Mary Butler (Waterford, Fianna Fail) | Oireachtas source

This legislation has three main aims. First, through amendments to the Health Act 2007, it will strengthen the regulatory framework for nursing homes and residential care facilities for people with disabilities and children, thereby driving improvements for those living in such facilities. These people are some of our most vulnerable citizens. It is vital that we have a robust system of regulation to ensure they are receiving safe and good-quality care. The provisions in the Bill will provide important new safeguards for residents in these services. As such, I am seeking Members' support to enable the Bill to be considered and agreed today by the Seanad and enacted in this legislative session. This will ensure the protections are put in place as soon as possible.

Second, through amendments to the Nursing Homes Support Scheme Act 2009, the Bill will widen the definition of those eligible to be considered as a family successor to a family farm or productive business assets under the nursing homes support scheme.

Third, through an amendment to the Mental Health Act 2001, the Bill will change the length of time a person can serve on a mental health tribunal operated by the Mental Health Commission from the current term of three years to five years.

I begin by focusing on amendments to the Health Act 2007. That Act established the Health Information and Quality Authority, HIQA, and the Office of the Chief Inspector of Social Services. It also provides for a scheme of registration and inspection of the residential services to which I referred and for the making of regulations and the setting of standards on safety and quality in respect of those services. The chief inspector of social services, who is the regulator of the services, monitors compliance with the regulations and standards. There are three substantive provisions in the Bill to enhance the chief inspector's enforcement powers.In a recent annual overview report of monitoring and regulation of older persons services in 2022, the chief inspector noted that although there was good overall compliance in 2022, “there are regulations with consistently higher levels of non-compliance over a prolonged period”. For these instances, it is essential there are effective enforcement mechanisms in place.

The first amendment to the Health Act 2007 is the introduction of compliance notices to provide a more timely and proportionate tool for intervention by the chief inspector when there is a breach of regulations. This is provided for in section 16 of the Bill. Focused on bringing the provider into compliance, it complements the existing enforcement processes under the Act. At present, the chief inspector’s enforcement powers centre on placing restrictions, known as conditions, on a registration or, in extreme cases, cancelling a registration. The chief inspector herself has described these as “blunt instruments”. Compliance notices will provide for a more nuanced intervention focused on bringing a provider into compliance and driving service improvement.

The second enforcement provision relates to the power to enter and inspect premises. The chief inspector currently has the power to enter and inspect premises that are registered or are in the process of being registered. It is an offence to operate as a designated centre without being registered by the chief inspector. However, there is no explicit power for the chief inspector to enter premises which she suspects are operating as designated centres to establish if, in fact, this offence is being committed. To address this, the Bill provides for an amendment to the Health Act to provide a clear and unambiguous power for the chief inspector in this regard and will ensure the protections afforded to residents of registered centres are extended.

The third amendment will reduce the timeframe that service providers have to make representations or appeal a decision of the chief inspector for current enforcement processes under section 51 of the Act from 28 to 14 days. This is provided for in sections 7 to 9, inclusive, and 12 of the Bill. Importantly, the Bill also introduces new provisions on the periodic and systematic collection of key data from nursing homes, the sharing of the data with the Minister, HIQA and the HSE, where appropriate, and the publication of this data at aggregate level. As Senators will be aware, the majority of nursing homes are in private ownership and we currently do not have any centralised process for the systematic collection of key data. Access to good quality, collated data on a sectoral basis is crucial to supporting effective national policy-making. These provisions are to address the gap. I want to be clear that no individual’s data will be circulated.

I will now outline the changes proposed to the Nursing Homes Support Scheme Act 2009. The nursing homes support scheme, commonly known as the fair deal, is a system of financial support for those requiring long-term nursing home care. As Senators will be aware, I introduced an amendment to the scheme in 2021 which extended the three-year cap that applies to the applicant's principal private residence and to family farm and business assets where a “family successor” is appointed. This family successor must continue to run the farm or business for at least a period of six years and have at least consistently applied to run the family asset for at least three of the last five years. This was a very important change. However, since introducing these amendments, it became clear there is a small group of individuals with no close relatives who seek to benefit from this relief but cannot do so because they do not have a person who meets the eligibility criteria. This Bill extends eligibility to great-nieces, great-nephews and great-grandchildren, and first cousins and relatives in the grandparental lineage, which includes first cousins once, twice and thrice removed. There are also a number of minor technical amendments to the Nursing Homes Support Scheme Act to provide for more precise cross-referencing.

The Bill also provides for a relatively minor amendment to the Mental Health Act 2001. This is provided for in section 34 of the Bill. As Senators will be aware, drafting of a mental health Bill which will substantially reform our mental health legislation is at an advanced stage, with the intention of it being published during this session. However, there is one pressing amendment that I would like to bring forward now for practical reasons. This amendment will change the length of time a person can serve on a mental health tribunal operated by the Mental Health Commission from the current term of three years to five years. The Mental Health Commission will begin the recruitment process for tribunal members later this year. Including this amendment in this Bill rather than the forthcoming Mental Health Bill will allow the commission to plan now for the appointment of tribunal members for five years. Each tribunal member recruitment campaign costs the Exchequer in the region of €250,000 so this amendment will have an immediate positive impact on the public purse.

I commend the Bill to the House and look forward to hearing from the Senators.