IRELAND IS NO country for old men – or women.

That was evident this week as RTÉ Investigates exposed the painful human cost of the Government’s relentless policy drive to privatise our social care sector.

We watched as older people were pulled, pushed, ignored, stripped or abandoned, often left sitting in their own urine.

Some were left lying on the ground after a fall, others abandoned in beds, their repeated calls for help unanswered. Throughout, older people were demeaned and dehumanised.

When do we learn the lessons?

Cue predictable outrage and finger-pointing from Government leaders. Michéal Martin, despite having witnessed multiple scandals in the sector, was shocked. Junior Minister for Older People, Kieran O’Donnell, was shocked. When it comes to the social care sector, our political leaders appear to be in a permanent state of paralytic shock, yet once the headlines fade away, so too does the political will to carry out meaningful reform.

‘We need the general public to have constructive anger here, that over 20 years later, we have not remedied the situation.’ Professor Des O’Neill, the author of the Leas Cross review, reflected on RTÉ’s Prime Time this week. It seems that public action is required to make quality care a political priority.

The members of political parties who proclaim they are outraged, are the very same ones who champion the unbridled development of the private model of care in which older people are now experiencing abuse and neglect.

There have been clear warnings of the dangers associated with private nursing care provision. Enough red alarms have been sounded about Ireland’s rapid and seemingly blind devotion to the profit-making model to prompt any Government genuinely interested in providing quality care to change course.

Instead, the Government continues to defend the status quo, with the Minister for Older Persons, Kieran O’Donnell, telling us on Morning Ireland this week that ‘regardless of any system you have, you will always have public and private.’

He failed to mention Ireland has the most privatised care sector in Europe, (a title jointly held with the UK, a legacy perhaps of Thatcher’s love affair with the private market). 81% of our nursing home beds are provided by the private care sector, a sector associated with the poorest outcomes for residents.

Despite repeated calls for action, the Government has failed to introduce adult safeguarding legislation. Staff members in the nursing homes were not legally obliged to report the abuse and neglect they witnessed. Safeguarding social workers have no legal right of entry to either of the private nursing homes, and access must be negotiated.

In other words, the residents featured on RTÉ Investigates are living in what is known to be an unsafe model of care, with weak safeguards and with regulation expected to act as a magic wand. We should be shocked that politicians are shocked.

Older people treated as second-class

There have been no political commitments to reverse the harmful policies which have promoted the mass privatisation of nursing home care, or, for that matter, of disability, home care, mental health and children’s residential care services. Children under two years of age have been placed in unregulated private care settings, which HIQA does not inspect. It is clear we have a ‘care anywhere’ social care approach, with no national strategy for the promotion of high-quality social care across the life-course.

This status quo is partly enabled by the invisibility of people who use social care services in our society. The omission of the voices of older people was striking this week. Despite a lot of informed and moving media commentary, I did not hear the views of a single nursing home resident, many of whom are perfectly capable of sharing their expert perspectives.

There is also clearly a two-tier response in this country for victims of abuse. Picture the same events filmed with women in a maternity hospital or a children’s residential setting. Think of the outcry if women or children were treated in the same way, pushed, pulled, left in their own urine, their calls for help ignored. Ministers would rush to assure us of the psychological and trauma-informed interventions offered to the victims.

Why is there a deafening silence on this when we witness the abuse of older people? Nobody spoke, and nobody asked about the individual supports offered to the individuals who lived through the abuse captured on camera. We seem to be collectively under the impression that older people with dementia or frailties don’t suffer psychological trauma when they are abused or neglected, equally, there is no talk of the need for a compensation scheme for the victims. We would have to view them as equal humans with equal rights to contemplate that.

Delayed response

These ageist attitudes came into sharp focus when O’Donnell confirmed that HSE chief, Bernard Gloster, readily offered HSE safeguarding supports, once asked to do so, after the programme aired. It implies nobody else had done so before that.

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If that is the case, why did no one with knowledge of what was happening, contact the adult safeguarding teams much earlier? Would they fail to contact Tusla if child abuse had been filmed? It appears that vital personalised safeguarding supports are only being offered now, months after residents had suffered. 

Ageism lies at the heart of this inaction. Ageism lies at the heart of public apathy. Similar discrimination erodes the rights of children in care and people with disabilities. I support the current calls for a commission into nursing home care, but caution that it should form part of a wider, comprehensive national social care strategy.

Rather than a piecemeal approach, we need to reset and develop a national vision for what we want social care to look like across the lifespan, for this and future generations.

What we tolerate, we accept. We need to stop tolerating the selling off of social care in Ireland, the lack of safeguarding legislation for adults at risk of abuse and the lack of action from political leaders.

Public influence starts with individual acts.

Act and let your local TD know what you want to happen.

Your future older self will thank you.

Sinéad McGarry is a senior social worker with a special interest in safeguarding.