Vol. 208 No. 10
I move amendment No. 1:
In page 2, section 1, subsection (1), after line 23, to insert the following paragraph:
"() premises in which a majority of the persons being maintained are being treated for acute ailments by or under the control of medical or surgical specialists".
This is an amendment to meet the amendment put forward by Deputy P. Hogan (South Tipperary) on Committee Stage, which I then promised to accept in principle.
I think the Minister's amendment meets fully the point raised.
We have no objection to it.
I move amendment No. 2:
In page 3, section 2 (2), paragraph (h), line 30, after "for" to insert: "periodical inspections of all such homes by health authorities and their officers and also provide for".
It is quite true that those of us who live in rural areas particularly have not any great experience of homes such as are covered by this Bill. The Minister, on Committee Stage, objected to an amendment somewhat similar to this because he did not feel there was any need for such inspection as is envisaged by this amendment. I read—I believe it was in the Press about four weeks ago—a letter purporting to come from the Irish Housewives Association in which it was stated by the Secretary that they had sent to the Minister, or were about to send to him, certain facts relating to difficulties in homes, which they felt should be inspected and should be investigated. It is because of the fact that such evidence is said to have been made available to the Minister that we felt that we should re-table our amendment on this Stage, to give the Minister, if he wishes, an opportunity of including in the Bill, before it becomes law, some regulations that would deter, in some way, by the mere fact of its being in the Bill, such happenings. It is rather unreasonable to say that until such report reaches the Minister an inspection will not take place.
I agree with the Minister nobody wants to make this Bill so difficult and so drastic as to stop the type of home, which is at present rendering such good service to people who are mainly in need of food, shelter and care, without particular medical attention. Nevertheless there could be, and apparently are, if the Irish Housewives Association are to be believed, in the city of Dublin, some homes which do need inspection. I would appeal to the Minister in the interest of making this a good Bill, to include in it the right of inspection. The mere fact of its inclusion in the Bill, even if it is never used, will be a deterrent and will put an obligation on those running such homes to keep them in such condition and to give the people in their charge such treatment as will be worthy of houses called homes.
I am glad Deputy Kyne mentioned the letter from the Irish Housewives Association which appeared in the Evening Press on 24th March last in which it was stated that in 1958, when the Irish Housewives Association first brought this matter to the Minister's attention, one of their members reported three cases, evidence of which she was prepared to give to the Minister, if called upon to do so. There then followed a statement of three instances where it was alleged abuses had occurred. May I say, if those statements had been substantiated by the Irish Housewives Association, I would certainly have been very greatly relieved in my mind in dealing with the problem. I would then have had, for the first time, some definite evidence produced by a responsible body, evidence which would demonstrate, to my satisfaction at any rate, that on the facts a real case might be made for inspection before registration, rather than take the line proposed in the Bill and defer such a visitation to premises, as the commissioning of an official to inspect and to probe into the conduct of them and the treatment of patients in them only when a complaint had been received.
My feeling in relation to this whole question of inspection is that one or two solitary cases are certainly regrettable but not conclusive. However, it might be, as I said, that it would have given me some satisfaction if people had come along and demonstrated that these abuses really existed. And, even if there had been only one or two, I might have been moved to ask the House to give me power to require inspection, though I would have done that with a great deal of hesitation, because in the exercise of such power I would be using the whole apparatus of the State to go into premises and probe into the conduct by people of their business—and this merely on the fact that one or two instances of abuse had emerged.
There are a considerable number of these homes throughout the country and it is admitted by everybody that in the great majority of cases, at any rate, they are performing a useful public service. As I said, if the existence of abuses had been demonstrated to me I think I would, on the whole, have said: "Well, since the evidence has been adduced, we will have an inspection". I would have done that with a great deal of hesitation, however, for the reason I have mentioned. I do not think we should have the equivalent almost of a Gestapo, walking without notice into a person's premises, into a house in which people are being looked after, and probing and investigating those premises from roof to cellar. That, very regretfully, would have been my position had evidence been adduced. The fact of the matter is that no evidence was adduced.
