Colette Kelleher (Independent) | Oireachtas source

I thank Ms Spillane and Dr. Long for their presentations. It is a real indication of how seriously the Department is taking home care. The witnesses rightly commended the Minister of State, Deputy Helen MacEntee, for her leadership on this, and she has passed the baton to Deputy Jim Daly who I am confident will progress this with the same rigour and enthusiasm. I have two general points. First, it is the clear preference of people themselves, older people, those with dementia who may be under 65 years, to live at home in their own communities for as long as possible. That preference for home care needs to be at the heart of the Department's deliberations. It is an obvious point but it is one that can be missed. Last year Age Action Ireland, the Alzheimer Society of Ireland and UCD were involved in a report which is a very good source document which can be consulted, there is no need to do it again. We have loads of consultations and have done all that, and got a huge response. It is the wish among individuals and we are talking about ourselves. We are all living longer. It is not an abstract point, but an enlightened self-interest in getting this right.

Second, and this is something Ms Spillane mentioned, is the position with regard to the 195,000 carers. With support from the State, in partnership, they can continue to do the work they want to. They will not down tools when a home care system is brought in.

They want to be involved but they do not want to be carrying the burden by themselves. They are urgently awaiting this scheme. I accept that progress is being made, but we cannot let deadlines slip. I draw the attention of the committee to the fact that 4,000 of these 195,000 carers are under 15 years of age and almost 2,000 are over 85 years of age, an increase in the latter of 35% according to the census. The will and preference of individuals and the strain on carers must be front and centre.

Ms Spillane mentioned that €370 million is being spent on home care. It would be helpful if she would compare that spend with what is being spent on residential care. What budget is being allocated for home care in 2018 relative to 2017, in respect not only of older people but home care specifically and what money is being set aside for dementia-specific home care, which is a very particular form of home care in terms of the manner in which it needs to be provided? Consistency and duration of care in this area is critical. One cannot hurry people with dementia.

Like Senator Burke I would welcome more information about the proposed regulatory system, including when it will come into force. There is currently no entitlement per seto home care such as applies in respect of residential care. Resources are limited and there is no statutory regulation and as such there is an urgency in this area. During statements in the Seanad on the fair deal scheme, the Minister of State, Deputy Daly, promised that the consultation on home care would be completed by the end of this year. We are now told it will not be completed until early in the new year. I am concerned about slippage in this regard because as I said the 195,000 carers and those for whom they care cannot wait.

My next question is to Dr. Long. In the four countries which she studied there are systems of regulation and funding regimes. Is it true to say that we are lagging behind significantly in terms of a proper system of home care?