Éamon Ó Cuív (Galway West, Fianna Fail) | Oireachtas source

If I understood Ms Power correctly, she referred to providing a package to people who are medically certified as having two years or less to live. I understand what she is saying. There is a human problem, as I try to figure it out in my own mind. This issue comes before us as constituency politicians when a person comes in to query carer's allowance to do with a cancer diagnosis. In most cases, it is the caree that comes in so we are not stuck with the awkward questions. In many cases, the person who comes in to us is the person with the illness. In my experience of dealing with the people who have a serious cancer, most believe they are going to fight it. It is humanly difficult to ask somebody to get a letter saying there is a likelihood that he or she will be dead in two years when the person is sitting in front of you and you are trying to edge your way around it. How do we humanly deal with that problem? I am sure all my colleagues are confronted with the same issue. We might believe from what the person has said that this is the situation but we must get around that. From what the witness has said a clear cut statement must be sought. I presume that not everybody who has cancer would get this package because this would raise precedence for all sorts of conditions. Many people walking on the streets today have had cancer in their lives. I am curious as to whether this does cause an issue. Certainly it has caused similar issues for me in the past.

The other way of going at this is on a wider scale. I will first refer to medical cards, although I am aware we are not here to discuss medical cards but they have been mentioned. The medical card income thresholds has not been raised in years. It has been done for the over 70s but still it is four or five years since that happened and inflation keeps eating into that every year. We have not increased the guidelines since, I believe, 2018 for ordinary medical cards for ordinary people. There are two easy things that could be done, one of which is to radically increase the medical card income threshold. The advantage of that is if there is money, then more GP visit cards could be given out to the less well-off cohort. This is not putting more pressure on the GPs by people going more frequently to their GP. It is not shown that people without medical cards die younger; in fact, the evidence is the opposite. It is often easy to administer once we change the guidelines.

Another measure could be taken and this is a very strong proposal. It is so very simple that it is unbelievable we do not do it. People over 70 years of age get a medical card and the means threshold per week is €550 for single persons and €1,050 for a couple. All the time I hear from people whose means are reassessed again and again. I asked a question about that and 97% automatically get the cards again. As people get older, they get more fragile and more vulnerable in every way, including being susceptible to illness. One of the easy things we could do is say, "Once you are 70" - unless there is some suspicion the person has won the lotto or has defrauded the medical card system by giving wrong information. On the 99% expectation that people tell the truth, it is not worth the cost of mean-testing again and again, and the hassle and upset for people as they get older or more ill. I am also interested in the household benefits package in the context of the issues raised here.

The other measure is absolutely clear cut. If a person is in palliative care, a two-year waiting list for an SEAI grant is just bogus. I would even go so far as to say that if people have significant cancers that are confining them to home, or any other condition that confines them to home, they should just jump to the top of the list. We have that in the housing list. Such a measure would be even easier to implement because it just needs to be determined that the condition is one that confines the people to the home, and then they would just jump the queue. We have a process, a HMD form, for medical priority for housing lists and so on. That is my two questions there.

The submission from Fiends of the Earth was interesting. We are all here with experience of operating the schemes, the complexities, the eternal means-testing and so on. When a scheme is devised, it must be operable. I agree with the suggestion that local authority housing must be done faster. However, then I say, "Hang on, you want to grab all of the contractors and make an even longer list for those on the warmer homes scheme or living in older houses." Many of those people are actually living in very poor housing. Is the real problem that we just do not have enough workers in this business at the moment? Is money the problem or are there not enough tradesmen trained to retrofit housing? Should a huge amount of concentration go into training more people? In my experience we may try to encourage those living in very bad houses to go into the scheme and, in many cases, it is complex. Most Deputies will find this. People may have a lot of money and still would not have done up the house. They might have a lot of cash and no borrowings but they are worried about nursing home costs, for example. The fair deal scheme would only take some money off them but they do not understand the schemes. Reference was made to education. While there is information available, one of the biggest disincentives is the householder being told, "By the way they will not come out to inspect this for two years". When people eventually come to make up their minds, having waited for years, they want it now. We all do that. This seems the single biggest challenge we face.

Last week I raised another issue around where we might be able to relieve some of the pressure. In reality, there are some very poor houses with draughty windows, draughty doors and faulty roofs. It could be the whole basic construction of the house. Why get a more sophisticated energy saving retrofit when the house is so faulty? It does not matter what someone does in energy saving retrofits until we get the fabric of the whole house right.

There is a grant called the HAOP, that is, housing aid for older people, which is available for roofs, windows and doors or anything you want. The only problem, certainly in Galway, is that the limit of the grant is €8,000. We know how little we can get for €8,000. There is no waiting list for it; it uses local contractors and it does not have to involve people on a special list to do the basic work. What is the view of the witnesses on the idea of increasing funding from the State for this scheme in order that people can get basic work needed on the house done before they get as far as the warmer home scheme? They could work in tandem and the warmer home scheme would be a follow-on in this regard. It would be an integral part but a follow-on to getting the basic structure right.

We could also take the element of older people out of it and have it for people on low incomes because it is means tested. People on low incomes who are under the age of 66 or 65 could access the scheme if they had very poor housing. If you are cold, you are cold. It is not only a problem for older people who are aged over 66. Many people, particularly in rural Ireland but also in urban Ireland, have inherited houses that were in very poor condition. They might have cared for a parent and inherited these houses that are in poor condition. They are of limited means because they gave up their lives to caring. They should be eligible for this type of scheme. We need to be practical about this. Some of the people I am dealing with are so far from heat pumps that they are not the issue. Not needing as much energy as they do would be the first big saving in their lives. If we got that far then we could then get to the warmer home scheme and heat pumps.

Do the witnesses get resistance from older people regarding things such as heat pumps on the basis that it would involve ripping up the house and they do not want to move out? In other words, do they want to do the 80% job and not the 100% job because of disruption to the physical house? They will certainly not leave their own house for anybody.