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Dáil
‹ Leaders’ Questions.

Leas Cross nursing home oversight

Summary

Kenny says the Government has failed to establish the promised independent nursing-home inspectorate and questions existing oversight after the Leas Cross scandal. The Taoiseach points to HSE inspections, statutory plans and increased funding for older people.

One of the darkest days this country experienced was 30 May 2005, when the "Prime Time Investigates" programme exposed the shocking conditions in Leas Cross nursing home. Following that programme, the Taoiseach on 31 May promised in the Dáil to establish an independent inspectorate for all nursing homes, the legislation for which would be published later that year. That promise was repeated by him on 1 June 2005 and reiterated by the Tánaiste on 20 July. We now see from the Government programme published by the Chief Whip that the promises by the Taoiseach and the Tánaiste have not been met. There is no date for the production of legislation on an independent inspectorate.

We should not be too surprised at this Government's failure to deliver. The health strategy published in 2001, the Sustaining Progress agreement and the programme for Government in June 2002 all promised an independent inspectorate for nursing homes. All these promises were broken. The Government has reneged upon these specific commitments, which refer to the most frail and vulnerable among our citizens. The Tánaiste was well able to bring in emergency legislation to claim back retrospective payments from money taken from people in long-stay geriatric homes. The issue of the standards in our nursing homes has not been addressed with the same sense of urgency by this Government.

Can the Taoiseach provide a reasonable explanation for why he stood up here on two occasions to promise this legislation and why the Tánaiste also made a promise if it has not been delivered? Can he tell us why he was in a position to say last May, June and July that this was a priority for legislation, given that it does not now appear in any of the Government's own programmes?

The Taoiseach should be aware — I am sure he is — that this delay has caused massive concern among the owners of nursing homes in which the standards of care and attention are as they should be. However, because of the Government's failure to implement and draft legislation for an independent inspectorate, everybody is being dragged down by those who do not even measure up to minimum standards. Can he explain why the Government has failed on this fundamental issue in respect of the elderly, the frail and, in many cases, the neglected and why it failed to deliver on this legislation?

Comment on this

I made the point several times last year that the HSE already has a large number of staff involved in the supervision and examination of standards in our nursing homes and we stated at the time that we would put that on a statutory basis and would enter a period of consultation on how it can best be done. That did not take from the HSE's move, immediately after the events of last summer, to examine all our nursing homes to make sure they had the requisite complement of staff on duty at all times, had drawn up individual care plans for patients, maintained a safe and supervised environment for elderly people, implemented activities programmes and had developed and implemented policies on incontinence wear. Many of these matters were highlighted in Leas Cross and recent inspections around the country have shown that these conditions are being applied and adhered to.

Deputy Kenny is correct that it is not yet on a statutory basis but he wrong in saying these issues are not being dealt with through the HSE and its various regions. The HSE has advised us that it will continue to closely monitor the conditions in nursing homes to ensure high levels of care are afforded to residents. Many of those were previously happening and happening well but, obviously, the Leas Cross breach shows that standards and numbers involved were not high enough. Leas Cross was an awakening to that and the home subsequently closed because of it. Other standards were implemented in other areas, so it was a useful exercise and a lesson learned. I am not sure of the latest date for the Department and the parliamentary draftsman to put forward legislation but the standards are being implemented.

Comment on this

The Leas Cross exposure was not simply important. It was a national scandal that brought shame on this country, in which the elderly, the sick and the frail were exposed to degrading and horrific treatment. I am informed by my colleague, Deputy O'Dowd, who has been pursuing this for a number of years through the Freedom of Information Act, that there are serious questions about the adequacy of the existing inspectorate regime within the Health Service Executive. I understand that an independent review of Leas Cross, which was completed in June 2005, found, in simple terms, that it should not have been registered in the manner it was or, indeed, registered at all. The report found that nine of the 11 double bedrooms in Lea's Cross were below the required standard. That means half the rooms originally used were below the required size.

To make matters worse, in August 2004, nine months before the "Prime Time Investigates" programme, the health authorities were given specific warnings about serious inadequacies in the inspection regime and were alerted to the type of activities the nation saw on that television programme. I believe worse was seen by those who inspected that facility. We can only speculate on how much suffering the elderly in that place had to endure. The novelist Mr. Anthony Powell said that "Growing old is like being increasingly penalised for a crime you haven't committed" and unfortunately, in some cases in this country, that appears to be true.

The Government has had massive resources at its disposal but has wasted obscene amounts of money in many areas. It has failed to draft legislation for an independent inspectorate. The Taoiseach opened this nursing home but he did not want those kinds of standards to pertain — I know he did not. It is his responsibility to ensure his Government introduces legislation to guarantee that standards are monitored and best practice prevails. When does the Taoiseach propose to introduce such legislation and when will the O'Neill inquiry, which is investigating 97 deaths at Leas Cross, be finalised and its report published?

This is not simply an ordinary legislative matter, it concerns the quality of life of those who built this country. In their last years, such people deserve comfort, high standards and the knowledge that the State takes an interest in their welfare.

Comment on this

We all agree, and that is why the Government has invested enormous resources. I do not have to go through the details, including those in the recent budget, but I do not think the Deputy is correct that we wasted any of those resources. We have invested significantly in the care of our older people, as well as looking after them in terms of welfare payments. We invested an additional €110 million in the recent budget, a sum of €150 million at full cost, for packages to help elderly people. We are committed to maintaining older people in dignity and independence in their own homes, in accordance with their wishes, for as long as possible and to providing high quality, long-term residential care for older people, where necessary.

The social inspectorate has been working on an administrative basis for the last six or seven years on protection issues but last year it highlighted that more needs to be done. Legislation is being prepared. I have already spoken about actions being taken prior to the enactment of the legislation, which will provide for the establishment of a health information and quality authority and a social services inspectorate, based on the current administrative arrangements. The social services inspectorate function will be vested in a new statutory office, to be known as the office of the chief inspector of social services, which will provide for the registration system in respect of residential services to make sure they adhere to all the standards I referred to at the outset for older people and those with disabilities. It will replace the existing registration system. We should not pretend there is no system in place, because there is, under the Health (Nursing Homes) Act.

It is intended that the function of the new office will be to monitor the standards for residential services for elderly people, those with disabilities and children in care. I do not have a date for the introduction of the Bill but the draft heads of the legislation are at an advanced stage, will be submitted to the Government and then hopefully the House will deal with it quickly. Legislation, however, is not the beginning and the end of the matter and all of these issues are being monitored closely.

Comment on this