Nursing Home Regulations Review
Rabbitte cites the Tánaiste’s assurance that regulations were properly implemented despite inspectors identifying serious problems. The Taoiseach says the 1990 Act and 1993 regulations are under review and that legislation will strengthen and unify inspection.
I do not mind but I note it is 10.50 a.m. I refer to a letter the Tánaiste and Minister for Health and Children wrote to my colleague, Deputy Seán Ryan, on 1 December 2004 which said "I am satisfied the nursing home regulations are being implemented properly".
Comment on this
She continued, "A range of problems are being identified by the inspectors of private nursing homes and these include staffing levels and nursing policy issues, maintenance of accommodation standards, hygiene problems, lack of activities for residents, poor record keeping, insufficient or no active involvement from the local authority in fire safety, lack of equipment appropriate to clinical practice, for example, pressure mattresses, etc". She goes on to explain the problems, having said that she is satisfied that the regulations are being implemented properly. This can only mean the regulations are woefully inadequate, based on an Act the Ceann Comhairle introduced in 1990 when he was Minister for Health. I want to put the question the Taoiseach avoided in responding to Deputy Kenny. Will he legislate on this matter before the House rises? Twice in the past three weeks he rushed emergency legislation through this House to save the State money and now he is humming and hawing about when he will legislate on an issue that is so pressing for some of our more vulnerable citizens.
The Taoiseach, in his remark to Deputy Kenny in respect of the HSE, stated they thought they were making progress with the operator. Can I ask him about that in the case of Mr. Peter McKenna, who featured in the programme and with whose family my office has been working over a period to deal with the circumstances that he confronted and that were shown on that programme? He died in awful and painful circumstances, which I will not describe, in Leas Cross. Following continued and persistent pressure from my office, Mr. Martin Hynes, former chief executive of the Irish Blood Transfusion Service, was brought in to investigate the McKenna case. Mr. Hynes reported a couple of months ago. How can the Taoiseach say the HSE thought it was solving these problems and how can the HSE go on television and state that it was as shocked as the rest of us and taken by surprise at the extent of the problems portrayed at Leas Cross? How can they say that when they have the Hynes report, which has not been put into the public domain? Surely they knew. Former civil servants are careful and use euphemistic language, as we know from recent events. When dealing with a Government permanently in office, they take great care to be understated. I know the Taoiseach has a bad record in inspections in north Dublin but surely this defies explanation.
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The Tánaiste and Minister for Health and Children announced some time ago that both the 1990 legislation and the 1993 regulations were being reviewed. They are being reviewed as part of the process that leads to this legislation, as I answered yesterday. Obviously, the reason they are being reviewed is they are not considered adequate.
The HSE is only in existence since 1 January but prior to that time there were ten inspectorate teams. They did not have conformity or a unified system. Since 1 January the HSE has been unifying the systems, trying to have a more robust organisation that will conduct far more vigorous inspections than at present. Under the current system, certainly since the 1990 Act and the 1993 regulations, they try to work with the management of the various institutions to bring them up to the standards they demand. I understand the Northern Area Health Board had problems, complaints and issues with the management and staff of Leas Cross. It believed it was making progress in getting these rectified. Staff now believe they were duped. That is their position and that is what they have said to me. They believe that what they were told on these issues was not being followed through and the systematic abuses we saw the other night were issues that they did not think happened. The reason for this is that they were not their 24 hours a day. The staffing levels were not what they thought. The standards were not what they thought. At times, obviously they were adequate but at other times they were wholly inadequate. That means we need a far more robust organisation with more detailed inspections. That will obviously mean, in time, more staff. It will mean a new inspectorate that will be probably far more vigilant than has been the case in the past. That is a fact.
In answer to Deputy Rabbitte, I am not tooing and froing. I have answered twice already that the legislation will be published in the autumn.
Comment on this
The legislation is being prepared. It is legislation which will include inspectorates for a range of areas, not just nursing homes. That is under way.
I do not have details or knowledge about the case to which the Deputy referred but I imagine there are other cases too. The reality is that while there is an inspectorate, it should fully cover medical, nursing and environmental inspectors. It does but it has not sufficient presence. That was clear from the programme and from complaints like the one to which the Deputy referred.
The lesson from this is that we need stronger legislation. As we all know, stronger legislation, if not implemented, means nothing. Really what we need is an inspectorate that has conformity, that is unified, that conducts more inspections and that obviously will have more staff without which it could not do the work. In the meantime, the current regulations allow for many of these matters anyway. The HSE is determined over the period ahead, not only with Leas Cross but with some others it has mentioned, to work with the individuals and the nursing home association to try to get action. That is the truthful and honest position.