Friday, 13 July 1990
Dáil Éireann Debate
In page 5, subsection (4) (b), lines 11 to 14 deleted and the following substituted “specified in subparagraph (ii) of subsection (6) (b) and relating to the person unless the person has been convicted of an offence specified in the said subparagraph after the making of the application for the declaration and the board was not aware of the conviction when it gave the declaration.”
 This is a technical amendment recommended by the parliamentary draftsman to ensure absolute clarity that a person can only be denied a prior declaration that he or she is a fit person to be the registered proprietor of a nursing home for an offence that he or she has committed. This amendment is to clarify the purpose of subsection (4) (b) beyond any doubt.
Amendment No. 2 is also a technical amendment recommended by the parliamentary draftsman to ensure that the right of the health boards to revoke a declaration is absolutely clear, thus the insertion of the word “may”.
Amendment No. 3 is another technical amendment recommended by the parliamentary draftsman to ensure that sub-paragraphs (I) to (IV) refer to paragraph (a) as well as to paragraph (b) of subsection (6). Consequently, the word “unless” is moved to a separate line.
Amendment No. 4 is another technical amendment recommended by the parliamentary draftsman which has the effect of ensuring the clarification of the health boards' power to revoke a declaration that a person is a fit person to be the registered proprietor of a nursing home.
Amendment No. 5 was originally an amendment proposed by the main Opposition party in the Seanad and supported by all the other parties and groups. In its original form it was technically deficient and I undertook to introduce a new amendment on Report Stage to achieve the original objective. The effect of this amendment is to introduce a proper statutory complaints procedure for residents in nursing homes. It provides that a resident, or a person acting on their behalf, may make a complaint in writing to a health board about any aspect of the resident's care. Subsequently, the health board must investigate the complaint. If the complaint is upheld by the health board they may give a direction to the proprietor of the nursing home, which must be carried out.
Amendment No. 7 is an additional one requested by the Labour Party in the Seanad and supported by the other parties to maximise the effectiveness of the introduction of a complaints procedure already introduced by amendment No. 5. It makes it an offence for the registered proprietor and/or the person in charge of a nursing home not to comply with the direction of the health board under regulations made in this Bill.
Mr. Yates: I welcome these seven amendments. The lesson in relation to both these Bills is that the time limits and the number of Bills, sections and amendments that are taken in a rather rushed fashion lead to perhaps the Minister not being given proper time to reflect on amendments tabled in the House. I will not comment on the amendments other than Nos. 5 and 7 which are the only substantive changes. The rest are simply drafting amendments which do not materially affect the legislation.
I welcome the introduction of a complaints procedure. In this House on Report Stage I tabled amendment No. 61 which proposed the introduction of a complaints procedure and that was voted on in the House and rejected. I am glad to see that one of my colleagues, Senator Joe O'Reilly, tabled the same amendment in the Seanad. The Minister of State positively accepted it and has come forward with his own amendment. It is important that there should be an established complaints procedure for all concerned, both for the nursing homes and for the residents, because it will do away with any innuendo or allegation that can be made to run down a nursing home. They will be properly processed. People who wish to have a grievance processed will have it done fully. I ask the Minister to monitor that there will be uniformity between health boards in the operation of this legislation.
The Bill has passed virtually all stages and the Minister might, even at this late stage, make some comment in relation to  subventions to nursing homes. This is the most important aspect of the Bill in so far as the public are concerned in terms of their friends and relatives who are trying to get into nursing homes but cannot afford the cost. The cost will go up because of the new standards put forward in this legislation and I hope the Minister will let us know the level of subvention and how many grades of it there will be.
Mr. Howlin: I am allowed a brief comment under the order of the House passed this morning. Not alone do I agree that we should have adequate time to consider all amendments to very complex legislation like this but it underscores the value of the Seanad as a House of second review where we have the opportunity to reflect a second time on issues. When a point might not be accepted in this House, or might not be made forcibly enough by parties in this House, adequate provision is enshrined to allow a second thought on it.
We had long discussions on some of the issues that are now being readdressed in the amendments before us. For example, we had much discussion about what constituted a fit person, and the clarifying amendments now put in, most of which are technical, I accept without reservation.
I welcome the two substantive issues which, happily, have now been accepted by the Minister, despite his reluctance in this House originally in relation to the complaints procedure. It is a good operation of democracy when rational amendments put from this side of the House, or put by the Opposition parties in the other House, are accepted. In relation to the complaints procedure, the arguments were well made on amendment No. 61 on Report Stage in this House and I am glad to see it is now going to be enshrined in the legislation.
