The Leas Cross nursing home scandal raises important issues about the linkage between economic progress and quality of life, writes David Begg.
The public outrage rightly expressed about the treatment of elderly patients at the Leas Cross nursing home will soon fade away. It is not likely to provoke any fundamental change in the way we approach questions of social policy.
Yet I cannot but feel that Leas Cross is a microcosm of many things that are wrong in Ireland today. In the last 10 years we have made outstanding economic progress but there has not been commensurate progress on a social level.
The interesting thing about Leas Cross, if examined closely, is the linkage it reveals between issues affecting the quality of work and life. These are issues which call into question, in some respects at least, the sustainability of our current economic model.
In the first place it is apparent that even personal wealth is no insulation against the vulnerabilities experienced by the elderly people in nursing homes.
The annual cost of care at Leas Cross is €45,000, although the care is provided substantially by an immigrant workforce paid less than €9 per hour.
Most of the people with relatives in the nursing home, who were interviewed in the media in the days following the Prime Time programme, had financed the care by selling the family home.
At the same time, there are very few families now who can provide care at home for their loved ones, because everybody has to work to pay for the high cost of housing.
Affordability issues often require people to reside long distances from their work, thus compounding the lack of time available for family responsibilities of any sort.
These property prices are in turn driven by a buoyant property market, fuelled by a series of totally irrational tax shelters.
Most nursing home provision is also driven by capital tax allowances. The nursing homes are seen as the answer to the numbers of elderly people occupying acute hospital beds. But we are 3,000 beds short in the hospital system because of public spending constraints. Public spending is financed by taxation, so it is a kind of vicious circle.
In fact, it can be said of our economic model that it is built on a combination of low business taxes, low public spending (less than two-thirds of the EU average) and light-touch regulation. Ireland is a very business-friendly country but there are consequences to following that policy.
Take regulation, for example. The current war cry of all the business representative organisations is that we have too much "red tape", by which they mean regulation.
Of course, nobody wants to see people who are trying to run a business constantly tied up in meaningless form-filling.
But Leas Cross is an example of what happens with light-touch regulation. The Gama case is another recent example.
In both cases, the inspectorate was insufficient, in both cases poorly paid immigrant workers were involved, and in both cases the employers resorted to legal action to try to prevent exposure.
As we in Congress see it there is a serious danger of a race to the bottom in regard to employment conditions, in circumstances where public projects of one sort of another are taken over by the private sector.
There is no way that Government can ultimately get out from under its responsibilities in regard to what people see as essential public services.
The fact that the HSE has had to take over the running of Leas Cross is an example of this.
The Leas Cross experience should be a cautionary tale against seeing wholesale privatisation as the solution to the health service issue. Indeed it could work only if high-quality standards were imposed through a tight system of regulation.
Those standards cannot be achieved without a highly qualified and properly remunerated workforce, and the minimum wage does not amount to proper remuneration.
If the people who want to make profits by using minimum numbers of staff on low pay in a virtually unregulated environment cannot do so, then it may not be so attractive to them to get into the business anyway.
Ireland since 1994 has come successfully through a long-delayed period of economic catch-up with the rest of Europe. We now have to start thinking seriously about converting to a model of sustainable development.
There are a number of important social policy issues which we have to crack within the next seven to 10 years to achieve the objective of sustainability, viz:
creating a proper infrastructure of caring, based on high standards, and embracing childcare, care of the elderly and care of people with disabilities;
investment in, and reform of, public services, especially health and education, to make them as good as the best in Europe;
dealing with the crisis in private sector pensions, which is related to the question of increasing numbers of elderly people being able to support themselves in old age.
From a sustainability perspective we should also consider whether, in circumstances of full employment, we should be pushing for higher levels of economic growth at all costs. Insofar as this exceeds our ability to maximise indigenous labour-force participation, it can only be sustained by increased levels of immigration.
People who come to work in Ireland have needs of their own. They need housing, health services and education for their children.
Providing for an increasing population involves paying for the cost of extra infrastructure.
We will get an increase in GNP but not in GNP per capita, which really means standards of living. If we are not willing to stump up the public funds to provide services to our non-national workers and their families, and to pay them a decent wage, then there is no point in expecting them to be willing to look after our most basic intimate needs in our old age. It is therefore imperative to plan sustainable development in the medium to long term.
I watched the Prime Time programme on Leas Cross nursing home with a profound sense of sadness for the old people living there. I have long accepted the argument for a market economy, but I do not like the way we are moving towards a market society as well. One good thing at least emerged from this event - we are still fortunate enough to have a public broadcasting service willing and able to expose injustices in our society.
David Begg is general secretary of the Irish Congress of Trade Unions