Nursing homes and gender-based violence
Deputy Sherlock raises failures in private nursing homes and the need for reform, with the Tánaiste agreeing the State is too reliant on the private market and promising work on care models and home care. Deputy Coppinger then challenges the Government’s record on gender-based violence and the fate of her Bill; the Tánaiste cites expanded refuges, Cuan, funding, training and a forthcoming Government Bill.
I thank Deputy Sherlock for highlighting this really important issue. The short answer is that I believe the State is too reliant on the private market when it comes to nursing home provision. This is why we established a commission of care. We need to look at the entire model of how we care for older people in this country. I also think the fact we have one statutory scheme as to how we care for older people, which is nursing homes, and we do not yet have a statutory scheme for home care, is another issue. I will commit with the Minister, Deputy Carroll MacNeill, and the Minister of State, Deputy O'Donnell, to work constructively with Deputy Sherlock and her party on this issue. I will also ask that consideration be given to some of the issues Deputy Sherlock has referenced with regard to the 2022 report.
I want to make the point that we need to get the safeguarding legislation in place. This has been very apparent in what we have seen in recent days with RTÉ's very excellent work. The Minister will bring to Cabinet within the next month the adult safeguarding policy and seek Government permission to draft the safeguarding Bill. We will then work intensively and constructively with Members across the House to get the right piece of legislation passed in a timely manner. This is really important.
I have been reflecting on this. I fully accept that people work in very demanding environments but I also believe that what stems from what we have seen in our television screens in recent days are real questions of personal accountability. There are laws in our land today in relation to assault and how we conduct ourselves. I urge that a referral is made to An Garda Síochána with regard to the footage we saw. What I saw with my own two eyes were haunting scenes of people being, in my view, physically assaulted in their home. The Government has a responsibility to do things absolutely but so too do people who carry out those actions. There is a need for a Garda investigation into what we saw with regard to the individual actions of people in relation to that.
HIQA also has questions to answer and I welcome the fact that the Minister, Deputy Carroll MacNeill, is due to meet it, along with the Minister of State, Deputy O'Donnell. HIQA is good organisation in many ways. I have known HIQA for a long time and I think it has done good. There are good people in HIQA. There were serious shortcomings also in this regard and there can be no doubt about that. There are actions that should have been identified and acted upon at a much earlier stage.
Yes, we need to have a much broader discussion about the model of care we have for older people in this country. That work is under way. Of course pay and terms and conditions, just as Deputy Sherlock rightly says are factors in other sectors such as childcare, are factors in this also. We also need to get the legislative basis right. We need the safeguarding legislation. We also need to make sure that HIQA understands its role and has all the tools it needs. I also think we should look at statutory home care as an alternative legal basis for how we care for older people. These are the three areas where I would like to see action shortly.
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The Tánaiste was the Minister for Health when the report of the inquiry into private nursing homes was published in 2020, with regard to the failures that happened in nursing homes.
The Tánaiste was the then Minister for Health who saw those very clear recommendations, which have not been implemented. We have a plethora of reports within the Department of Health post-pandemic, mainly stemming from 2020 to 2022, which have not been implemented.
There are hundreds of thousands of people out there who are looking to their future. We know there will be half a million people over the age of 80 in 25 years' time. People in my constituency have three generations in a house and will have no choice but to go into a nursing home. We can have all the home care supports they want, but they will end up going into a nursing home when they get to a particular stage of their lives. They need to know that they will get the care they need. There is a pattern between Leas Cross, the failures in 2020 and what was revealed last week. In the Labour Party's view, it is the influence of big business with regard to how they have used nursing home care in this country to generate profits and not provide adequate care on the ground. The State needs to take a leading role in that regard.
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I agree with Deputy Sherlock's earlier point that there are many good nursing homes in this country. There are many good public nursing homes and many good private nursing homes, big and small, throughout the country. I do not have an ideological view in that regard. I just want older people to have a choice in their care, I want their families to be supported in making those decisions and I want to know, whether it is a public or private nursing home, that everyone is safe and is being treated with dignity. I also believe we should be more ambitious about care in the community and that far too many people in Ireland go into a nursing home far too early. I can think of good examples of where we have housing alternatives in place and home care opportunities, but they are far too rare. That is why the Minister of State, Deputy O'Donnell, became the first Minister of State with responsibility for older people ever, based between the Department of Health and the Department of housing, because we must get this model right.
