Mary Harney (Dublin Mid West, Progressive Democrats)

I thank all the Senators who have contributed. In particular, I wish to acknowledge what Senators Terry and Glynn said about the late Kate Walsh. Wonderful tributes were paid to her yesterday and it is a pity she was not here to hear them. She was a very special person. Many people have portfolios, but her only portfolio was friendship. She had friends everywhere and was a much loved and well respected person. She had a great grá for many people in this House and I never heard her say a bad word about anybody here.

I visited her a lot during her illness, most recently last Sunday night. However, little did I know she would be dead on Tuesday morning. We were all shocked to hear it because it was not her cancer that killed her but something different. The pity is she was not here to hear the tributes because she would have had a good laugh. Right up to the end, she did not lose her sense of humour and had many funny stories to tell over the past few weeks in St. Vincent's Hospital in Dublin.

On the questions raised, following the passing of the order here and in the Dáil today, the investigation will be established to be conducted by a sole member, Mr. Derry O'Donovan SC, over a 12-month period, with provision for an interim report. We estimate the inquiry will cost approximately €2 million. The matter of the transfer of patients from St. Ita's will be a matter for the chairman who will have the power to consider any issues relating to transfers of patients.

I met some family members of former residents of Leas Cross and must say that after hearing their stories I would be very bitter if it had been one of my parents involved. To take up a point made by Senator Ryan, it is a fact that many people, including those who are well informed, do not always realise that bed sores could be the result of neglect. Sometimes they feel these are a natural consequence of old age. Many relatives of patients feel guilty or think they should have noticed more. The least we can do is to ensure we learn from the experience. In particular, we must learn from the experience of how the authorities responded to the complaints made. Much of Mr. O'Donovan's inquiry will investigate this area. Hopefully, the authorities, those with an inspection function and those involved with complaints, will learn lessons from the experience in Leas Cross.

As Senators know, up to now there has been an inspection process only for private nursing homes. However, the Government has decided the new social services inspectorate process under HIQA will inspect all nursing homes in the public and private sector, which is appropriate. Senator Glynn mentioned somebody going to visit an aunt who had been dead 16 years after the announcement of the repayment scheme. Unfortunately, we hear such stories, but such people are in the minority. I have heard a similar story on several occasions when visiting residences for older people. Nurses have said to me they did not know some patients had relatives because they had never seen them. This development is infuriating and annoying. There is no legislation that can insist people must visit their relatives, but visiting the elderly is, I hope, one of the wider values in our society.

I share the view expressed by Deputy Ryan and do not just see young people as productive and older people as a drain on the State. I was listening to a radio programme last Sunday when driving from Cork to Offaly and heard a comment made that we were investing moneys in properties overseas that should be going into the health system. The implication was that the Government was investing in properties overseas. This was one of the few occasions I was tempted to phone the programme and point out that it was citizens rather than the Government who were investing in overseas properties, but I did not do so. I hate the value system that talks like this, particularly with regard to who is or is not productive. Although I support enterprise in society and the reward of enterprise and initiative, I am equally strong about the importance of a value system in our society through which we can support each other and the importance of community. I will not be provoked into giving my views on the public system except to say I believe access to State-funded services should be available to everybody on the basis of medical need and no other basis. We are far from that ideal. In all public hospitals a minimum of 20% of beds is ring-fenced for private patients and a consultant receives a private fee for any private patient who goes into the public hospital except through the accident and emergency department. The same applies to the pathologists and radiologists if the person is in the accident and emergency department. I have problems with that when taxpayers are funding the system. We are trying to ensure that what the taxpayers fund is available only on the basis of medical need. Who invests the money and how are minor issues, what matters is the standard of care. I am strongly of the view that all consultants must be available to all patients not just a few. That is the basis for some of our decisions but I refuse to be drawn into that debate.

The current standards are the 1993 standards, which are deficient. We have learnt a great deal since then. The draft standards are available for discussion. We held a good conference a couple of weeks ago to discuss them with many stakeholders, on foot of which they are being revised. The Health Information and Equality Authority, which becomes effective after the introduction of the regulations on 11 May will be responsible for all these issues, particularly for enforcing them.

I accept Senator Henry's point that we are great at inquiring and fact-finding but often do not draw the conclusions and change practice. There is no point in holding this inquiry at the not inconsiderable cost of €2 million unless we put into effect any conclusions reached. Relative to a budget of €15 billion the sum is not much but it could achieve much in other areas. The standards will be phased in over three years, to deal with physical and environmental issues, rather than care. This will take time and we must be reasonable and proportionate in our approach to this change. I am delighted with the support for the establishment of the inquiry. I wish it well and look forward to its conclusion and report within 12 months.