Simon Harris (Wicklow, Fine Gael) | Oireachtas source

We are all aware of people in the community telling us that they find the fair deal scheme does not work for them, be it a farmer, small business owner or people who might wish to rent or sell their house and wish to be able to keep a greater proportion of the proceeds. My colleague, the Minister of State, Deputy Jim Daly, is reviewing a number of those issues. That might expand the pool of people who might find the fair deal scheme more appealing than is the case currently.

On medical cards, the Deputy is correct that there had been a staffing problem. I am assured by the PCRS section that this is now resolved and that there will be a significant improvement in the turnaround times in the next published figures, which are due shortly.

The Deputies referred to home help. I have a couple of comments on that. In certain CHO areas there is a capacity issue regarding the availability of home care staff. That will not be a surprise to anybody.

In some parts of the country we do not have that problem while in others there is a very significant challenge in that regard. In such cases, the HSE and local CHOs try to utilise the home care package scheme to enable a person to remain at home or return home. While many have quoted figures pertaining to home help hours, those needs to be considered in the context of the home care package figures. The number of intensive home care packages is 22.1% ahead of target and the number of general or more regular home care packages is 9.9% ahead of target. The statistics tally with anecdotal evidence of CHOs utilising home care packages more and more when home help hours are not available. Many in attendance, such as Deputy Kelly, have spoken in favour of a statutory home care scheme. Deputies Kelleher and Murphy O'Mahony's party colleague put forward a Bill in relation to a version of the fair deal scheme for home care. Everybody was inspired to do more on that issue by Brendan Courtney's very telling documentary that highlighted the situation faced by many families. The Government is committed to introducing a statutory home care scheme. All members want people to be able to stay at home in their community and grow old with dignity in the place he or she is from but the nursing home support scheme or fair deal scheme is the only statutory scheme. The home help scheme does not exist in statute but, rather, it is ad hocand not consistent in different parts of the country. As members know, it is not easy to make it a statutory scheme. Consultation is due to close in early October and we will be able to begin to outline the scheme in 2018.

Deputy Kelly has identified a fair point on targets. They need to be re-evaluated and that is being done in the context of the preparation of the national service plan and budget 2018. There is a careful line to be drawn between not removing the responsibility to reach targets from hospital managers and stress testing the targets to ensure they are realistic. Managers make a difference and good management makes a big difference. Figures published by the Irish Nurses and Midwives Organisation, INMO, rather than the HSE for patients on hospital trolleys over the period January to July of this year show that Beaumont Hospital had its lowest number of people on trolleys since the counting of trolleys began in 2006, as did Connolly, Cavan Monaghan and Mayo hospitals while St. Vincent's University Hospital, one of the large hospitals in Dublin, has its second lowest number since 2006. Were Deputy Kelly to pre-empt what I might say next as being that one can also identify record highs in those figures, he would be correct. However, there are capacity and staffing issues in all hospitals in the State, yet some are making far more significant progress than others. I do not accept the idea I sometimes hear from certain elements that all hospital managers are the same and everybody is doing an excellent job. It is clear that some are doing a far better job than others.