Prime Time

• No Place Like Home

  Adrian Lydon blogs ahead of tonight's programme:
  
  
  
  
  Home Care is a vital service allowing thousands of older people to live independently at home. Every day tens of thousands of paid carers go into the homes of 65,000 older people to take care of them.
  
  However, it’s unregulated and with no proper standards in place there is growing concern that older people are being put at risk. This concern is supported by internal HSE reports obtained by Prime Time into two not-for-profit home care companies. It was on foot of the Prime Time programme that the HSE announced that it would carry out a review into the care being provided to the 65,000 older people. The HSE has confirmed that review is now 89% complete.
  
  The findings from the internal HSE reports obtained by Prime Time are disturbing.
  
  In Clontarf Home Care, the HSE investigation found staff without Garda clearance, references or training. It found one staff member with no Garda clearance or references had received a verbal warning for gross misconduct.
  
  It found 14 complaints, which is high given that many older people in receipt of home care don’t complain in fear that the service will be cut. In one complaint, an older person was left to sleep in a chair overnight on six occasions because a carer failed to turn up.
  
  Similar problems were uncovered at Dublin North Inner City Home Care and Home Help Services Limited. Here 200 staff had not been Garda vetted and the company has confirmed to Prime Time that when staff were put through the vetting process, 18 had a previous conviction.
  
  The findings once again point to the need for statutory regulation, robust standards and an independent inspectorate, possibly the Health Information and Quality Authority, who inspect both public and private nursing homes. Even the HSE in tonight’s report say that regulation is required. So what’s needed? According to the former Commissioner at the Law Reform Commission, Patricia Rickard Clarke it’s very simple – political will. Tonight the Minister of State for disability, older people, equality and mental health, Kathleen Lynch joins us in studio.
  
  Adrian Lydon

  

  
  Prime Time, RTÉ 1, 21:35

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• Shooting By Appointment (VIDEO)

  See below for last night's report by Frank Shouldice and Paul Murphy on 'punishment shootings' carried out in Derry by Republican Action Against RAAD.

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• Shooting By Appointment

  Reporter Paul Murphy and producer Frank Shouldice blog ahead of tonight's programme:
  
  
  
  

  

  
  
  Picture this frightening scenario: You are at home and masked men come knocking at your door. They are looking for your son. They say he has been selling drugs or has been causing a nuisance in the area. They don’t have any hard evidence of any crime, simply the word of others. They offer you a choice: you bring your son to an appointed place at an appointed time for him to be shot in the legs -- or don’t bring him and expect them to kick down your door and shoot him anyway. In the legs, or maybe worse.
  
  This is the awful choice that has been presented to dozens of parents in Nationalist areas of Derry by a group called Republican Action Against Drugs (RAAD). Set up four years ago, RAAD bomb, shoot, exile and threaten those that they decide are guilty of drug dealing or anti-social behaviour.
  Tonight, Ciaran McFadden, a former IRA member whose son was recently shot in the legs by RAAD, talks to Prime Time. He describes how RAAD members came to his door alleging that his son was involved in a fight outside a pub in which another RAAD member was injured. RAAD wanted vengeance and they got it. Ciaran tells how he accompanied his son and his nephew to the RAAD appointment and stood yards away as two RAAD members shot both young men in the legs.
  
  RAAD are a small organisation with an estimated 20 to 50 members. But they are having an extraordinarily chilling effect on a city that is the 2013 UK City of Culture. There are no precise figures but Derry-based author John Linsday, whose ‘No Dope Here? Anti-Drugs Vigilantism in Northern Ireland’ is due for publication later this year, says there were at least 26 RAAD shootings in the Derry area which resulted in casualties and that the group have detonated 21 pipe bombs. Community activists estimate RAAD has threatened around 200 young men from Derry and exiled as many as 30 in the last three years. It’s a big problem for a small city.
  
  In February, RAAD carried out its first murder, shooting Derry native Andrew Allen in his rented house in Donegal. The killing of Allen, a former amateur boxer from a religiously mixed family, provoked the first significant public demonstrations against the group. RAAD have tried to paint Allen as a drug dealer, but this portrayal has been rejected by his family.
  
  Despite the recent waves of revulsion against RAAD, the group it is growing. It has gone beyond its original self-ordained role as anti-drugs vigilantes into targeting those it judges to be guilty of anti social behaviour. But in a potentially a very significant change, RAAD told Prime Time that they intend to begin targeting the Police Service of Northern Ireland (PSNI). RAAD also told Prime Time that while they initially supported the Good Friday Agreement they have now turned against it. This would represent a further headache for the PSNI, whose success against RAAD has been poor with no prosecutions yet for any RAAD shooting and only three prosecutions for other crimes committed by suspected members of RAAD. The PSNI say that they need more cooperation from the community to get convictions, and point out that even those that RAAD has shot are typically too afraid to give adequate witness statements. If RAAD starts to target the PSNI, as their representatives told Prime Time, that means the dissident threat to the peace process in Derry is about to get significantly bigger.
  Paul Murphy & Frank Shouldice
  

