Pauline Tully (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I welcome Minister of State at the Department of Health with responsibility for mental health and older people, Deputy Mary Butler, and her staff. The first point I want to make as spokesperson on older people, and it is also a point that is made to me regularly, is that disability does not disappear when one turns 66. For example, one man told me his wife was disabled due to a stroke and she was receiving supports and services in the community. When she turned 66 she was told she had to move to a different service that was for older people but it did not offer the same supports. They did argue the point and the supports were maintained for her but disabled people often say to me that it is like their disability has suddenly disappeared.

Even when we talk about the cost of disability, the Indecon report that was published a year ago said the cost of disability was anywhere between €8,700 and €12,500 on average, depending on the nature of the disability. Older people who have a disability have asked me why they were not given the €500 this week because they still have the additional costs and they were not given it. They do recognise they were given double payments etc. and they appreciate that but they were still not given the recognition that there is a cost to disability regardless of what age they are.

Second, I welcome the increased spending on home care supports but we have an ageing population so we have increased need. As the Minister alluded to there are many people who have been approved for home care hours and nobody is providing them. That has led to delayed release from hospital and to people having to consider going into a nursing home and that is the last thing they want. The sooner the pay and conditions can be dealt with, the better so we can get more people working in this area.

The Minister mentioned that the most vulnerable are prioritised but that is not my experience in every case. In the case of one man the community nurse told his wife that he and one other person in the community were the most vulnerable and in need yet his care providers are not available and he has not been prioritised for care. This is the matter of the person who was offered the home care cash grant that I brought up with the Minister before and neither he nor his wife is in a position to be able to negotiate that. It might be a grant that suits people who have children who could look for and hire the person but that is not available to this couple.

Another matter that is brought up with me on a regular basis, and that I raised with the Minister before, was the boarding-out option. Not everybody needs nursing home care yet they may not be able to live in their own home. There is a boarding-out option which is much more economically viable than nursing home care yet it has not been reviewed in 12 or 13 years. Some boarding-out places are closing because the money they receive has not risen in tandem with the cost of living and inflation.

My colleague, Deputy Ellis, raised the issue of dual diagnosis which related to addiction and mental health issues but it also has to do with mental health issues and disability. Mental Health Reform attended this committee a few weeks ago and we discussed how people constantly fall between two stools because disability services say that mental health services should be dealing with someone, and the mental health services say that disability services should be dealing with them. The child and adolescent mental health services, CAMHS, is an example of this where they will not accept people with a diagnosis of autism for mental health treatment. I make the point that a lot of people have mental health issues because they are not getting the supports required when they have a diagnosis of autism but, regardless of why, there needs to be cross-departmental work between the different groups to address the issues.

The UN Convention on the Rights of Persons with Disabilities, UNCRPD, is about supporting people to live independently. I have an example of a 21-year-old man in my constituency who has muscular dystrophy. His mother was his main carer but is not able to help him to get in and out of bed now due to an accident. The home care support comes in, sometimes as late as 11.15 a.m., so he is not up until 12.30 p.m. What is worse than that is that they have him back in bed at 6.30 p.m. that evening. That is not a life or independent living. This is a young man of 21 and some days he is only up for six or six and a half hours. I know other people had complained about the timing of the care and that it is down to constraints on the number of carers that are there but it needs to be looked at. The person's needs have to be taken into account as well and especially when they are a younger person but it applies to many across the spectrum that they have to get up at a certain time and have to go to bed at a certain time to suit the carer, rather than the carer suiting them.