressed the same opinion. The health boards were advised legally this was inappropriate and the Ombudsman was expressing concern but the practice persists. No defence of ignorance could be entered.

The Ombudsman's experience of complaints between 1993 and 1999 suggests that the underlying problems of complainants which surfaced prior to September 1993 continued to manifest themselves under this new regime. There were plenty of problems and they were flagged. A serious situation has arisen recently with regard to the law on statutory rape and at its heart was the question of communication deficits, to put it politely. It seems this also happened here in the Department. That is regrettable and I hope the Bill goes some way towards mending the situation.

The Bill contains a provision for the recipients of this money to render it back to the State if they do not need it so it can be used by the health service. That may be an honourable thing to do but I hope that no moral pressure will be put on people to do so. I salute those I heard on the radio saying they were grateful to the health services for the way in which their relatives were treated. They also said they would not wish to take this money.

As I understand it, there is no systematic inspection of public nursing homes for the elderly. If that is the case, such a system should be instituted. While this is not directly germane to the matter, people should be made aware that the development of bedsores among patients in these institutions is absolutely unnecessary and indicates bad nursing practice. Relatives often believe that bedsores are the inevitable consequence of the aged being bedridden but they are not. The matter is a cause for concern and there should be regular inspections of nursing homes.