Teresa Costello (Fianna Fail)

A recent "RTÉ Investigates" documentary exposed substandard care in nursing homes operated by Ireland's largest private provider. What we saw was a litany of repeated failings, chronic staff shortages and residents left unsupervised, denied basic care and, in some cases, subjected to outright neglect. The most disturbing part was the complete lack of dignity shown to vulnerable people in their final years.

Deciding to move a loved one into a nursing home is never easy. For most families, it is a last resort and something that is done only when a person's needs become too complex to manage at home. I do not know a single person who has not struggled with that decision and who has not felt guilt and worry. Now, those fears have been confirmed. That documentary showed families that their worst nightmares could be a reality. As I watched, my blood boiled. What I found particularly sickening was how staff told families that their loved ones were taking part in activities, giving them a false sense of comfort. Families believed their loved ones were being cared for and engaged with.In reality, they were being neglected. That level of deception is cruel. It was not just cruel to the residents. It was also humiliating for their families. We have all heard the argument that staff are under pressure. We know about the understaffing and that there were supply issues but none of that justifies what we saw. It does not excuse mishandling an elderly person, ignoring someone calling for help or lying to families. If someone is in a caring role, that person's core values should be respect, empathy and honesty, none of which were displayed in that footage.

HIQA appeared before the Oireachtas Joint Committee on Health last week. I listened as it referred to the testimonies of residents and their families and, honestly, I was baffled. How can we refer to testimonies from people who, as we saw on camera, were being lied to? How can we trust the word of dementia patients who say they are happy when footage clearly shows them being neglected? What we saw on camera was the testimony. It was the truth unfiltered.

Beneavin Manor can cater for up to 115 residents and charges roughly €1,400 per week under the fair deal scheme. Despite the company being paid well, staff constantly face shortages of basic supplies such as incontinence products, towels, bed sheets, sanitary wipes and gloves. At the committee meeting, I asked witnesses about the billing process in these homes. I would bet everything I own that these homes are extremely efficient when it comes to collecting payment but ordering incontinence pads is apparently too much to ask. I would think it reasonable to expect that, when HIQA carries out inspections, one of the very first things to be checked would be stock levels of basic care items. If that is not happening now, it needs to be added as a priority.

We also heard that HIQA could not conduct undercover investigations. One of the witnesses told us that HIQA had to declare its right of entry. Unlike RTÉ, the authority cannot undertake undercover surveillance. It cannot turn up in the middle of the night or observe staff in action without warning. How can we get an accurate picture of what is happening if inspections are announced ahead of time or are even just suspected? Issues can easily be hidden. If this is what it looks like with warning, I dread to think what it is like when nobody is watching.

These companies were paid very well for a service they did not deliver. We need to talk seriously about financial penalties because providers should not be allowed to keep money for delivering care when what they were delivering was neglect, humiliation and cruelty. What financial consequences will they face?

While preparing for the committee meeting, I came across a book written by a French investigative journalist who had spent three years investigating Orpea, which has rebranded as Emeis, the company that owns two of these homes. The book revealed a strategy of cost-cutting at these expensive care homes, underpaid staff, illegal use of temporary contracts and the rationing of food and hygiene products. In France, that scandal hit so hard that the company's share price dropped by 90%, and rightly so. Back home, two of our leading geriatric doctors called what we saw in the documentary exactly what it was, namely, abuse. This was abuse in a place that was meant to be safe and neglect in a place that was supposed to be called "Home". Families placed their trust in these homes and, for many, that trust has been eroded, if not completely destroyed. A constituent of mine, a healthy independent man in his 70s, rang me after the documentary aired. He was furious but he was also terrified. He said "God help me if the day comes that I need to go into one of those places." Can you blame him?

I acknowledge that HIQA referred the matter to An Garda Síochána. I welcome that but I would like to know whether there has been any update on that investigation. I am open to correction on this but I understand there are approximately 95 nursing homes under review based on concerns raised. Have the families of the residents been contacted? Have they been told their loved ones live in homes that are under scrutiny?

The governance we saw in some of these facilities was nothing short of disastrous. If we are going to change that, we need to look at how HIQA inspects homes and whether legislative change is needed to allow for undercover investigations because, until homes do not know who is watching or when, we will not see real accountability.

While my speech today has focused on failings in the sector, there are many committed, compassionate and hard-working carers and providers out there. I have met them. They care deeply about the residents and do the work for the right reasons in very tough circumstances. We cannot lose sight of that.

At the same time, these revelations have shone a light on systemic issues in nursing home care and, while the Government's response to date is welcome, we need to go much further to ensure this never happens again. This Government is committed to strengthening protections and will shortly publish the first ever national adult safeguarding policy and develop legislation that builds on what is already in place. The adult safeguarding Bill included in our legislative programme is a critical next step and must ensure robust prevention, reporting and enforcement.

In the end, it is all about dignity. It is about how we, as a society, treat our older people, those who built this country, raised families, paid taxes and contributed so much. They deserve to live their final years with dignity, respect and the highest standard of care.