  Prime Time, RTÉ 1, 21:35

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• The Cost Of Living

  Eithne O'Brien blogs ahead of her report tonight on the cost to the State of life-saving drugs and who gets what:

  

  
  
  Every day, more and more drugs are being brought to the market that offer great hope for patients; hope of a cure, hope of a longer, healthier life. But these drugs come at a cost. The price of drugs are going up but healthcare spending is going down, so how do we choose what drugs to pay for and what patients should have them? Last month, the issue came to the fore when a number of melanoma patients contacted RTÉ's Liveline to express concern that a new drug for advanced melanoma called Ipilimumab, or Ippi - as it is known, would not be made available to patients.
  
  The decision about the cost-effectiveness of new drugs is made by the National Centre for Pharmacoeconomics and they recommend to the HSE whether these new drugs should be made available or not. Up until recently, a drug that extended the value of life by a year at a cost of €30,000-€45,000 was considered good value for money but, in a bid to reduce costs, a figure of €20,000 is also being presented to the HSE . When the NCPE looked at Ipilimumab, they decided that at a cost of €85,000 per patient and an average survival rate of an extra 3 months, it was not good value for money.
  
  But oncologists like Prof John Crown say that this is a crude measurement as a drug like Ippi can have a spectacular effect on a small number of patients and so the cost is worth it, if it means a major prolongation of some patients lives. Martin Mc Mahon is one of those patients and he is hoping that Ippi will give him that chance of life that he needs. When he heard that Ippi was not available to him he contacted the Liveline programme and pleaded his case. The result saw an extensive media campaign and Ippi was approved for use for melanoma patients.
  But health economists like Prof. Charles Normand believe that decisions like these will mean that other patients will lose out as there is only so much money to go around. This year the HSE want to cut €112 million from their drugs budget, so hard choices must be made.
  
  Doctors like Prof Orla Hardiman are also concerned that even when drugs are deemed good value for money by the NCPE, the HSE (who have the final say) are not making drugs available to patients because of funding problems. One example of this is the MS drug Gilenya. Thirty year old Karen O’Shea has had MS for five years, but the drug she was on was causing her terrible side effects. Her doctor recommended Gilenya but she can’t get it. She is now without any medication for her condition.
  
  So with less resources to go around how can we make choices that are fair to everybody? Prof Hardiman argues that we need a transparent system rather than a system that sees the most tragic diseases with the greatest advocates get an unfair proportion of the funding. Prof. Crown argues that diseases like Cancer should not face the same harsh economics assessments as other medical costs. As the HSE comes under more pressure to manage diminishing resources, tough choices will be made and patients could get caught in the crossfire.
  Eithne O'Brien
  Prime Time, RTÉ 1, 21:35

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• Unwelcome Home

  Tonight’s Prime Time features a report by Adrian Lydon into conditions in some private rented accommodation in Ireland.

  

  Around a quarter of a million people are tenants of private properties in Ireland, but despite the introduction of tougher legislation in 2009 covering basic standards for accommodation, Prime Time has found properties without heat, hot running water or sanitary facilities. And in some cases, the State is helping to pay for them.
  
  Prime Time has also found serious issues around illegal evictions and tenants’ deposits being withheld by landlords. Since 2004, disputes between landlords and tenants are meant to be settled primarily outside the Courts through the Private Residential Tenancies Board – but even here, Prime Time has uncovered evidence of long delays and difficulties with enforcing decisions.
  
  Background Note: Some material in this report was gathered in Autumn 2011 for the Prime Time Investigates strand. Research and filming has continued throughout this year. It is now being broadcast as an extended Prime Time report.
  
  Prime Time, RTÉ 1, 21:35

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• Prime Time - 8th May 2012

  Edel McAllister blogs ahead of tonight's programme:
  
  
  
  
  
  It was meant to end the anxiety and uncertainty of funding nursing home care for older people. But last year the figures did not add up for the Fair Deal scheme - it ran out of money in the middle of the year and it's temporary suspension caused upheaval and confusion. The Fair Deal scheme is now three years old the Minister with responsibility for Older People Kathleen Lynch has announced a review.

  

  The flagship Fair Deal scheme replaced an old system of public beds and subventions that was widely regarded as unfair. But projecting how many people would need beds under the new scheme and how much they might cost proved complex and precarious.

  Over 20 thousand people rely on the Fair Deal scheme to fund their nursing home care, and hundreds apply every month. Under the Fair Deal scheme the state pays three quarters of the bill for nursing home care - a cost of over 1bn. Under the scheme, you pay 80 per cent of your assessable income and 5 per cent of the value of your assets every year - including your house. For family homes this is capped at three years or 15 per cent and it can be deferred until after death. However there is concern that the dramatic fall in property prices leaves the government exposed.

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