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Dáil
‹ Ceisteanna ó Cheannairí - Leaders' Questions

Nursing home abuse and HIQA powers

Summary

Mary Lou McDonald raised serious abuse and neglect allegations in nursing homes and pressed for safeguarding legislation, stronger HIQA powers, mandatory reporting, and effective sanctions. The Taoiseach acknowledged the scandal, cited existing and forthcoming protections, and said HIQA already has powers including registration removal, but the exchange was repeatedly interrupted and the questions were not fully answered.

The scandal of abuse and neglect of elderly residents at two of the country's nursing homes has deepened with the publication of a HIQA report last night. It revealed that one of those homes, Beneavin Manor in Glasnevin, had almost 200 allegations of abuse of residents in the past three years. HIQA has notified the Garda of its concerns regarding the two nursing homes concerned and has requested that Emeis Ireland, the company that owns the two facilities, stops admissions to all 25 of the homes it controls. How can we have 108 allegations of abuse at just one nursing home, yet it took an RTÉ programme to expose the scandal?

What we witnessed on our TV screens was horrific. Vulnerable elderly people were manhandled, neglected, disrespected, pushed down hallways and forced roughly into chairs by the very people who were supposed to care for them. Their families are absolutely devastated and are calling on the Government to act now. The HIQA report reveals that these were not one-off failures in care caught on camera. The culture of abuse and neglect at Beneavin Manor was obviously endemic, hardwired into the operation of the home and went on for a very long time.

It is clear that Emeis did not fear HIQA. Quite frankly, it did not give a toss about regulations or inspections. It is little wonder because the hands of HIQA are tied behind its back. It does not have the legal power to impose fines. The corporate entities that own these nursing homes are out of its reach. HIQA badly needs new powers to deal with both of these fundamentals. The toxic culture in these nursing homes and the regulatory and governance failure that allows this wholesale abuse of elderly residents are a direct result of Government policy. For decades, campaigners have called for robust adult safeguarding legislation to protect residents in nursing homes, but their calls have been ignored by the Government.

Some 20 years on from the big promises of change made after Leas Cross, we have had a litany of abuse scandals, including the Brandon and Grace cases and Áras Attracta. We have had case after case of abuse after abuse, yet the Government sits on its hands. There is no safeguarding legislation, mandatory reporting or legal right of entry for social care teams to investigate complaints. There is no accountability ever.

This abuse and neglect has happened with the corporate takeover of nursing homes and care. Twenty years ago, 30% of homes were in private hands. Today, that stands at 80%. The State walks away from its responsibilities and the profit of wealthy companies is put above the care and dignity of the very people who built this country. Is toradh é an scannal seo maidir le drochíde agus neamhaird a léiríodh do sheandhaoine a bhí ina gcónaí i dtithe altranais ar theip an Rialtais gníomhú. Teastaíonn reachtaíocht láidir a chosnóidh daoine fásta go práinneach.

The Taoiseach may well seek to distance the Government from this scandal, but the fact is that the neglect and abuse and weak regulation and oversight are a direct result of Government policy, a policy to allow big corporates to take over nursing homes. The Government needs to act now. When will the Taoiseach listen to the calls of families and campaigners? When will HIQA have the powers it needs? When will the Taoiseach bring forward robust safeguarding and mandatory reporting legislation and ensure that our elderly citizens are safe and respected?

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One of the most difficult decisions for any family to have to take is to place a loved one in a nursing home. It is a very difficult decision. The least people can expect is that the dignity of their loved one will be respected at all times and that their loved one will be looked after, cared for and not be subjected to the abuse, neglect and unacceptable behaviour revealed in the "Prime Time Investigates" programme. I pay tribute to RTÉ for the important programme that dealt with this issue.

There is a fundamental obligation on the nursing homes concerned, and all involved, to look after people in their care. In no circumstances can the abuse of people be tolerated. People have a right to expect that level of care.

Additional measures to strengthen the powers of the chief inspector of HIQA have been granted from 2017 up to 2021 and onwards. A range of additional measures, capacity, power and so on were outlined in the interim report of HIQA published yesterday.

There are some very disturbing and clear facts in the interim report. For example, 61% of the homes in question did not adhere to fire regulations. That is a red alarm. There is a power to close nursing homes, which is sometimes described as a nuclear option. In my view, when things are at the level as revealed in this report, in terms of more fundamental issues like that, where clearly the health and safety of residents is at stake, that is an option.

I know it brings with it a whole range of issues but it is one that in the past used to be invoked and the HSE would be engaged. We are all familiar with HIQA investigations and reports in which it would have recommended closure. People would ask about their loved ones and ask where they should go but there does come a point if it reaches a level. The lack of compliance in a number of key areas is clear in the report. The one that jumps out, in my view, is with regard to the fire regulations. There are other aspects of either partial compliance or non-compliance. This is deeply traumatic for the families involved. In our system approximately 75% of our nursing home centres are in private hands, 20% are publicly owned and approximately 3.5% are section 38 or section 39 organisations. The fair deal scheme was the last major intervention trying to facilitate making it more affordable for people in respect of sending their loved ones and placing their loved ones in nursing homes.

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Verona Murphy An Ceann Comhairle Independent

Thank you, Taoiseach.

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In recent years the push has been towards home care but home care also involves privatised nursing care. People contract in people to help. I will come back to the final point I was going to make.

