^ Health (Nursing Homes) (Amendment) Bill 2006: Second Stage. – 7th December 2006
Mr. Norris: I have spoken on the issue of nursing homes on a number of occasions, but not on this Bill, of course. I am reluctant to regurgitate what I have said on the subject before. However, this is a very important area and it has been highlighted by the media, in particular the investigations by RTE and others into the tragic situation at Leas Cross.
From the outside, what a lovely place it looked. One would imagine everybody was comfortable and well cared for. Then we learned that the situation was not as it appeared once one was inside. I listened to a woman on radio the other day who told a tragic story about her father. He had been very active, went into Leas Cross, I believe, and had a series of illnesses complicated by minor strokes as well as lung infections.
The woman visited one day and her father was not well. The next day they said he was better. They wheeled him out in a type of pram with a rug around his legs, his spectacles stuck on his face and the newspaper on his lap. The man was dying, but this was all just cosmetic to persuade the relatives that he was improving. The relatives insisted on an ambulance being called and waited a considerable time, but nothing happened. Eventually the daughter said they would take the man to hospital in their own car because the nursing home people had first of all said, "There is no admission from here", which was a very strange phrase to use.
Ms O'Rourke: Where was "here"?
Mr. Norris: It was Leas Cross, I believe, and there was no admission. In other words, they did not want to send patients from Leas Cross. Again, when one considers the phrase, "bed blockers", it precisely fits the description of people such as this old man. People describe them as bed blockers. That has ramifications whereby people do not want them admitted to hospital. It is a dreadful phrase-----
Mr. S. Power: It is terrible.
Mr. Norris: -----but in any case, they found that the ambulance did not turn up. A real ambulance had not been called, rather a type of patient care vehicle. It was only when the family said they were taking him into hospital that an ambulance was produced. In the event, that ambulance was there in ten minutes, so sometimes the services exist, but are not properly being called on.
There is a growing problem for a variety of reasons. First of all, Ireland has changed in social terms. We do not have the extended family any longer. This is having major effects. I expressed concern yesterday on the Order of Business about the alleged extraordinary high levels of what was described as psychiatric illness among children. If it is true that one fifth of children suffer from serious psychiatric illness, then it is not just the children who should be examined but the whole organisation of society. Again it strikes me that the extended family norm no longer exists.
For a variety of reasons an increasing number of people make use of services of this type and in some cases this is not entirely appropriate. I heard a woman speak on this subject who said she had been running a nursing home for the past 30 years and that it had changed significantly because of the increased number of elderly people with severe Alzheimer's disease who needed one-to-one care virtually around the clock. She said nursing homes were not in a position to provide this care. It is wrong to blame nursing homes if there are people in them who are not appropriate candidates for this type of treatment. We must look very closely at the issue of Alzheimer's disease.
I am very concerned about the inspection of nursing homes. It seems to me that particularly since Leas Cross, private nursing homes are subject to inspection. I am much less happy about publicly funded nursing homes because we hear so little about what goes on in them. If, in the regime of nursing homes for which patients pay enormous amounts of money and relatives routinely visit, almost nothing is heard about the situation in State-funded and State-run homes, there is an urgent case for a proper inspection regime for such institutions and I do not believe this is happening.
By coincidence I have just left the restaurant where I spoke to somebody who
is not a Member of the Oireachtas but is a crucial part of the parliamentary
system, namely, Ms Anne Byrne, a programme manager to Deputy Howlin.
Acting Chairman: The Senator is aware he should not refer to people in that manner.
Mr. Norris: I beg the Acting Chairman's pardon. I did so in the most positive possible manner. However, the name cannot now be withdrawn. In any event, she is representative of-----
Mr. S. Power: Members will keep it secret.
Mr. Norris: They will. However, there is a large number-----
Ms O'Rourke: She is a very nice woman.
Mr. Norris: She is. She is much better than nice as she is also very effective and capable.
Acting Chairman: This is getting worse.
Mr. Norris: As my good friend, the Leader of the House, is aware from her own ministerial responsibilities, a number of people in Departments never receive the accolades they deserve.
Some years ago, an aunt of mine who had reached her 90s needed to enter a home. She decided on this herself and, while I was abroad, had gone in and out of a particular place, which turned her down. She was extremely upset because she thought it was because she was too old. I wrote to the home to ask whether that was the reason and in any event to let me know whether there was anything I could do for them, because it was such a wonderful place. They did their own baking and at Hallowe'en, the attendants dressed up as witches, which was good fun. Everyone knew one another and had their independence. They had their own little rooms in which they could have their glass of sherry.
