Topical Issue Debate

Fuel Rebate Scheme

Deputy Timmy Dooley

I welcome the Minister of State, Deputy Brian Hayes. He has a keen interest in this area and will be aware that as a result of the Budget Statement, the Government decided to extend a fuel rebate system to the haulage sector. I was grateful for this decision, having lobbied hard and having worked with the hauliers on it. They brought forward some concrete proposals demonstrating that were a rebate scheme to be put in place in line with other jurisdictions, there were significant revenues to be generated by the State. The approach they took was that many hauliers who travel internationally would buy fuel at home in the event of such a rebate scheme being in place. The Road Haulage Association thought that many of its members were engaged in what might be referred to as fuel tourism, whereby they purchased fuel outside this jurisdiction because it was cheaper elsewhere, with the State losing the entire duty as a result of their decision. The hauliers came forward with a comprehensive and detailed analysis carried out by Deloitte and I was very pleased the Government accepted the position in this regard.

Following on from that decision, there has been an approach from the Coach Tourism and Transport Council of Ireland which, as the Minister of State is aware, represents bus and coach operators. The council does not make the same argument in respect of fuel tourism but nevertheless has a strong argument. These operators believe that were the scheme to be extended to include them, the cost would be a relatively small amount out of the €70 million that has been set aside in this year's budget. I believe its estimate is somewhere between €2.02 million and €3.79 million per year. This proposal should be considered in the context of the services these operators provide to the tourism sector. The Minister of State is aware of the existence of coach tour business in a wide variety of markets. Initially it was geared to the North American market but in more recent years has expanded into the European and other markets. This is an effort to assist the coach tour business in difficult economic circumstances, much of which are based on the current recessionary environment, in maintaining a quality fleet of vehicles that is appropriate to the kind of service that must be provided to the discerning tourist.

They have expressed concern to me and others that if the operators of the coaches are not in a position to have quality fleets, the image of the product we offer will disintegrate. These businesses pay VAT on various services and fuel, and they are a significant generator of revenue for the State.

I support these transport businesses as they have a legitimate case, which should be recognised by the Department and acted upon based on the costing available. I am sure these people have contacted the Department and I appeal to the Minister of State to reflect on the issue. Perhaps in the presentation and publication of the finance Bill, there will be consideration of these coach tour operators.

Minister of State at the Department of Finance (Deputy Brian Hayes)

I thank Deputy Dooley for raising this important matter. I will not read out a script but I will instead cut straight to the point. We are considering this issue very closely. The Deputy makes a very solid point, particularly about the age of the fleet. Having recently met some coach tour operators, I know the age of the fleet has been increasing because of the cost of fuel in recent years. As the Deputy rightly indicates, hauliers can make a case because of fuel tourism, and fuel can be bought outside the country to make a saving. This is not usually the case with tour operators, although some are involved in activities outside the country. I fully appreciate it is a key export.

Representatives of these hauliers made a point in a submission which I relayed to the Minister for Finance that there are solid economic arguments in extending the relief to this industry as we have with hauliers. We are considering the question and the decision will be for the Minister for Finance. In other parliamentary replies and in my meetings with the groups two weeks ago, it has been indicated that we are considering this issue in the context of the finance Bill, although that is without giving a firm commitment one way or the other. We accept many of the arguments made and the Minister will come to a full decision when he publishes the finance Bill.

Deputy Timmy Dooley

I thank the Minister for an open and frank response, which I had expected and which is helpful. A detailed analysis should be done, and when the Department and the Revenue Commissioners examine the issue, they will look at it in the broadest extent. I am sure some of the numbers may appear astronomical when one takes into account the entire fleet of commercial vehicles in the State. Nevertheless, there are ways of achieving the objective, and if necessary there should be consultation with the coach tour operators, including the Coach Tourism and Transport Council of Ireland. Its members are a solid bunch of people who have worked in a very difficult environment, and they understand the Minister's position. I hope a system can be put in place that could meet their needs to the greatest extent possible.