This Association wrote to the Minister for Health, not in 1958, as they have said in this letter to the Evening Press, but on 19th April, 1960. I had better put their communication on the records of the House. It is written as from the Irish Housewives Association, 19 Ely Place, and it is dated 19th April, 1960. It is addressed to the Minister for Health, Custom House, Dublin.
Dear Sir,
We enclose a short statement on the need for the registration of Nursing Homes and we should be grateful if you would receive a deputation to discuss the matter.
Our Association is seriously concerned by persistent reports of unsatisfactory conditions in nursing homes and we have several cases which we can use as evidence of the need for such registration.
We know you will appreciate our difficulties in mentioning names of Homes or patients but we ask you to trust out integrity as a nonprofit making Association with a long record of service to the public and to grant us the favour of an interview.
Certainly housewives do not seem to lack appreciation of their due need of self-praise. But what evidence can there be when even the name of the place where the abuse is alleged to exist cannot be stated and they are not prepared to mention the name of the person who gave them the information.
Did the Minister see them?
Following that letter they were seen by my officers on 20th May, 1960. At the meeting they tendered a statement on their own headed paper saying:
NURSING HOMES 1.
Nursing Home owned by a woman not a nurse, catering for patients who require general nursing as well as old people requiring care. Number of patients about 20.
That might be case No. 1 in their letter to the Evening Press on 24th March last. In the Press the home is described as—
A "home" run by a retired nurse, who had entire charge of five bedridden elderly patients, with the help of a charwoman for two hours each day.
In the letter to my Department it is a home owned by a woman not a nurse, so there would appear to be a discrepancy between their two accounts of this particular case,
The second reference is a—
Nursing Home catering for seven patients in small private house run entirely by the owner, a trained nurse aged 79. Only help employed was a charwoman....
It occurs to me now reading both, that perhaps their No. 1 case in one letter has become their No. 2 case in the other, and vice versa.
CASE No. 3:
Nursing Home catering for general cases and old people. Aged patient kept in room under stairs with no window, wire netting. Fees from 10 guineas downwards.
That appears in the letter to the Evening Press as—
A home where an elderly patient was in a "room" under the stairs, with no window.
There is no mention of wire or anything else in the letter to the Press. I grant you these would be deplorable cases, provided it were demonstrated that they in fact existed. The ladies on this deputation came in and saw my officers. They discussed the whole matter with them and the record of the meeting shows that they left, apparently, without mentioning where these homes were which they alleged ought to be inspected, and without mentioning the names of their informants. Despite what the Honorary Secretaries of this Association said in their letter to the Evening Press of 24th March, of this year, I do not think there was any evidence adduced at that interview which would justify me coming to the House and asking the House to empower local authorities to inspect every nursing home in the State.
Having considered the matter, as I have said, I declined to do that. Instead, I brought in this Bill which, let me say, is an empirical measure. It is, I think, as far as I am justified in going on the basis of the information given to me, and on what I know, so far, about this problem. It is not impossible that, when this Bill becomes operative, some evidence may become available to us, which will justify the Oireachtas in meeting to some extent the views expressed here and elsewhere as to the need for inspection. Until the need for that inspection, however, has been fully demonstrated we are not, I think, justified in going further than we go in this Bill. I hope, therefore, that the House will reject the amendment and allow the Bill to pass through its final Stages.
The Minister has actually made the case in his speech as to why this amendment was put forward by the Labour Party. He admits that, if the claims made in the letter were substantiated, he would seriously consider the amendment, or a similar amendment introduced by himself, even at this late stage. I must accept the fact that the statements made by the Housewives Association have not been substantiated. This amendment was put in merely to give the Minister an opportunity of explaining, as he has done, whether or not these charges were made, whether or not they were investigated and what were the results. I am satisfied from what the Minister has said that on the evidence he has, he probably would not be justified in accepting the amendment and, accordingly, I am withdrawing it.
