Anne Rabbitte (Fianna Fail)

I thank the Leader of the House for ensuring we are having statements on this today. They are timely. I thank the Minister of State for taking the time to appear before us to allow us the opportunity to speak about what we witnessed on "RTÉ Investigates". It is unfortunate that we have to rely on a television programme to do the job of HIQA. If we are to talk about the elephant in the room here, it is HIQA. It is the statutory body. It is the eyes and ears that protect the most vulnerable, the staff, the residents and their loved ones. As far as I am concerned, it failed in its job and has questions to answer. Why did it allow admissions to continue? That has to be the question. Is the private sector too big to fail? I asked that the last day and ask it again today. Are we afraid, because over 80% of all nursing homes are now in the private sector, that it is too big to fail? It should never be too big to fail. We are funding it. We can take it over. We took over nursing homes during Covid. We should be able to take them over again.

We should at all times ensure that the rights of the individual come first and be front and centre and never come second. A person's rights should never be a compromise. I completely agree with Senator Kyne, and everybody else, when he asked "How absolutely degrading". How degrading for a grown man to arrive at 80 years of age and to be told to - I will not repeat the word because I find it horrific - go to the toilet in his bed. How dare they? That goes down to management but it also goes down to the failure of the watchdog. We as politicians do not work nine to five and I do not expect our statutory agencies to do so either, but they have an obligation in terms of compliance and regulation. As for this idea of making a phone call to call in, it is not a cup of tea, nor do I take lightly their job. I feel, however, that they have shown leniency or tolerance towards certain groups.

At the same time, it is very important to be balanced in what I say. I want to be balanced about a lot of our family-run nursing homes. We have seen a loss in our county of Galway where it has not been sustainable for the family-run nursing home of 30 or 37 beds. The average to be sustainable now is 70. I talk about Portumna Retirement Village, the Holy Family Nursing Home in Killimor and Rosemount Nursing Home in Gort, which provide 100% care and diligence. It is a family relationship when a family member goes in. The whole staff get to know the individual. I therefore want to be balanced in my contribution but I also know the coals HIQA hauled these homes over to achieve that standard and I do not feel that the same standard was applied uniformly across all providers.

I welcome the Minister of State's remarks about the statutory home care scheme. I will support him in all he wishes to do in that regard but I also think the cases that are presenting to family nursing homes are getting more complex because of our discharge policies. We do not have that transitional space to be able to support people either to return home or to find their way into rehabilitation. Our disability providers have more of a social model than a medical model for intervention. Maybe we are putting pressure on some nursing homes to support more disability discharges into nursing homes, which is inappropriate. More than 1,350 under-65s are in nursing homes because we do not have that transitional care pathway. We have been a long time talking about it. There is a road back again to the HSE as to how it is managing to support that transitional care pathway. With the complex cases, it is no longer a question of people going in because they just do not have loved ones. Maybe the care and support are very expensive to provide, but we should ensure they are delivered in a person-centred way in the people's own houses.

I thank you for your leniency, a Leas-Chathaoirligh. A lot of good work has gone into nursing homes and older persons when we look at the meals on wheels scheme and see the home supports. With an ageing population, though, I think the Minister of State has the biggest job of work to do in these Houses because we are all getting older and I think not one of us ever wants to find ourselves or a loved one in this position. We are getting closer to that age bracket. We need to ensure we have more space.

Today is the last day for submissions to the NDP. If I were to appeal to the Minister of State, I would say we need to double our community nursing homes' capacity immediately. We should not build them with 40 beds or 60 beds. They do not need to be campuses or institutional settings but we need to build more of them. At the same time, we need to balance that with supporting our family-run nursing homes where when someone rings the doorbell, he or she knows that the manager answering is a local person.