Colm Burke (Fine Gael) | Oireachtas source

I thank the witnesses for the work they are doing and the support they have given through the years with regard to elderly care. I am approaching this from the perspective of trying to fast-track the changes we need. As I said earlier, I brought forward a legislative measure in 2012 in a Private Member's capacity and it is only now in place, five years later, so I was trying to tie down a timeframe for when we would see the change from the Department and the HSE with regard to the provision of home care. We are talking about two to three years. It is important that we try to give every assistance possible to the Department and the HSE to bring that timeline of two to three years forward.

With regard to home care, I wish to follow up on what Senator Conway-Walsh raised regarding rural areas where there are insufficient numbers of people available. It is a huge challenge and it will be an even greater challenge in the next ten years. There are a number of reasons for that, one of which is the increasing number of elderly people in rural areas. More people are coming into that category. On the other side, there is the economic upturn. Whereas previously people might have been available to provide home care, they are now not available to provide it. There are two challenges in that regard. One of my concerns is whether we have an adequate number of people going through the training process at present to be available to provide home care and how we can incentivise that.

If we get more people to provide home care, there will be a huge saving for the State in real terms. The expenditure on somebody in a nursing home is approximately €50,000 per annum or approximately €1,000 per week, whether it comes from the patient or the State. Home care, therefore, is not even one third of that if it can be provided adequately whereby people can stay in their own home. We must incentivise the provision of home care and incentivise the people who could be encouraged to come into it. Has that issue been considered? For example, should we consider a scheme whereby for somebody who is providing home care the first €15,000 of their income, if it comes from the provision of home care, would be exempt from tax. Has something like that been considered, particularly in view of the challenges we are facing now? With the economic upturn, it will become increasingly difficult to get people to take on this role.

I have seen this working successfully. For example, I know somebody who is in their mid-90s and is confined to a wheelchair. The person is living alone and as a result of the home care being provided, which is through a combination of her family and the HSE, she is living independently and has a far better way of life than if she was in a nursing home. That is not to criticise nursing homes. They provide a very good level of care as well. However, that lady is far happier and I am sure there are many others in a similar situation.

The other issue I wish to raise is older people who are afraid to allow anybody to get in involved in providing care for them, even though they need the care. I have encountered a number of such instances recently involving people in their 90s who have a mistrust. In fairness, the community nurse, the community garda and everyone is involved, but we have still failed to get them to accept that home care is the way forward for them.

How would one deal with a situation like that and make progress on such an issue? I thank Mr. Moran for the work he is doing in this area.