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The Taoiseach is not a commentator on these matters. He is after giving me a whole spiel there that told me precisely nothing, with all due respect. A total of 198 complaints were made against a nursing home with not a cent of financial penalty. There were no consequences until RTÉ showed up. This tells us the system is not working. It is not sufficient for the Taoiseach to take to his feet and offer tea and sympathy. We all know how difficult it is for anybody to make a decision to place a loved one in a nursing home and how difficult it is for the person themselves to lose that sense of autonomy that comes with all of that. The Taoiseach should know also there are people throughout the State terrified they would ever end up in a nursing home. More families are worried sick about the treatment of their loved ones in these facilities. I have made the point on the corporate takeover of care and the Government has facilitated that. HIQA cannot investigate individual complaints.

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Verona Murphy An Ceann Comhairle Independent

Thank you, Deputy.

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It cannot impose financial penalties. It cannot reach into these corporate structures. What is the Taoiseach going to do about that? Will he please answer my question on safeguarding legislation-----

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Verona Murphy An Ceann Comhairle Independent

Thank you, Deputy. Your time is up. The Taoiseach to respond, please.

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-----mandatory reporting and the need for social care teams to have access to these homes to protect these very vulnerable elderly people?

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Deputies

Hear, hear.

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The interim report outlines a whole series of measures that were taken to enhance and strengthen the measures and powers of the chief inspector of HIQA, in terms of the legal timeframe for decisions by the chief-----

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The CEO of HIQA is before a committee today looking for more powers. Answer my questions.

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You are interrupting again, Deputy. I have had enough of that now. I have the floor now.

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Then answer the questions.

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Verona Murphy An Ceann Comhairle Independent

Excuse me, Deputy, please resume your seat and afford the Taoiseach the same benefit that you had.

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I will answer it but you have a tactic all the time-----

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No, answer the question.

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-----of interrupting every time I get to my feet and make a point.

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And you never interrupt?

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I do not interrupt Deputies.

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I can check the record if you want. You do it regularly.

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Verona Murphy An Ceann Comhairle Independent

The clock is ticking if you wish to have an answer. Deputy Mac Lochlainn, it is not your question. I ask the Taoiseach to please resume his response.

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He is accusing people of doing something he is guilty of regularly.

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Verona Murphy An Ceann Comhairle Independent

Taoiseach, please resume your response.

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The fundamental power that HIQA has, particularly in the face of breaches, in my view, and it is one that should not be balked at, is cancellation of the licence. In my view, this is the teeth that HIQA has. Yes, we do need to review the methodology-----

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It is not sufficient.

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Verona Murphy An Ceann Comhairle Independent

Sorry, Deputy.

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-----of HIQA and it has said it itself.

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And the CEO-----

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Verona Murphy An Ceann Comhairle Independent

Thank you, Taoiseach.

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No, sorry I-----

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Verona Murphy An Ceann Comhairle Independent

No, I understand.

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Hold on a second-----

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Verona Murphy An Ceann Comhairle Independent

Taoiseach, it is not your fault and it is certainly not the other Members-----

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Conor D McGuinness Deputy Conor D. McGuinness Sinn Féin

If you did not waffle as much in the first four minutes.

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Verona Murphy An Ceann Comhairle Independent

Let me say please Taoiseach-----

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How long is this going to continue?

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Verona Murphy An Ceann Comhairle Independent

This is the problem, Taoiseach.

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It is not my problem. I am not in a position now to answer.

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Verona Murphy An Ceann Comhairle Independent

They are not hearing the answer because they are not listening.

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I cannot get my points across because of this constant-----

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Verona Murphy An Ceann Comhairle Independent

Yes, I agree.

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The Taoiseach had five minutes. If he did have an answer, he could have given it in five minutes.

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I ask the Ceann Comhairle, given what has happened and what has happened in the past number of weeks, I want a review of how this is happening. I am not going to come in here-----

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Verona Murphy An Ceann Comhairle Independent

It is not your fault, Taoiseach.

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-----and listen to everybody and give them the courtesy of listening and not be allowed to reply.

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Verona Murphy An Ceann Comhairle Independent

That is the point.

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That is fundamentally wrong.

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Verona Murphy An Ceann Comhairle Independent

Excuse me.

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It needs an intervention from the Ceann Comhairle-----

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Verona Murphy An Ceann Comhairle Independent

My intervention is that the answer-----

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-----and the Whips as well, and the Chief Whip, to sort this out.

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Verona Murphy An Ceann Comhairle Independent

They have a timeframe-----

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Then answer the questions that are put to you.

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Verona Murphy An Ceann Comhairle Independent

Excuse me, Deputy. There is a timeframe in which the Taoiseach can provide the answer.

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Resign as Taoiseach. That is the easiest way.

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Verona Murphy An Ceann Comhairle Independent

If they choose not to listen, it is kind of pointless asking the question. The reality is that everybody should be afforded the opportunity, as Deputy McDonald was by her colleagues, to ask a question.

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And I would expect answers-----

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Verona Murphy An Ceann Comhairle Independent

I would expect-----

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-----to my questions.

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Verona Murphy An Ceann Comhairle Independent

I am speaking, Deputy.

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As am I. I am entitled to answers to my questions.

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Verona Murphy An Ceann Comhairle Independent

I am speaking, Deputy, so I would expect that you stop speaking when I speak. What I am asking is that everybody afford each other the same level of respect. In that way the House will operate with decorum. I call Deputy Bacik.

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