I ask the Minister of State to enter into a dialogue with the group, although I am grateful he has met them already. There was a dialogue with the Irish Road Haulage Association, with toing and froing over a period of 12 months, and now a principle has been established, it should be possible for all sides to formulate a workable solution that does not break the bank. We have got rid of one bank today and we certainly do not want to break another. We can help these people, who are such an integral part of our tourism offering. There is no point in laying a greater layer of fat on what we have done but it is the year of The Gathering, and this would be a helpful measure for all concerned.

Deputy Brian Hayes

The Government is very mindful of the Deputy's comments and the arguments he has made so cogently. There is still time and the rebate for haulage will not come about until July this year, when the finance Bill is enacted. Without giving a commitment in the issue, the Minister is looking at this very seriously to see if something can be done. There is very little money around and rebates and breaks of any description have a cost, and we must be able to offset that cost with additional economic activity that may come through the sale of additional better equipped and more modern fleets.

I was struck by the argument made that if people are coming to the country for coach tours, we need high specification vehicles in which to bring them around in preference to coaches that are seven, eight or nine years old. The Government understands that and wants to help. We will have to wait and see if we can do this with the finance Bill. The Minister for Finance is mindful of the arguments.

Private Rented Accommodation Provision

Deputy Dessie Ellis

The Minister of State is aware of the crisis in the buy-to-let market, with 29% of the 150,000 buy-to-let mortgages in arrears and 17% in arrears for 90 days or more. This means a staggering 26,770 rental properties are at risk of serious default. One of the most immediate consequences of the crisis is that the people living in these properties are at great risk.

When a bank repossesses a buy-to-let property, it appoints a receiver, which writes to a tenant to demand from that point that rent must be paid directly to a receiver and not to the landlord. The tenant is left not knowing whether the terms of the tenancy agreement will be met or if the receiver will take on the full role of landlord. Added to this is the question of whether the term of the tenancy agreement will be kept or a deposit will be returned when a tenancy ends.

Some receivers appear to be adopting a constructive approach but others are not, with some who act belligerently towards the rights of a tenant. That is unacceptable. As the buy-to-let mortgage crisis worsens, there will be ever more tenants left in a precarious position, and the Government needs to get a handle on the problem. It should immediately instruct the Central Bank to bring receivers and banks to the table to hammer out a clear code of conduct. At the end of this code of conduct must be a commitment by the receivers to honour the terms and obligations of the tenancy agreement. No tenant should be allowed to go homeless as a result of the appointment of a receiver, and no tenant should lose their deposit because of such an appointment. A tenant should not be left without maintenance services because of a receiver's appointment. In the first instance the Central Bank should seek agreement with receivers and banks but there should be no doubt that in the absence of agreement, the Central Bank should impose a code of conduct.

In dealing with individual cases I have engaged with Threshold, which shares my concern that this problem is serious and likely to escalate. This means the Government must act now and not wait for the problem to spiral out of control. I ask the Minister to examine the problem, establish its extent and the probable rate of increase as the buy-to-let mortgage crisis deepens and set out a clear plan to ensure no tenant will lose rights or entitlements because a landlord defaults on a mortgage. I hope the Minister of State appreciates the serious nature of the problem and that the Government will take the necessary action to address it before it is too late.

Deputy Brian Hayes

I thank the Deputy for raising this important matter in the manner he has. He is correct in pointing out the scale of the buy-to-let market, and there are approximately 150,000 mortgages through all the financial institutions that are effectively buy-to-let mortgages. The most recent information available to me indicates that approximately 18% of those accounts have been arrears for approximately 90 days or more. For primary dwelling mortgages, the corresponding arrears are between 11% and 15%, so the problem is real.

As we begin the process of introducing the schemes we have through financial institutions, we will see more of the buy-to-let mortgages moved on from the banks' loan books. It is an inevitable consequence. The Deputy is more aware than I am of the recent comments of the Governor of the Central Bank in this matter when he correctly put pressure on the banks to get on with the task of moving on some of these properties.

It is arguable that we will not get to the bottom of the housing market until such time as much of the buy-to-let market, which is in a difficult and precarious position, has been moved on.

