Bríd Smith denounces corporatisation of care, urges public investment

Goethe, Cahirleach. Just to follow on from what Deputy Gino Kenny has been talking about, and I know Gino a long time and I knew him when he was a young fellow doing this sort of care work and the pride with which he did his job and the type of people that he looked after for long periods of time. He looked after people with whom he built up relationships, people who were wheelchair-bound, people who suffered with mental health and the whole point of the type of care that was delivered through, as he said, the public sector, the HSE, was that the carer builds up a relationship with them that they care for. I have been involved in a few special committees in my time in the Oireachtas, which is a short time, but one of them is currently getting ready to issue its report on the Gender Equality on the Citizens' Assembly. For one session we had before us Dr Kathleen Lynch, who has written a brilliant book on capitalism and care, and she points out a number of really strong home truths on the same lines as what Gino has experienced in his life. One of the things she points out is that care itself is not about providing just the physical facilities, it is actually about building up a relationship and having an affection and a sort of a friendship with the person for whom you care. And it goes to the heart of what the people need in their lives in terms of their need to flourish. And we learned a lot about that during COVID. The other committee I was involved on was the COVID committee which sat, I don't know for how many times during 2020, and looked particularly at the care sector and what was indeed what was happening in our nursing homes. Just to remind people, 56 of all deaths in the state taking place inside the nursing home system, which is totally disproportionate to a group of elderly which comprise 0.69% of the total population. A recommendation that came out of that long-sitting, long-suffering committee was that a public inquiry would be established to investigate and report on all the circumstances relating to all the deaths from COVID-19 in nurses' homes. The reason we fought for that recommendation was to look at what is going on in the private sector. Because again, Kathleen Lynch's work and her statistical study shows that 70% of all nursing home beds are now owned by for-profit companies and a huge amount of subsidy takes place in the state. So if you look at the overall care relationship between the state and the for-profit sector, the proportion of public expenditure allocated to private for-profit care rose from 5% in 2006 to a handsome 40% in 2019, and that is not the latest figure. So although it is not defined as profitable, it is currently valued at around 718 million annually, with 599 businesses registered as delivering care. Now what is that if not the commercialisation of the most human thing, action one can carry out in one's life, is to care for another, particularly when they are vulnerable, able or disabled. That is really the corporatisation of care, and this state is very much guilty of how it implements it. I welcome the Sinn Féin motion, I think we do need a real serious think about how we are delivering it. I remember about 10 years ago when the HSE were washing their hands locally of the home care, the home health system that existed in all our communities. It was so localised that we had a special dedicated office in Lower Ballyfermot and another one in Upper Ballyfermot. It was mostly run by nuns and voluntary elements of the HSE, but they did work closely with mainly local women, sometimes local men, and delivered them to provide hours of care to their neighbours, and that was real care because they knew those people, they knew those elderly men and women that they were looking after, they had grown up alongside them, they loved them, they had relationships with them, they'd bend over backwards for them, they were available to them out of hours, they got paid reasonably decent hourly rate, and when the home health system was removed, all of that went under the radar. All of these women and men, if they wanted to stay in the industry, were expected to pay for their own training, their own uniform, and go work for a for-profit company who then provided them with an app where they timed them. How come you were longer than 15 minutes with Mrs Murphy around the corner, and why did you stay back there? You should have only just given her a shower and her tablets, but what people really need, just to repeat it, is relationships, is affection, is care, is friendship, and if we move away from that model, then we're really doing society a huge disservice. As part of my work on the Climate Committee, I read a lot of the alternatives to what is going on in terms of the burning of the planet, and there is a lot of theories out there about how we could do things differently in society, and many people have written about what they call the care and repair of society, and very central to that is for society to move to spending a lot of public money on looking after each other, on training people properly, on paying them properly, and on giving the sort of care that our vulnerable and elderly people, which we will all get there someday, absolutely deserved, and it would be a very productive and fruitful thing to do, and I think this debate around the motion that Sinn Féin have put forward begins to help us to understand that that's where we need to go.