Brendan Ryan (Labour)

Cuirim fáilte roimh an Aire Stáit. Mar is gnáth nuair a phléimid an cheist seo, I must say something. My mother is in a public old people's hospital in my home town of Athy. Would that all our old people were in receipt of the quality of care provided at St. Vincent's in Athy. If the HSE wants a model of good practice, it does not have to get involved in complicated, complex, time-consuming and slow pilot projects. It has models that work very well to the satisfaction of patients and families and those who visit. I happen to know one and I am sure there are many others.

I do not want to rehearse the horrors of Leas Cross because they have been rehearsed time and again. I did not hear the Minister of State but I read his script. I note the absence of reference to most of the recommendations in the Leas Cross report and considerable emphasis on one issue, that of standards, which is important. We are in danger, as we are often, of the legislative response to a crisis which is to set up a raft of complicated legal procedures and then forget the implementation of those requirements costs a great deal of money. I want to put on the record a little from the report and a good deal from what the HSE supplied Members on the recommendations and what it was doing or, as the case may have been, not doing.

There is a tendency in the HSE's commentary on Leas Cross to give the impression that this matter sprang on it out of a blue sky without any serious prior warning. That is nonsense. I have no idea whether it got lost in the transfer of documents or files or whatever. As the report states, Years Ahead was published in 1983 and as Professor O'Neill said 23 years after it was made official health policy, its recommendation for an independent inspectorate for residential care remains unfulfilled. I fully accept that is the fault of a number of Governments but we are in a unique period in this country's history in that we have had the same Government for ten years and one that has had at its disposal resources which were undreamed of by any previous Government. Of the 23 years, ten have been the period of this Government when it did not have the excuse that Governments of all hues of the 1980s and early 1990s had, namely, that resources were scarce and were being consumed by an armed uprising that spilled over to this part of the island and which incurred substantial damage and cost.

I continue to wonder how long it will take the Government to stop looking back over the horizon of previous Governments. It is ten years in office and considering that the official lifespan of a politician is 20 years — that is when we are allowed to retire on full pension — half the lifespan of a politician is about the time when a Government should stop talking about what its predecessors did or did not do.

Professor O'Neill referred to the health strategy of 2001, its wonderful improved staffing levels and extended care units, the extended remit of the social services inspectorate, and national standards for community and long-term residential care of older people. The latter issue has always raised for me one question. How was it that a health strategy that was compiled in 2001 which referred to those issues never asked how it would be paid for? Clearly if one asked how it would be done, one would look at the legislation and the issue that arose for the Minister, Deputy Harney, but which was conveniently not noticed by her predecessor. How in heaven's name an otherwise very intelligent man managed not to wonder about paying for all that is beyond me. It is also beyond everybody else and I have my own explanation.

What Professor O'Neill's report stated about the health strategy was: "No documentation has been offered to me suggesting movement on these objectives prior to the Leas Cross Prime Time programme". It launched the strategy with rhetoric and did absolutely nothing for five years until it was shamed into it by a television programme. The report continued: "The deeply deficient Nursing Home Legislation and Regulations have been tolerated well beyond what the time span...". We now know this and have known it for some time. The report further stated: "it was with some surprise that the reviewer noted a claim in the OECD overview of long term care that Ireland has put into place national standards of care". Not only were we conning the public at home, we were also conning the OECD by informing it we had done things we had not done. The report continued: "A Cabinet Member ... is documented as being briefed on these deficiencies on 30/5/2005, and the Assistant Secretary of the Department of Health and Children received a comprehensive memo on the grave deficiencies of the current legislation/regulations on 24/5/2005".

Professor O'Neill went on to make a succession of recommendations, most of which were ignored in the speech of the Minister of State. Let me go through some of them. "The Department of Health and Children and the Health Service Executive must in its policy, as a matter of urgency, clearly and formally articulate its recognition of the complex health and social care needs". The response to this recommendation was:

A report of current and future long term needs has recently been completed as part of an interdepartmental working group on the funding of Long Term Care. A national forum with HSE and Nursing Homes representatives is working on a number of quality initiatives including the development of service level agreements.

Some 23 years after the first public policy statement we are to have a national forum. Not one older person in a poor quality private nursing home will get any benefit from a forum. They will just have to wait longer.

Recommendation No. 2 reads: "The provision of this care . . . should be clarified formally in terms of adequate numbers" etc. The response reads:

The Report of the Working Group to examine the development of appropriate systems to determine nursing and midwifery staffing levels was published by the DOHC in Sept 2005 ... It is proposed to have a number of pilot sites across the country that would examine . . .

I will read a few more. Time after time——