I will not rehash the various arguments on the general issue as the Deputy is aware of them. We have had the Keane report and the Government wants the banks to fully implement the provisions of the Personal Insolvency Act. More important, a new agreement has been reached between the Central Bank and financial institutions to introduce a suite of measures to meet the needs of their customers, whether by writing down or restructuring debt, where necessary. As I noted in the House the other day, the banks are well capitalised for this purpose. When we capitalised them in March 2011 we made abundantly clear that we were providing money for the purpose of substantial write-downs on their mortgage books. There is frustration across the Government that the banks need to proceed with this task and write down more mortgages. I am confident that we will see much more action in 2013 than we did last year on moving on housing stock.

The Deputy referred to a code of conduct for receivers who are given powers to act on the part of the banks. I will refer to the reply provided to me on this matter as it has been issued by another Department. Regarding the protections and rights of tenants in the private rental sector, these rights are provided for in tenancy law, including the 2004 Residential Tenancies Act, which is the main regulatory framework for the private rented sector. It is important that the rights of tenants, as provided for under tenancy agreements and the Residential Tenancies Act, are protected. While the circumstances of each case may vary depending on the terms of the mortgage or charge under which a receiver is appointed, it is important that the policies and procedures of banks in appointing receivers do not affect the statutory or contractual rights of tenants. This is the point the Deputy raised.

It is also important that clarity be given to tenants as to where the responsibilities of landlords, as set out in the 2004 Act, now rest. Clear and legally sound direction must be given regarding to whom the rent should be paid. It should also be noted that receivers who are acting on behalf of an entity regulated by the Central Bank are also subject to the requirements of the consumer protection code.

To cut to the chase, the view of the Minister of State with responsibility for housing and planning, a portfolio that cuts across the financial area, is that protection is in place in respect of how a receiver should act. It is logical that where a receiver is appointed he or she will want to have a rent roll and will want tenants in situ as a means of maintaining the business as a going concern, if that is the choice of the receiver. Ordinarily, the rights that are prescribed for the tenant in a case where the tenant has a rent book and lease agreement still stand and would take precedent. The view of the Minister of State with responsibility for housing is that protections are in place under the consumer protection code. However, if the Deputy has specific proposals he would like me to put to the Minister of State, I am all ears.

Deputy Dessie Ellis

I thank the Minister of State for his response. There is a major problem in this area and some form of code of conduct is required to address it. While I accept that other issues arise in respect of the banks, a code of conduct is needed for the receivers who work on behalf of the banks. My party and Threshold are encountering cases where tenants have not had their leases renewed and maintenance and other issues connected with private rented dwellings are not being addressed. This is unfortunate. The receiver and banks should have a role to play in this regard. For example, the receiver could issue a letter to tenants guaranteeing their rents and providing a commitment that the lease will be continued. It is vital to have a code of conduct in place because people are being left at the mercy of landlords and financial institutions. While some of the financial institutions pull out all the stops and do everything possible to help, others are frustrating tenants, for example, by failing to inform them that a lease has expired, with the result that they are in danger of being put out on the streets. Tenants are being left in limbo. A code of practice must be introduced that encompasses all the financial institutions, the borrowers and the receivers who work on their behalf.

Deputy Brian Hayes

As the Deputy raised the matter, I should point out that the Minister of State with responsibility for housing and planning, Deputy Jan O'Sullivan, recently met representatives of the Irish Banking Federation and agreed a draft guide for tenants regarding rent receivers and the rights and responsibilities of landlords and tenants under the Residential Tenancies Act. This guide, which has the imprimatur and support of the Irish Banking Federation, will be rolled out across all the covered institutions in the coming months. This is an important development in that the financial institutions will be made aware of their responsibilities towards tenants in cases where the property in which they reside has been taken over by a receivership. The guide is backed up by the Irish Banking Federation. We will monitor closely what effect this initiative will have and I believe it will make a difference. The Deputy's observations will be forwarded to the Minister of State immediately.

