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

I mentioned those places in the Deputy's absence. I am happy to record my strong support for the Tallaght home help service which is part of the Tallaght welfare society.

The Health Service Executive areas have piloted home care grant schemes as an alternative to long-term residential care to assist older people living at home in the community. Older people who are discharged from the acute hospital system, as well as those living in the community, are targeted under these schemes. In the HSE eastern regional area, people have been discharged from acute hospitals under the Slán Abhaile and Home First pilot projects. In the HSE southern area, a similar project, Cúram, has been piloted. The Department of Health and Children has been working with the HSE to develop a national home care grant scheme. A draft of the scheme is being finalised by the HSE for presentation to the Department. Funding of €2 million has been allocated to the HSE in 2005 to introduce the scheme.

It is acknowledged that there is insufficient provision of public long-term care beds to cater for the growing elderly population with a resultant over-reliance on the private nursing home sector. I served on the Eastern Regional Health Authority along with Deputy Mitchell and other colleagues and am brave enough to lament its passing. I know it might get me into trouble in some quarters but I am not that happy about its passing. The Eastern Regional Health Authority and the Southern Area Health Board are particularly affected because of a lack of public long-term care beds. This was acknowledged when the Department of Health and Children was preparing the health strategy and there is a commitment in the strategy to provide 1,370 additional assessment and rehabilitation beds, 600 additional day hospital beds and facilities encompassing specialist areas such as treatment for falls and osteoporosis, fracture prevention, Parkinson's disease, stroke prevention, heart failure and other problems. In addition, the strategy proposed the provision of an extra 800 extended care community nursing unit places over a seven-year period that would include the provision of long-term care beds for people with dementia.

Under the national development plan, capital funding of over €253 million is being made available for the provision of services for older people in the period 2000 to 2006. On a national basis, this will enable a comprehensive infrastructure of community nursing units and day care facilities to be put in place as well as the refurbishment of existing extended care facilities and the replacement of older unsuitable accommodation. The House will recall that I mentioned the elder abuse programme. The publication of the report, Protecting Our Future, in late 2002 was a momentous occasion for the elderly in this country. They were given a blueprint to deal with the scourge of elder abuse and a pledge that this blueprint would be implemented. Up to recently, there was a feeling that elder abuse did not exist in this country, but the report confirms that there is a problem, the extent and nature of which remains to be identified.

By defining elder abuse and recommending implementation of structures to deal with suspected cases, the report will, I hope, give older people who feel they are the victims of it the confidence to report their anxieties, as appropriate, to social workers, public health nurses, gardaí, professionals or care workers. While the report is the first attempt to deal with elder abuse, it is still an important one. As abuse can come in many shapes and forms, there is need to make the general public more aware of the problem. It is even more important to target relevant service providers to make them aware of the steps taken to respond to elder abuse and the procedures that will be available to deal with it. I hope greater awareness of the problem will lead to lessening of its incidence.

As recommended in the report, a national implementation group has been established. A number of the report's recommendations are based on experience gained from two pilot projects. Despite the absence of major publicity, sufficiently serious and numerous cases have come to light to justify the process. The Department of Health and Children is determined to press ahead with gradual implementation of the report. Funding of €800,000 was provided in 2003 to commence implementation of the elder abuse programme. Last year, an additional €750,000 was allocated to each health board area to ensure the continued implementation of the programme, including the appointment of case workers. An additional €900,000 has been allocated for 2005.

I concur with the broad thrust of the report, which recommends placing the response to elder abuse in the wider context of health and social care services for older people. As the number of older people rises, we should not forget that they have been instrumental in building the healthy State we enjoy today. Their contribution to the economy is widely acknowledged and the Government is fully committed to improving all aspects of their lives by focusing on issues that affect their well-being. The cornerstone of the Government's health policy is to keep older people living in their own homes for as long as possible. To remain at home has been shown in research as the preferred choice of older people. All Members will have seen this finding corroborated through their constituency work.

Implementation of the recommendations outlined in the report will help to ensure the observation of the fundamental right of older people to be treated with respect in their twilight years. The starting point for making the changes called for in the report may well involve each of us reflecting on our attitudes to older people. We must begin to question our attitude to older people to satisfy ourselves that we do not harbour the in-built negative feelings towards them, which can often be the source of unintentional abuse. We must proceed on a journey during which we absorb much and learn to cope with what may be considerable fallout.

In November 2004, the Tánaiste announced additional funding of €70 million to implement a ten-point action plan to improve delivery of emergency services. The Tánaiste met senior management of the Health Service Executive with which the Department of Health and Children is working closely to ensure early implementation of the plan. The measures outlined in the plan include transfer of 100 high-dependency patients to suitable private nursing home care, negotiation with the private sector to meet the needs of 500 people annually for intermediate care of up to six weeks and the expansion of home-care packages to support an additional 500 older people at home. Funding of €16.8 million to the former Eastern Regional Health Authority will result in more than 600 patients being discharged to more appropriate settings. A total of €5 million was provided to the former Southern Area Health Board under the delayed-discharges initiative 2003-04 to facilitate the discharge of patients from the acute hospital system.

It will be clear to the House from my contribution that the Progressive Democrats Party and Fianna Fáil have an undeniable commitment to older people. While we acknowledge the need to avoid complacency about the continuing development of services to meet growing demand, the Government and its immediate predecessor can be proud of their record to date. We are aware that we must continue with our efforts.

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