Frances Black (Independent)

The Minister of State is very welcome to the Chamber today. I thank him for being here to discuss this very important issue. We have a collective responsibility to safeguard the safety, dignity and well-being of older citizens, particularly those in nursing homes and care settings across Ireland. It is a matter of profound importance. As recent events have laid bare, we all know there is an urgent need for reform. It is a moral imperative that we respond decisively.

Most of us have seen and spoken about the recent "RTÉ Investigates" programme, which exposed distressing safeguarding failures within private nursing homes. These revelations echo the tragic failures we saw at Leas Cross in 2005. As a previous speaker said, here we are again, 20 years on. It is outrageous. Other speakers have spoken about the very good care some providers deliver - we must give credit where it is due - but these reports reveal systemic issues of abuse, neglect and human rights violations that are entirely unacceptable. They serve as a stark reminder that, despite progress, significant gaps remain in how we protect our most vulnerable.

Ireland's ageing population is growing rapidly. In 2011, 11.4% of our population was over 65. By 2022, this had risen to just over 15%. Most older people live at home, but many more reside in residential care. As people age, their needs change and their dependence increases. This is where we must get it right.

It is shocking to think that our system for supporting older persons is fundamentally flawed. While inspections can help to standardise care quality, they are snapshots in time and reactive rather than preventative. Complaints are often delayed and investigations sometimes require ministerial requests, creating gaps in timely responses. Systemic abuse, as uncovered in recent investigations, reveals failures not only in direct care but also in governance and oversight.

As other colleagues have said, the landscape of nursing home ownership has shifted dramatically over the years. Since the introduction of tax incentives in 1998, private providers now run about 80% of nursing homes, with a growing presence of large international companies. While this has increased capacity, it also raises questions about regulation, quality and the prioritisation of profit over person-centred care.

Furthermore, the community-based options for ageing in place remain limited. The fair deal scheme, designed to assist with care costs, inadvertently favours statutory support in residential placements, leaving many vulnerable older persons without sufficient options for independent living or affordable community supports. What is the timetable for the delivery of appropriately funded home care or community care? This should be a priority.

In response to these challenges, I support the urgent implementation of the framework for adult safeguarding published by the Law Reform Commission in April 2024. This comprehensive blueprint offers legislative and policy reforms, such as safeguarding orders, warrants for access and transfer orders, that are crucial for protecting adults from abuse. However, progress remains slow. We must accelerate the establishment of an interdepartmental and interagency working group tasked with implementing these recommendations. I note that the adult safeguarding Bill is not on the priority list for the Government's summer legislative programme. It should be prioritised. Equally important is the establishment of a fully independent national safeguarding authority, empowered by legislation, with the resources and leadership necessary to oversee safeguarding across sectors - health, justice, social protection and community safety. It is important that this is cross-sectoral approach. It is vital. We also need to strengthen the regulation of healthcare staff to ensure consistent standards of care. Many support staff remain unregulated, which is unacceptable given the vulnerable populations they serve.

Some immediate actions can be taken without delay, such as legislating for better information sharing across agencies when safeguarding concerns arise and broadening the offence of coercive control to better protect vulnerable adults in all relationship contexts. The Department of Social Protection must also step up its role in preventing financial abuse, especially in cases involving third-party agents, as highlighted by recent cases.

A simple yet vital measure is the establishment of a national register of advance health directives. This would empower individuals to specify their healthcare wishes, ensuring these are accessible when needed. The infrastructure already exists through the Decision Support Service. A legislative order could implement this swiftly. That is something the Minister of State might consider.

Safeguarding our older citizens is not just a policy issue, it is a moral obligation. They have built this country. They are our mothers, fathers, brothers, sisters, aunts, uncles and grandparents. They deserve to live their later years free from fear of abuse or neglect. I often think about myself and what is ahead. We all have to think about that as well. We must move beyond debate and take concrete, co-ordinated action to protect their rights and dignity. We must do this work across all sectors and Departments to support these urgent reforms. That is one of the most important things I want to say today. It has to be done across all sectors and all Departments. Let us act decisively, implement these recommendations and finally ensure that our system of care truly upholds the human rights and happiness of the older population in this country. The time for talk is over. Now is the time for real action.