Flood Prevention Measures

Deputy Paschal Donohoe

I thank the Ceann Comhairle for affording me an opportunity to raise this important matter. The Minister of State, Deputy Brian Hayes, indicated to me that the Minister of State at the Department of Health, Deputy Alex White, would take this matter and I appreciate that he has come to the House.

This issue, which I have raised several times in the Chamber, relates to the difficulties faced by householders living in or adjacent to areas that have been flooded or are at risk of flooding when they seek to have their homes insured or reinsured. Many individuals living in various parts of my constituency of Dublin Central are being refused insurance cover, having previously obtained insurance, albeit at an expensive rate.

I understand the difficulty this matter presents to the extent that we cannot require private companies to act in a certain manner. The Government has been moving in a positive direction on this issue by putting in place infrastructure worth billions of euro aimed at eliminating flooding risk in particular areas. This benefits insurance companies and we need to ensure they are made aware that flooding risks have been reduced as a result of work undertaken by the State and local authorities. This could also provide a means of ensuring that some form of insurance is made available in the areas in question.

In November, when I raised this issue with the Minister of State, Deputy Brian Hayes, he briefed me on negotiations that were taking place between the Irish Insurance Federation and Office of Public Works aimed at agreeing a way in which information could be shared so as to ensure greater insurance cover was provided. This is a major issue.

However, it is not getting the attention it deserves because it affects a relatively small number of homes. I am glad the Government has recognised this and I urge the Minister of State, Deputy Brian Hayes, and the Office of Public Works to do everything they can to resolve the matter and to provide an update to the House on it.

Minister of State at the Department of Health (Deputy Alex White)

As indicated, I am taking this debate on behalf of my colleague, the Minister of State, Deputy Brian Hayes, who has an urgent commitment. I thank Deputy Donohoe for raising this issue and for affording the House an opportunity to revisit it since he last raised it in autumn. Other Deputies have also raised the matter.

I assure the House that the impact of flooding on businesses and householders and the issue generally of flood insurance cover remain to the fore on the Minister of State's agenda. The difficulties that some people have been experiencing in securing insurance cover for flood risk at affordable prices, or at all in some instances, particularly in areas that have had flood defence works carried out, is something that the Minister of State is actively pursuing.

To consider the flooding issue in overview for a moment, the strategic focus of the Government through the work of the OPW and local authorities is to alleviate the impact of flooding through the provision of defences to reduce existing flood risk and by taking steps to manage and reduce flood risk in the future through a strategic and sustainable approach under the national catchment flood risk assessment and management, CFRAM, programme. This comprehensive programme to identify and assess flood risk nationally will, in time, provide a level of information that will allow a more informed engagement with the insurance industry in respect of flood risk cover and, in turn, will enable the insurance industry to take decisions on the provision of cover based on the fullest possible assessment of that risk. The CFRAM studies will lead to the provision of integrated flood risk management plans, which will assist the management and mitigation of flood risk well into the future.

Prior to the completion of the CFRAM programme, the Minister of State has been concerned to ensure that the insurance companies make their assessment of risk in any particular case based on the best available data. In particular, he has often stated that he does not accept that any property protected by significant public capital investment would not be able to receive a quote for insurance at a reasonable cost, the point referred to by Deputy Donohoe in his introduction.

Accordingly, following a number of meetings that the Minister of State had with the Irish Insurance Federation, IIF, and a number of the main insurance companies, a joint working group has been established between the OPW, the IIF and representatives of several insurance companies to progress agreement on a sustainable format and system to facilitate the exchange of information currently available on completed flood defence schemes. This will ensure that the insurance industry can be fully informed as to the extent of OPW investment in flood protection measures in recent decades and will take that investment fully into account in assessing flood risk for insurance purposes.

A preliminary exchange of information between the OPW and the IIF has taken place on selected completed flood defence schemes and the standard of protection that they provide. Clearly, it is important that the information be as thorough as possible to verify the level of protection involved. This requires a considerable amount of detailed work on the part of the OPW to collate the required data and present it in an acceptable format.

The Minister of State is happy to say that the feedback received from the insurance industry on the "template" information provided has been positive. Some relatively minor technical issues remain to be resolved, but he is optimistic that the template format will be agreed shortly.

