Jerry Cowley (Mayo, Independent)

There are provisions in the community to support older people, even those not fit to go home, whether on a short or long-term basis. There is also provision for respite services. However, these provisions are only available in particular situations and locations. Under the old system, the health boards provided what were known as welfare homes, now referred to as community nursing units. These facilities are only available in particular areas and location was often a reflection of the strength of the political representation in an area.

I have spoken to the Minister of State, Deputy Seán Power, about the proposed community facility in Ballinrobe in south County Mayo. Older people are on trolleys or in beds in Castlebar Hospital who should be in the Ballinrobe facility for which €400,000 is required in order for the project to advance to design stage this year. I hope the Tánaiste will address this issue. A consistent approach must be adopted in centres throughout the country. As I said, it involves support at home through the day centre, low support and high support housing.

Such an approach could provide all the necessary facilities. The Tánaiste should be looking to communities rather than private enterprise to provide these facilities. There are several hundred housing associations which have built low support, sheltered housing. Such developments could be expanded to a major degree if there were a defined revenue funding scheme. High support units could also be provided in a similar manner. This would mean that older people who require such care would not be "bed-blocking", a term which, like Deputy McManus, I dislike. Such inappropriately placed persons could be placed in their own community. Those who are not fit to return to their own homes could be cared for in such high support facilities.

Housing associations are prevented from providing high support facilities because of the existing legislation. They can provide housing but not the full support facilities required by those in need of full nursing care. People often go through a continuum whereby an initially minor disability may develop into a condition which requires greater support. The idea is that no matter the degree of support required, people should receive it in their own community in a facility akin to that in St. Brendan's village in Ballinrobe.

For this to happen changes are required in legislation. However, it is possible to adopt such an approach and it would not require any payment to private enterprise. It could be done by working in partnership with communities. This is what older people want. Such arrangements allow people to have a greater say in the running of the facilities in which they reside. There is no need to pay the shilling to the private operator for whom the primary objective is profit. The agenda is not to make money but to support older people in their own communities and this can be done by empowering communities. The community model is a better option than private nursing homes which are necessary only in the absence of community facilities.

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