A new offence is created under the new amendment No. 7, a Labour Party amendment put forward by my colleagues in the Seanad. It is an important one and will add to the effectiveness of the legislation we are trying to enact.
 We have made general comments about the provisions of the Bill. I am glad it will be finally enacted in this session, and I am glad I was able to assist in the time-tabling on it as Whip of my party. I underscore again that it is important to have this legislative provision in relation to standards and the quality of care available to elderly people and that it will be subject to monitoring by health boards. The availability to the generality of people is very important and since this Bill left this House there has been a great deal of discussion and queries have been coming to all our officers in relation to the type of moneys that will be available from health boards to help people who cannot afford a place in a private nursing home. Will the Minister clarify that point?
Mr. Byrne: The Workers' Party have given great support to this Bill in its passage through this House. The amendments before us, as a result of the Bill being before the Seanad, will result in a marked improvement in the Bill and we welcome those amendments wholeheartedly. It is important to recognise that the health boards have an onerous task in giving a written statement declaring the applicant's suitability. This strengthens the cover for the health boards in handling the registration applications. That is an improvement to section 4 of the Bill.
In regard to section 6, the complaints procedure is an excellent provision. There have been very sad cases of people being badly treated in homes. This provision gives the opportunity to not just members of the family but to anybody concerned with the welfare of an elderly person in a home to detail their complaints in writing. It is very important that this outlet is there because very often elderly people in homes have no immediate family member to keep an eye on their wellbeing. I welcome that improvement wholeheartedly.
The question of subventions does not arise when dealing with big, expensive,  exclusive nursing homes but it applies seriously when dealing with the requirements of low income families. I join with previous speakers in asking the Minister to give us some assurance about the level of subventions for low income families and generally some indication of his thinking here today on that.
Mr. Howlin: This is a technical consideration in relation to amendment No. 7. It has a paragraph (b) but there is no paragraph (a). Is there a requirement to insert (a) in the existing subsection (3)?
I thank all the Deputies sincerely for their contributions. I cannot comment on the time available for the Bill in this House as I was not involved in the Bill at the time. However, I concur with what Deputy Howlin has said, that the return of these amendments from the Seanad is positive proof of the importance and the relevance of the Seanad in the totality of its contribution to the legislative process. I thank the Deputies for their contributions and the party spokespersons here, and the Whips of the parties for agreeing to take this Bill this morning. It is very important to have the Bill passed before the summer recess.
This year we allocated an extra £5 million for the geriatric services and the care of the elderly, and within that we allocated at least £0.5 million to take account of having the new Health (Nursing Homes) Bill passed. If we did not get agreement today we would not be able  to avail of that in the second half of the year because we would not have enough time from October to Christmas. We are very grateful for the co-operation we got.
The new subvention rate will be higher than at present. I cannot at this stage say what the exact figure will be as we have to discuss this with the relevant interests involved, the nursing homes sector, the health boards and the voluntary organisations.
This Bill regulates the private nursing homes sector in a definite way. We have drawn up draft regulations and a draft code of practice for nursing homes. This will ensure that the nursing homes are run to a very high standard, that the dependent people resident there will get the maximum care and attention and that the health boards, through the Department of Health on behalf of the people, will be able to ensure that these standards are maintained.
On the subvention, I can say that anybody in an approved nursing home and getting a subvention will continue to do so. They will have the option to apply for an increase and if on assessment their means allow it, they will get that increase.
(i) for the consideration and investigation by the health board concerned of a complaint made to it in writing by or on behalf of a dependent person being maintained in a nursing home in relation to anymatter concerning the home or the maintenance, care, welfare or wellbeing of the person while being so maintained or any specified related matter, and
(ii) in case a complaint under subparagraph (i) is upheld by a health board, for the issue by the board to the registered proprietor of the nursing home concerned, if the board considers it appropriate to do so, of a direction requiring the taking by such proprietor of specified action in relation to the matter complained of,”.
In page 10, subsection (3) lines 13 and 14, “person carrying on the home and any person in charge, or taking part in the management,” deleted and “registered proprietor and the person in charge” substituted.
Question, “That amendments Nos. 1 to 7, inclusive, be agreed to in Committee, that the Committee report this agreement to the Seanad amendments and that the Dáil agrees with the Committee's report”, put and agreed to.
An Ceann Comhairle: Messages will be sent to the Seanad accordingly in respect  of items Nos. 2 and 3, that is the Turf Development Bill, 1988 and the Health (Nursing Homes) Bill, 1989. We will now proceed to deal with item No. 16.
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