He acknowledges the commitment by the IIF to making substantial progress through this working group, which has already engaged in this matter in a co-operative manner. The working group will meet regularly to advance and complete its work in the quickest possible timeframe.

While the Minister of State is hopeful that an agreed system of information exchange will significantly improve the situation over time, it is important to bear in mind that the provision of new flood cover or the renewal of existing flood cover is a commercial matter for insurance companies, as acknowledged by Deputy Donohoe. The insurance companies cannot be directed to provide flood cover to specific individuals or businesses. It remains a matter for the insurance market to manage the assessment of risk and the provision of all classes of insurance cover at an individual policy level. This assessment takes account of a range of factors and is often considered on a case-by-case basis.

However, avenues are available to those who continue to experience difficulty with flood insurance cover. I am informed that queries or complaints in this regard can be directed through the IIF's free insurance information service. In addition and as Deputies know, the Financial Services Ombudsman deals independently with unresolved complaints from consumers about their individual dealings with all financial service providers.

Deputy Paschal Donohoe

I thank the Minister of State for providing that information. I welcome the fact that since I last raised the issue in the House, progress has clearly been made on the way in which information can be shared. I hope this situation will be resolved soon. It is important that we end up with a process that allows the infrastructure provided by the State to be taken into account by companies when deciding on whether they want to insure someone. Given the moneys being invested by local authorities in dealing with this issue, I am gravely concerned that regard is not being given to that infrastructure. I thank the OPW for the seriousness with which it is taking this matter. I want the issue progressed and I will raise it in the House again in the near future.

While it is for an insurance company to decide on whether it wants to offer cover, perhaps we could consider a system through which companies would provide cover to areas that could be at risk while taking this possibility into account when determining the magnitude of the premium to be charged. They would do this instead of providing no insurance at all. The stark reality facing many of my constituents is that they can get no cover at all despite the fact that infrastructure to prevent flooding is either in place or will be in the near future.

Deputy Alex White

The Deputy makes the case well, particularly his point on the necessity to have a process by which public infrastructure funded by the State should be factored into the question on the provision of cover by insurance companies. The Minister of State has made considerable progress in this matter and has received a great deal of co-operation in his work and that of the OPW. I note the Deputy's intention, which I am sure will be carried through in his usual way, to follow this matter up in future to ensure it remains on the agenda of the House and the OPW. The Minister of State takes a great interest in this matter.

Nursing Home Accommodation

Deputy Michael McNamara

I wish to bring to the Minister of State's attention, if it is indeed necessary to do so, SI 236 of 2009, which provides for minimum standards of health care. It goes without saying that the standards contained in the statutory instrument are to be welcomed and are desirable. The statutory instrument reads: "The registered provider shall not use premises for the purposes of a designated centre unless the premises are suitable for the purpose of achieving the aims and objectives set out in the statement of purpose". The statement of purpose, contained at paragraph 10, reads:

The registered provider shall ensure that residents are provided with:

...

(c) privacy, insofar as is reasonably practicable, to the extent that the resident is able to undertake personal activities in private;

As the Minister of State is undoubtedly aware, the Health Information and Quality Authority, HIQA, was tasked with extrapolating more detailed national standards from this provision. No one could take issue with the statement that all elderly people in care in public and private facilities should have sufficient privacy and dignity to perform whatever functions they require. Under HIQA's extrapolation, however, existing bedrooms that are currently shared must have at least 7.4 m per resident.

Within six years of implementation of the standards, there are to be no more than two residents per room, except in high-dependency rooms, which shall have up to six highly dependent residents.

Since getting elected I have spent time visiting the State facilities for community care across County Clare. There are three facilities, in Raheen Hospital, Stella Maris and Ennistymon. I spent a lot of time in St. Joseph’s Hospital in Ennis for personal reasons. I express my thanks to the staff of St. Joseph’s for the excellent standard of care which they provide. I am pleased to say the standard of care was vindicated in a recent HIQA investigation in St. Joseph’s at the end of 2012. An inspection was carried out on 27 and 28 November. However, the fact that St. Joseph’s, like the great majority of such facilities across the country, is a relatively old establishment, unsurprisingly, it was found not to comply with the standard of having only two residents per room.

