Fergal Browne (Fine Gael)

I welcome the Minister of State and his official to the House. The Minister of State's last paragraph is laughable. It takes a great deal of imagination and creativity on his part to talk with a straight face about the Government's commitment to older people. I was amazed to learn when listening recently to Vincent Browne's show that on 4 July 2001, Deputy O'Dowd, who was then a Member of this House, put down a motion about care of the elderly. The first paragraph of his speech stated:

That Seanad Éireann, concerned that elderly people will have appropriate, responsive, accessible and high quality care and supports either at home or in extended care settings, such as nursing homes, calls on the Government immediately to introduce a comprehensive package of care supports, including an independent inspectorate of nursing homes, both private and public, an approved quality training programme for care assistants, and the creation of the office of ombudsman or advocate for the elderly.

Senator Glynn was a Member of the House at that time and might recall the debate. The then Senator O'Dowd referred to nursing staff administering the flu vaccine to patients without medical back-up, and in the absence of emergency drugs, which was contrary to safe practice. He spoke about a nursing home where there was no doctor's signature for medications given to a named patient. He quoted the report of an inspection of a home carried out on 22 June 2000, more than six years ago, to the effect that a resident's prescription had not been renewed since November 1999.

The Minister of State's predecessor at the Department of Health and Children, Dr. Moffat, spoke about the Government's policies and commitment to elderly people exactly as the Minister of State did today. He said Government's policy was "to provide high quality hospital and residential care for older people when they can no longer be maintained in dignity and independence at home." Here we are, five years later, in a situation much worse than we ever imagined, as the Leas Cross nursing home has brought home to us all.

Even Dr. Moffat, the then Minister of State, said:

There is concern that while there is provision, as outlined above, under the nursing home legislation for monitoring standards in private nursing homes, no similar arrangements are in place for health board facilities, an issue both I and my colleague, the Minister for Health and Children, will rectify. As Members will be aware, the social services inspectorate has the authority to monitor standards in children's residential centres and is operating effectively. It is intended to expand its role to cover extended care facilities for older people.

It is like Groundhog Day all over again but five years have passed and people have paid, in some cases with their lives, for this neglect. It is shocking to think that some people may have died from renal failure due to dehydration where nurses and staff in nursing homes were not aware these people were dehydrated. If we saw that happening in another country we would call for resources to be put into the country or withdrawn, depending on the context. It is happening here, where our elderly people are denied the dignity they deserve. They are the people who founded the State in difficult times but my generation has never had it so good.

The Minister of State referred to publication of the reports but the HSE has covered only part of the country, and published only some reports on its website. This is still hit and miss because there is not 100% coverage.

I will not enter the debate this evening about private versus public homes. I make no bones about saying I am in favour of private nursing homes. Only for that scheme there would not be half the number of nursing homes there are, and they would not be in their present locations. In County Carlow there are fantastic nursing homes in Tullow Road, Leighlinbridge and Ballon. I would be terrified that if this were left to the public sector the homes would not be built in the first place and if they were they would be located in major urban areas. It is great that people who have to go to nursing homes are able to reside near their homes because it also makes it easier for family members to visit them.

The O'Neill report on the Leas Cross nursing home points to the need for the Government to set in place minimum staff levels. There may be only one nurse on duty in a nursing home. That is not acceptable. There should be clear guidelines on the minimum number of staff required and on inspectors and the number of their visits.

When Dr. Aidan Browne recently addressed the Oireachtas Joint Committee on Health and Children he explained that there are 54 inspectors going around the country and that they visit private nursing homes twice a year. The number of farms is similar to the number of people in nursing homes, at approximately 18,000 but there are only 54 nursing home inspectors, divided into 18 teams of three. I was shocked to learn, from a response to a question to the Minister for Agriculture and Food yesterday, that in her Department there are 1,685 inspectors. There is almost one inspector for every 11 farms while in nursing homes there is one inspector for every 370 patients.

If someone gets food poisoning in a nursing home or the food preparation area is not clean the nursing home can be closed down instantly. Malpractice in the care of the patient, however, can continue without swift remedial action. It took a "Prime Time" programme, and my colleague Deputy O'Dowd who has been raising this issue for years, to expose the scandal in a few nursing homes. It is worth putting on record that many nursing homes offer an excellent service. We were all shocked by the contents of the "Prime Time" programme.

Was the Minister of State, Deputy Seán Power, briefed or warned specifically about the major problems in nursing homes, on his appointment as Minister of State at the Department of Health and Children? Dr. Aidan Browne stated at a meeting of the Oireachtas Joint Committee on Health and Children that the current Act and regulations are cumbersome and that it has been recognised for some time that new legislation and regulations are required.

Many people have been baffled by the slow response of the Government. The "Prime Time" programme to which I referred was aired more than 18 months ago. In contrast, almost two years ago the Government rushed emergency legislation through this House on nursing home charges. Thankfully, that legislation was rejected by the Supreme Court. Almost 18 months later we are still hearing about the inspectorate and other issues relating to nursing homes. The Government is very quick to charge pensioners in nursing homes but very slow to bring in safeguards to protect them while in the care of these same nursing homes.

It is shocking to compare the number of inspectors in the Department of Agriculture and Food with the number of nursing home inspectors. We need to set minimum guidelines. I urge the Minister of State to ensure all inspection reports are made available immediately on the Health Service Executive website so that people are made fully aware of the conditions in individual nursing homes. If any of us were planning a weekend away, we would find out how many stars a hotel had and what facilities were available there. People who want to find a nursing home for themselves or a relative should have the same option but that has not been the case to date. It is vital that nursing homes are brought up to the highest specifications. It is the least we deserve as we get older.