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Padraig O'Morain: How could the HSE let home care get so bad?

Last night's Prime Time programme did the job the HSE should have been doing for years.

The resources available to Prime Time are minuscule compared to those of the HSE. If Prime Time was able to get a camera into people's homes and to film them being mistreated by paid carers then you have to ask what the HSE has been doing all this time.

It isn't as if nobody told them. The HSE has been getting complaints for at least three years about families whose loved ones are being "cared for" by so-called home-care providers paid for by the State.

Precious little has been done about this. Now, of course, the HSE has asked its local managers to look into home-care services in their areas, but exactly what that means is anybody's guess.

The Irish Private Home Care Association complained early in 2010 that nearly 60,000 people are being given home care that goes unmonitored.

The HSE's response to this, so far as anyone can see, is to do nothing at all.

Home care has become a moneyspinner. People who know nothing about the care of those who cannot care for themselves have, according to Dermot Kirwan of Friends Of The Elderly, been buying franchises to provide home care.

That businesses seek to make a profit out of this area is not necessarily bad in itself -- it all depends on the service they provide for the money they get.

And there's the problem. The only ones who know about the quality of the service they provide are the people receiving the service, some of whom may not be in any position to complain. Their families too, may have their suspicions but it would appear that attempts to have these suspicions acted on were ignored.

Why were they ignored? Is it because the people at risk are not children? Is it because they are out of sight and nobody, apart from Prime Time, put the resources aside to check on what they are doing?

Whatever the reason, it is outrageous that this was allowed to happen. The HSE and its many predecessors have been in the business of caring for older people for a very long time.

It should have been obvious to HSE management that turning the care of older people over to an unregulated industry behind closed doors could only lead to trouble.

With all this going on, you'd hardly think that we have a Minister of State for Older People. Aine Brady is quick enough to issue press releases, but what is the point of having her there if things can get to the point revealed last night?

Of course, she finds the practices revealed by Prime Time unacceptable and announced that HSE review and so on. But what, actually, is the point of the taxpayer funding a Minister of State for Older People, and that minister's staff, if we have to wait for Prime Time to tell us what is going on?

Will things change now? My fear is that when the public uproar about this programme dies down, our political shenanigans and economic woes will take our attention off the home-care sector and leave it free to behave as it will for years and years to come.

Dermot Kirwan of Friends Of The Elderly has said he fears that in the absence of effective action by the HSE, we could have another Leas Cross on our hands. My fear is that we already have. We just don't know about it yet.