There are also genuine, serious issues of personal accountability. There is no law, ideology or model of care that can excuse away, either in its existence or its absence, the conduct of people who decided to physically manhandle elderly people with dementia. I want them held accountable and the Garda to look at the matter.
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How important does the Tánaiste think the issue of gender-based violence is? The United Nations and the WHO say it is the greatest threat to the health of women and girls in the world. There has been a record number of calls to Women's Aid and a rise in calls to gardaí regarding gender-based violence. I am struggling to find one measure the Government has introduced in its six months.
Today, however, the Government had a chance to allow a Bill to progress that would actually deal with something very concrete, that survivors and therapists are very much behind and that the Tánaiste supported only a year ago, namely, the outlawing of counselling notes being accessed by defence teams in trials for gender-based violence. The Government has decided to delay my Bill, which will be discussed in the House later today, by a year. It is a very cynical measure and is something that will be noted by so many people. This is an unbelievably damaging and misogynistic practice for survivors. I will give the Tánaiste an example of what Sarah Grace said:
... in many ways I found my trial more traumatic than the attack itself. Can you imagine saying that? ... I would take the attack again before having to step foot back in that courtroom. The most heartbreaking obstacle of all was the seizure of my counselling [notes].
Is the Tánaiste listening to what survivors are saying about our legal system - that they would actually go through the attack again, rather than go through the legal system? One of the most egregious things mentioned by survivors is the fact that their therapy notes could be read by the perpetrator of the heinous crime against them. I will let that rest with the Tánaiste.
I have a Bill to outlaw it. I do not know what the Tánaiste's excuse is. We have been hearing from the Minister that it could be unconstitutional. However, evictions could not be banned until this week. Suddenly, that is not unconstitutional. Therapists will gather outside Leinster House later in support of my Bill. A total of 60 professionals wrote to the Ministers for Health and justice and the Minister of State with responsibility for mental health. This is a health issue, by the way, not just a mental health issue. Survivors of gendered violence are much more likely to have self-harmed, poor physical health, suicidal ideation and eating disorders. Therapy is the one avenue that could possibly help them work through those issues.
I spoke to one of the therapists who signed the letter on the phone yesterday, who told me a 15-year-old has dropped out of CAMHS because the teenager had heard in the media that therapy notes could be accessed in court. A survivor of child abuse is dropping out of therapy because of this. How long must we wait? Why would it take the Government a year to come up with a Bill in the first place? Why would the Government put a stop of a year on my Bill? People have waited. The then Minister, Deputy McEntee, said she would do it in 2023. The Tánaiste said it in the Dáil on 2 July 2024, as did the Taoiseach, Deputy Martin, but here we are again. We have a Bill to be debated in the Dáil but the Government will delay it.
Comment on this
I thank Deputy Coppinger. First, I do not think that is a fair portrayal of the Government's record, Fine Gael's record or the Government's position regarding this issue. The Minister, Deputy McEntee, is sitting beside me and I challenge the Deputy to name any Minister who has done more-----
Comment on this
-----regarding domestic, sexual and gender-based violence than she has. She worked on a cross-party basis at every opportunity to make progress. The Deputy does not need to take my word for that; victims' groups and survivors' groups acknowledge that. I saw it with my own two eyes as well. Not every issue has to be partisan, or Government-----
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Not every issue has to be defensive either.
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This is a very sensitive issue. I am just making the point that every time Deputy Coppinger stands up it does not have to be a case of the Government being a terrible bunch of people and that she is great. Sometimes, perhaps there are just some issues that are so important that we should actually work together to try to make progress on them.