While I was there I took the opportunity to discuss the issue with residents. A close relative of mine who was there likewise, discussed matters with her fellow residents. There is not unanimity among residents on the facilities. Not all of them would like to be in single rooms or rooms of two people. In many instances, people prefer to be in larger rooms. That is not to say the standard should be lowered in any way or that people do not want their privacy to be respected. Of course they do. However, to extrapolate from respecting privacy to putting people in single and double rooms exclusively is questionable. I question whether it is feasible. It has been acknowledged by the HSE that there would be great difficulty in bringing St. Joseph’s into line with the requirement of single and double rooms. Likewise, with the facilities in Kilrush and Raheen, and to a slightly lesser extent in Ennistymon. I speak of County Clare but I am sure the situation is mirrored across the country.

I do not for a moment wish to appear to advocate a lower standard for residents in such institutions. That is not the case at all. However, I wonder about the extent to which the views of residents have been canvassed and their opinions sought when it was determined that it was in their best interests to be in single rooms. Many people would love to get out of private facilities where they have single rooms and to get into public facilities where they share rooms and have companionship, regardless of the reason they are in the facilities.

A second issue to which I would like to bring to the attention of the Minister of State is the manner in which the inspections are carried out. I refer to a facility that is not in my constituency; it is in the constituency of the Leas-Cheann Comhairle, namely, St. Anne’s in Woodford on the Clare and Galway border. A follow-up inspection was carried out on 19 October 2011 and, by and large, it was unfavourable. Fire hazards were not raised at all. In February 2012 a further inspection was carried out and the facility was closed within 24 hours. I do not understand how no issue relating to fire hazard could arise in October 2011 yet the following February the facility was to be closed within 24 hours, which created considerable difficulty for many elderly residents who had to be moved. Some of them had spent a long period of time there and the nature of their departure created much turmoil for them and their families. Nobody from HIQA was prepared to meet with any of the relatives to explain how the closure came about. There seems to be no redress.

Deputy Alex White

I thank Deputy McNamara for raising the issue and for his insights and observations on it. I will make some general remarks at the outset.

The overarching policy of the Government is to support older people to live in dignity and independence in their own homes and communities for as long as possible and to support access to quality, long-term residential care where that is appropriate. If it becomes necessary for an older person to move to a nursing home, their safety and well-being is of paramount concern. We must ensure that the highest standards of care are provided to all residents in a safe and secure environment, and that we meet the needs of those who require our services in the very best way possible.

The Health Information and Quality Authority, HIQA, is the independent body responsible for promoting quality and safety in the provision of health and personal social services for the benefit of service users. On 1 July 2009 statutory responsibility for inspecting and registering nursing homes was given to HIQA's chief inspector of social services. That is underpinned by a comprehensive quality framework comprising the Health Act 2007, Care and Welfare Regulations and the National Quality Standards for Residential Care Settings for Older People in Ireland. Members will agree that it is important to have effective mechanisms to maintain and enhance public confidence in the delivery of quality residential care. Residents, their families and the public need to be reassured that the care people receive is monitored. The Health Act 2007 provides that, with a regime designed to protect the public through an independent inspection and registration system for residential services.

Patient safety and quality assurance in nursing homes is secured by setting quality standards, reinforced by regulations that specify how the best service possible can be delivered in an effective and appropriate way. The national quality standards to which the Deputy refers are an essential component in ensuring the quality and safety of residential care for the older population. There are 32 standards under seven groupings: rights, protection, health and social needs, quality of life, staffing, the care environment and governance and management. They are patient-centred, providing a blueprint for the provision of a higher standard of care delivered against a set of clear and comprehensive criteria. In summary, the standards promote health, well-being and quality of life, and older people are entitled to their effective implementation and monitoring and for effective steps to be taken if they are not met.

All nursing homes for older people, whether public, private or voluntary, are subject to the same core standards for quality and safety. As Deputy McNamara indicated, HIQA carries out inspections across the nursing home sector to ensure that the standards are being met and that residents are receiving the best possible care.

