Jimmy Deenihan (Kerry North, Fine Gael)

I welcome the opportunity to speak on the Bill and this very vulnerable sector of society. Unfortunately the benchmark for success as seen by the Government and a large number of commentators is how the economy is progressing. The economy should be seen as an important part of society as it provides the necessary resources to enable the most vulnerable and those who need support to get it. Those who look on the economy in isolation have tunnel vision of how a society should be run.

We politicians are elected to represent the entire society, not just a particular sector. That is why the Bill is important although we in the Fine Gael Party do not agree with all aspects of it and consider it should be more comprehensive. I understand that our spokesperson, Deputy Twomey, will table amendments to improve the Bill. Nevertheless, it is important for the type of protection it will afford to three vulnerable sectors of society, children in residential services who are in need of care and protection, people with disabilities and older people.

I understand there are approximately 21,000 patients in public and private nursing homes. According to Government figures the number will increase to 44,000 by 2036 and to 61,000 by 2056. That is a conservative estimate. From my experience, people are living longer because, generally speaking, when they go into nursing homes they get better care and more services are provided for them. Due to isolation and given that families are not as committed as in the past to looking after their elderly relatives, more elderly people will go into nursing homes. There is no doubt this will result in a greater imposition on the budget to provide services for them.

In general, our nursing homes are in good condition and have good hygiene standards and a major effort is made to keep patients and their environment clean. Unfortunately, there have been exceptions where nobody seems to have bothered. That nobody monitored or supervised what was happening means there are a number of bad examples. Hopefully the Bill will provide the protection people need.

When replying will the Minister indicate whether standards will include accommodation, qualifications, numbers of employees and screening of employees, their background and so on. Employees who work with vulnerable people must be of the highest calibre and have an impeccable record and must be of sound character. Recently we discussed an advocacy Bill for people with disabilities. Will part of the remit of the chief inspector of social services be to provide advocacy services for patients and, if so, is that provided for in the Bill?

There are respite centres for children with disabilities. Are such centres provided for in the Bill? Given that it is important for a parent who has a child with special needs to get rest at the weekend, the child is placed in a respite centre operated by the HSE or by other organisations. Is that provided for in the Bill?

On the issue of care of the elderly, the home care package is weak; I am aware of this from recent experience. If we were to depend on the home care package to keep people at home they could not stay at home unless other services were provided. While it has been said that a good home care package exists, that is not the case. The back-up services for people who come out of hospital following a stroke or a serious operation are not as extensive as they might be. Unless a family member is present or unless the family pays somebody to be present, the home care package as it exists is not adequate to provide the type of support needed by older people recovering from illness and who may never fully recover to allow them stay at home as is their wish.

There is a certain therapeutic aspect for an old person to live in his or her own home. It helps them to recover and remain positive. In many cases when people are institutionalised they give up hope and just wait until their life ends whereas when they stay at home they are far more positive.

I welcome the Bill. It provides us with the opportunity to debate the issue of care in nursing homes. Perhaps the Minister will indicate if the three issues I have raised are provided for in the Bill?

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