Charlie O'Connor (Dublin South West, Fianna Fail)

I am tempted to say to Deputy Ó Caoláin that it might do his party the world of good to visit that place of pilgrimage in Cork. They might take their scriptwriters too, and it might change their attitude.

To be serious, I have been listening carefully to the debate. I listened in particular to the Minister of State this morning. There has been some talk as to what Minister should have been here and I will not get involved in that. However, I have great admiration for the work of the Minister of State at the Department of Health and Children, Deputy Seán Power, and what he does in the Department. He blazes a trail struck for him by Deputy Callely, who certainly impressed greatly as regards services for the elderly, in the short time he was at the Department. Deputy Seán Power's speech this morning was measured, particularly as regards services for all the people. He also made the point, in fairness, about the doctor-only medical cards. The term "yellow pack" has a good soundbite, and perhaps that is all right, but we should be careful about upsetting people who wish to qualify for such medical cards. Perhaps we should find a different phrase. The occasional soundbite is all right, but let us remember the Government is trying to create a situation whereby people on lower incomes qualify.

As a Government backbencher I support the view that we should help those who are in need of medical cards. Since I have picked on Deputy Ó Caoláin I will give some credit to Deputy Crowe who has made the point, as I often have, that the best way to get people out of the poverty trap is through employment. Many people in my constituency often make the point that where they are unemployed, receiving different assistance benefits and want to go to work or into full-time education, it is often difficult to make such a decision because they must do it in the knowledge that they will lose benefits. There is often an issue with medical cards, although the situation has improved a little in recent years.

I am pleased to have an opportunity to speak on issues related to the provision of services for older people and to support what the Government is doing in that regard. I speak as a representative of the constituency of Dublin South-West where there is a young population, particularly in Tallaght, but also in Firhouse, Templeogue, Greenhills and Brittas. There are also many elderly people in those communities and I am always happy to support the groups that look after them. The significant progress which has been made in the growth of funding available for this sector is indicative of the Government's commitment to the ongoing development of health funded services for older people.

One of the great achievements of western societies in the 20th century has been the increase in life expectancy. As the standard of living for the young and middle aged in this country has risen, so the quality of life of successive generations is improving. Modern medicine, social policies, political will and community enterprise mean that more people live longer and more fulfilling lives. The majority of older people are healthy and fit and hold good positive attitudes. I recently spoke to a gentleman in my clinic who let slip that he was aged 81. I was astonished and it is great to see that kind of attitude in our elderly.

It is interesting to note that there are more than 60 million people in the European Union who are aged 60 and over. Figures from the Central Statistics Office collated from the results of the census suggest that the average age of the population is increasing. Projections based on the 1996 census indicate that in 1996, 11.5% of the Irish population was over 65. Forecasts suggest that 18% to 21 % of the population will be aged over 65 by 2031. The Government is aware of this trend and addressed some of these issues in the health strategy, Quality and Fairness — A Health System for You, published in 2001. The Government is committed to developing services for older people, both residential and community based, to meet the needs of our growing older population. We know there are economic and financial consequences of people living longer. Each generation of people in their active years must accept responsibility towards the support of the elderly.

The Government's commitment to the development of a comprehensive range of services for older people can clearly be demonstrated by outlining the resources made available in recent years for service developments. In excess of €287 million in additional funding was provided for health services for older people between 1997 and 2004. This demonstrates the Government's ongoing commitment to improving services for our older population. In 2005, a further €15.228 million in additional funding was allocated to services for older people. This funding is being used for a variety of services, including the nursing home subvention scheme, the home care grant scheme, home help service, elder abuse programmes and support for voluntary organisations. Since 1993 there has been an unprecedented level of investment in the nursing home subvention scheme. A total of €5 million was allocated for the scheme when it was introduced in 1993. The total expenditure on the scheme in 2005 will be €120 million.

In line with a Government decision, an expenditure review of the nursing home subvention scheme was undertaken by the Department of Health and Children in association with the Department of Finance. The review was carried out by Professor Eamon O'Shea and the objectives of the review were to examine the objectives of the 1993 nursing home subvention scheme and the extent to which they remained valid, to assess the service delivered and to establish what scope, if any, existed for achieving the programme objectives by other more efficient and effective means. Professor O'Shea's report, Review of the Nursing Home Subvention Scheme, was launched in June 2003 simultaneously with the Mercer report, Study on the Future Financing of Long-Term Care in Ireland, which was commissioned by the Department of Social and Family Affairs.

Community supports are vital to maintain older people in their homes for as long as possible. Long-stay nursing care should only be a last option in care planning for older people, with the community supports acting as a real support for older people who wish to live in dignity and independence in their community. Numerous studies have highlighted that older people would prefer to remain living at home rather than going into long-stay care. The Government is committed to developing the various community and home support schemes. The total expenditure on the home help service in 2005 will be €118.75 million. I would like to be unusually parochial and mention my support——

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