The reason we are delaying the Deputy's Bill, to use her phrase, is not out of disrespect for her Bill; it is actually out of respect for what she is trying to do and in recognition of the fact that we have our own Bill. The Minister, Deputy O'Callaghan, received Government approval to bring forward legislation in this area last month - in advance of the Deputy's Bill being tabled for discussion in this House - building on the Minister, Deputy McEntee's work to make sure that we rectify the exact issue she rightly highlighted.
I too have met victims. I am horrified; how can anyone not shudder when they hear what the Deputy said about the survivor of child abuse and the impact it has had on the survivor in accessing CAMHS. The Deputy is not wrong on this; this is a very serious issue that has a real chilling effect on victims and how our criminal justice system and courts system interact with them. It is our intention to legislate, or it is not just our intention in that the Minister, Deputy O'Callaghan, already has Government approval for the general scheme of the criminal law and civil law (miscellaneous provisions) Bill 2025. That is the vehicle through which we intend to address this issue.
The Government will not vote down the Deputy's Bill because it is an honest effort to make progress on a very important issue. Therefore, we are saying that the Deputy's Bill will be read today and the Minister's Bill will be brought forward. Let us try to get progress on this on a cross-party basis and work together in this regard.
For the record of the House, there was an effort in 2017 to reform the law in this area and put in place a process through which the courts would assess the relevance of counselling record. I am not saying it is perfect; it is far from it, but my understanding is that this legislation has not operated in any manner or means as it was intended to. Therefore, we have listened very carefully to the views of victims and survivors. They have made clear that they felt compelled to agree to waive the disclosure hearing in order to not put a successful prosecution at risk or to risk delaying their trial. That is an appalling vista and was never the intention of the 2017 provision. Records are routinely being released. That was not the intention of the 2017 provision.
We are fully aware of the stress and revictimisation that the disclosure of personal records can have on survivors of sexual violence, including counselling records. We are not waiting for a year to do anything. The Minister has approval to draft this legislation. The Deputy will bring forward her legislation today and we will work constructively to pass a good, robust Bill as quickly as possible.
Comment on this
There is an irony in the Tánaiste saying we should all work together when the Government is stopping my Bill. The Government could have allowed the Bill to progress. We could debate it and it could amend it on Committee Stage. The problem with the Bill the Minister seems to be talking about is that it will not exclude the potential for counselling notes to be admitted. That is the problem. The actual potential of having one's therapy notes accessed is what creates the trauma and is what is putting people off taking cases. The Government will not exclude that, which is the problem. The right to a fair trial is very important, but so is the right to actually pursue a case for a crime committed against a person. There is no evidential value in counselling notes.
I blame Éamon de Valera for many things, but I doubt counselling notes were at the top of his agenda when he inserted the Article dealing with fair trials in the Constitution. A lot was said about zero tolerance, but every single misogynistic practice I highlighted in this House in 2018 is still going on in the courts. Clothing, underwear, contraception and alcohol and drug intake can all still be used against a survivor in court. All the victim-blaming is still there. None of that has been dealt with by successive Governments since the "I Believe Her" marches, the Cork rape trial or the Belfast rape trial.
That is the problem.
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Let me be clear: domestic, sexual and gender-based violence is still an epidemic globally, including in Ireland. We are not immune to it. That is not to say that the work that has been undertaken has not brought about real assistance. I refer to the expansion of refuge places, the establishment of Cuan, record funding for groups working with people in this area and training now being in place, which is a key part of the zero-tolerance strategy. That includes training for people in the public service and for our courts system. Our courts system, however, is not where it needs to be. I think members of the Judiciary have recognised that too, and that is why we are changing the law, so on this issue I plead with the Deputy not to start telling people we are blocking her Bill and doing nothing for a year. That is called misinformation. It is called fake news. We are not blocking her Bill. We are passing a timed amendment that means her Bill will move forward in 12 months if we have not got our act together, and we will get our act together. That is why the Minister, Deputy O'Callaghan, months before Deputy Coppinger's Bill got permission to draft his own Bill. Victims and survivors do not care whose Bill it is; they care about action. This Government will take action to protect victims and to make sure we do it in a way that is compatible with our Constitution but protects victims and survivors in a way they are not today. That is what we will do, and we will get it right.