Frances Fitzgerald (Fine Gael)

I thank the Minister for coming to the House to discuss this important topic. Of course, there must be ongoing debates not just about elder abuse but about the issues of how we treat our elderly in society, ageing and ageism in Ireland and how we can have a more inclusive approach to the elderly and the development of health and personal social services for the elderly.

The withdrawal of the medical card from the elderly was a retrograde step. It took away the peace of mind of many elderly people. The universality of the medical card was extremely important to the peace of mind of the elderly. The provision of the medical card was a good step and we saw the benefits of its universality in terms of the peace of mind it gave, the encouragement for people to remain in their homes and the confidence it gave them about their medical needs. These were incredibly important in the lives of elderly people in Ireland. Its removal was a retrograde step.

Today, I heard from community groups that an important grant of €3.5 million for security for the elderly has been withdrawn. The community groups have been notified of the withdrawal of this important grant for the provision of security equipment, such as pendants and so forth for use in an emergency, and are very concerned about the impact it will have on the elderly.

Recently we have had debates about standards in nursing homes and the Leas Cross report. As the Minister said, there is no room for complacency so I am glad we are having this debate today. People will find it hard to believe that 1,800 cases of alleged elder abuse were reported to the HSE in 2008. The vast majority of these incidents occurred within people's homes and were carried out by somebody known to the elderly person. There are parallels in this area with what we have learned about child abuse. We are still shocked by what we hear about child abuse but the issue of elder abuse is only now becoming more widely known. The same standards, guidelines and implementation will be required in the area of elder abuse as have been developed over the years to deal with child abuse. It took us a long time to learn good practice when dealing with child abuse in terms of intervening properly and implementing and monitoring the right approach. I hope it will not take as long with regard to elder abuse. If it does, people will die. I welcome some of the initiatives the Minister mentioned which are being taken by her Department and the HSE.

Age Action Ireland has described the figures for abuse of the elderly as just the tip of the iceberg. There is probably a great deal happening that has not yet come to public attention or been reported. The issue of elder abuse is complex. The abuse can take many forms — psychological, physical, sexual or financial. Today, however, in the short time available to me, I will focus on the findings of an inquiry commissioned by the Mental Health Commission into two psychiatric hospitals, which was published last Friday. This was a Mental Health Act 2001, section 55 inquiry. There have been only two such inquiries in Ireland.

This inquiry, its recommendations and what it discovered make shocking reading. The report not only outlines the dreadful conditions that many elderly patients were exposed to within HSE care but also raises serious questions about the care practices in the hospitals examined. This report has been published four years after the Leas Cross report, about which there was a huge public outcry. The inquiry was into standards at St. Michael's unit in South Tipperary General Hospital and St. Luke's Hospital, both of them in Clonmel. It was prompted following concerns expressed about the number of fractures suffered by a number of residents at the two hospitals.

The reports are very upsetting. This is not to suggest that all staff in those hospitals were involved in this or that attempts were not made to provide good care. However, the reports found that residents were inappropriately sedated or tranquillised to control their behaviour, wards were unnecessarily locked, seclusion was used too often, the poor design of the building posed difficulties, more than 19 patients suffered fractures between 2002 and 2004 and there were environmental and safety and welfare defects. The Irish Times and the Irish Independent commented on the conditions of the people who were living in those hospitals. They said the findings of the report paint a bleak picture of life at St. Luke's, a picture of an environment in which human dignity has reached rock bottom.

There are many elderly people in institutional and residential settings throughout Ireland and serious questions must be asked about this report and its implications. Why was no action taken despite the fact that the Minister was informed of these issues regarding lack of care by the inspector of mental health in 2006? What action has been taken to date to remedy the major failings highlighted by the Mental Health Commission report? Has the Minister met the HSE to discuss its plans to deal with the issues raised in the report? How confident can we be that this is not happening elsewhere? We must be confident it is not. These are very serious questions. I do not have time to deal with the matter in more detail but it is critical that elderly people in institutions get proper care.