Ms O'Rourke: Lovely.
Mr. Norris: It was marvellous. Moreover, there was a smell of cooking from the kitchen. They did not use bought-in television dinners, rather they made their own bread and all the rest of it. It was lovely.
Its managers immediately wrote to me and asked me to visit them at once. It was run by the old girls of Alexandra College, who were charming. It was a real old-style St. Trinian's effort. However, they did not operate in the real world at all. They charged something like €200 a month for the service, which would not even cover the cost of the food. I told them to take the decision to stay open, that everything would flow from that and that I would take responsibility.
I contacted the unnamed person whose name I put on the record earlier and she secured a subvention for them. It was the kind of subvention that is being addressed by this Bill because for some reason, they had not been in receipt of it. Consequently, any old dear who did not have the money was topped up. I then contacted the grand nephew of one of our greatest writers, namely, James Joyce. I will not name the grand nephew because Members are not allowed to do so. However, we are at least allowed to name one of our great writers. He was a financial expert.
Acting Chairman: The Senator may name anyone who is dead.
Mr. Norris: Great. I thank the Acting Chairman. I refer to the grand nephew of James Joyce, who is a financial wizard and does not have an artistic bone in his body. However, he put together a scheme whereby if relatives paid in money - I forget the name of the mechanism - they could get the income tax back.
Ms O'Rourke: Did the Senator's aunt pass away?
Mr. Norris: Eventually, yes. However, she lasted for ten years and lived to be 103.
Ms O'Rourke: Baking every day.
Mr. Norris: The term is covenanting. Between the document we drew up on covenanting and the assistance of the Government, I am pleased to say the establishment has its doors open to this day, which is terrific.
Ms O'Rourke: That is great. Where is it?
Mr. Norris: It is in Harold's Cross. It is also extremely disturbing for elderly people, who are used to a regime, to be moved somewhere else. This is a problem, regardless of whether it is as good.
Mr. Glynn: It confuses them.
Mr. Norris: I accept the Government must regularise the position, particularly after it was discovered that there was an illegality in taking money from people. However, one of my concerns regarding the Bill is that it states that older people with an income of more than €9,000 per year, or savings worth more than €36,000, may be refused subvention. The sum of €9,000 per year is very small. I am unsure whether this is before or after tax. This comes to approximately €800 per month.
Ms O'Rourke: What about their pension? I forgot to ask that.
Mr. Norris: This is not a large sum. Moreover, a subvention is merely a top-up and if these figures are accurate, it seems to be extremely mean-minded.
The question of the home also arises. In a small number of cases, there is a possibility that people might be able to return home after some restorative care. It seems to be unnecessary in every case to sell a modest suburban home. It seems that under some of the Bill's conditions - Age Concern has expressed reservations in this regard - there could be pressure on older people to sell their homes, which would be a pity. In cases in which people who had a house were in a nursing home and died, perhaps there could be some mechanism for making up part of the money subsequently. However, I would leave them with the opportunity to return to the home, if that is at all possible.
Mr. Glynn: That is the Bill's objective.
Mr. Norris: If that is the case, I am all in favour of it.
Ms O'Rourke: Perhaps the Minister of State will respond to this point.
Mr. S. Power: I will.
Mr. Norris: However, the reports-----
Mr. Glynn: Just to say that-----
Acting Chairman: Members are not engaged in a Committee Stage debate.
Mr. Glynn: Yes. However, it is the objective of every hospital to return people to the community.
Mr. Norris: I am delighted by that. However, it does not appear to be the Bill's objective. Perhaps this can be examined.
Acting Chairman: Senator Norris has exceeded his time considerably.
Mr. Norris: Have I?
Ms O'Rourke: He is well worth listening to.
Mr. Norris: Not really.
Acting Chairman: I do not have that discretion.
Mr. Norris: However, the interruptions certainly were most helpful. In fact I would scarcely describe them as interruptions. They were well intentioned additions to my comments from my friends on the Government side of the House, with whom I disagreed only yesterday regarding the Defamation Bill. I am glad that in the spirit of reconciliation and Christmas, all Members are again at one in attempting to protect elderly people among whom, if they are lucky, they will be numbered eventually. As the American gentleman noted, the alternative is considerably less comfortable.
Acting Chairman: I am relieved Senator Norris has not reached that point just yet.