I expect we would all agree that lessons had to be learned from some very unsatisfactory and well-publicised incidents in nursing homes in recent years and from reports such as that of the Leas Cross commission of investigation. Our system of regulation and inspection was established for the sole purpose of ensuring safety and quality of care for nursing home residents. While standards of care are, thankfully, generally very good, we cannot and must not be complacent when it comes to the protection of older people.

The Deputy raised a query on one of the categories of requirement concerning nursing homes. It is an interesting point, in particular on the extent to which there was consultation with older people themselves in respect of the standards. Deputy McNamara would agree that we can only operate on the basis of standards that are put together in a rational way. They cannot be nursing home-specific or area-specific; the standards must be national in order for them to be understood and properly monitored.

As the Deputy is aware, the current standards were approved in 2009. They were developed by a working group that was chaired by HIQA, which importantly comprised the regulator, service providers of private, voluntary and HSE nursing homes, older people's advocacy groups, people involved in the care and treatment of older people and the Department. There was an important and, as the Deputy indicated, necessary, input on behalf of persons directly affected, in particular the active and effective advocacy groups for older people who operate in this country. I reassure the Deputy and the House that such groups who are engaged in the issue were consulted. It is important that they should be. There is no harm in there being continuing debate on the issue but I reassure the Deputy and the House that it is something that was taken carefully into account when the standards were being put in place.

Deputy Michael McNamara

I thank the Minister of State for his reply. There was not a sentence in it with which I could possibly disagree. We all agree that we want to have the highest possible standards of care across the health system, but especially for elderly people who contributed to the State, built it up and frequently created excellent facilities from what were work houses across County Clare and turned them into care facilities of which any country could be proud. The standard of care provided there is second to none.

I know anecdotally, although the Minister of State will not be particularly interested in anecdotal evidence, that treatment is frequently better in public facilities than in private facilities, hence the huge queue for treatment in public facilities.

On the issue of patient-centred standards, if one were to take a survey of patients in care, I wonder whether they would want to be in single rooms or prefer to be in rooms accommodating four, five or even six patients. I wonder when the time period applying to these standards runs out, as it inevitably will, whether a detailed survey on that issue will be carried out. I accept these points are based on my observations and are anecdotal as opposed to being based on statistics and rational evidence and that it does not meet any of the tests, but from what I have seen, I think many people would prefer to be in communal rooms.

It is important that we have an independent body but it is also important that an independent body is not beyond reproach or certainly not beyond accountability. Efforts by families members of patients moved from St. Anne's to get in contact with HIQA were singularly unsuccessful. I do not blame HIQA for that because it believes that to safeguard its independence it cannot engage in a dialogue, but there must be some mechanism by which people who feel aggrieved or feel there is a discrepancy between two reports can have their concerns addressed.

Inspections are important but they must be carried out uniformly. There is not a uniformity apparent to me with regard to these two reports. I appreciate I am bringing up these specifics to the Minister of State for the first time and that HIQA is independent and therefore there is very little that he can do. I urge HIQA to examine the uniformity of its inspections and also to examine how it deals with relatives of patients who are unhappy with the results of the inspections, even if they were carried out in the very best interests of the patients.

Deputy Alex White

The Deputy would not expect me to comment on or refer to any of the individual inspections to which he has pointed, but I repeat the comment and observation on how the particular standards play out in particular nursing homes. I take the Deputy's point, that it may not always be immediately clear to us if we walk into a nursing home that the standards are wholly appropriate when we view a particular human situation, but I think we can be sure and reassured that the standards did not come from nowhere, that the standards were put together on a rational basis, that they make sense, that people were consulted on them and that nothing is set in stone. I have taken careful note of what the Deputy said. I am sure there is a mechanism to provide for a review - I do not have it immediately to hand - but I am sure that a review is contemplated in all of these kinds of standards. It may well be that in the future the kinds of insights that the Deputy has raised could be taken into account.

Dáil Éireann díospóireacht - Thursday, 7 Feb 2013