Dáil debates

Wednesday, 1 February 2006

Social Services Inspectorate: Motion (Resumed).

 

7:00 pm

Photo of Pádraic McCormackPádraic McCormack (Galway West, Fine Gael)

We must acknowledge that the majority of private nursing homes provide excellent care to their patients and that many families are grateful to be able to avail of the services of such homes for their relatives. However, this debate is very important. Its purpose is to ensure our elderly will be well cared for in our nursing homes. The "Prime Time Investigates" programme showed what happened in some nursing homes and demonstrated for us why the putting in place of the inspectorate is so important.

Why are there such long waiting lists for our public nursing homes, for example, the long-stay care in Merlin Park Hospital in Galway which has a two or three-year waiting list? St. Brendan's nursing home in Loughrea also has a two or three-year waiting list. The State should be in a position to provide more public nursing homes. Many of our public nursing homes provide excellent care. I visited one in Clifden recently where the patients get top class care.

It is difficult for an older person living alone to get a place or to afford private nursing home care. A person on an old age pension without relatives could not afford the €500 or €600 a week charged. Many of these people are denied subvention through an anomaly in the means test.

In the budget the Minister for Finance used a sleight of hand when he pretended to raise the thresholds to €500,000 for a house in Dublin and €300,000 for a house in rural areas. However, he did not really raise them. If a house in a rural area is valued at over €300,000, the owner does not qualify for the subvention. If, for example, one's house is worth €250,000, 5% of the value of the house is assessed as income. This amounts to approximately €12,500. The income limit to qualify for the full subvention is €11,000 and therefore if one's house is valued at €250,000, one does not qualify for the subvention.

It is all very fine for the Health Service Executive or the Minister to ask why relatives do not sell the house and cater for the owner in a nursing home but many people in nursing homes really believe they will be returning to their houses the following summer. They believe they would be cutting all ties with their communities if they sold their houses. Selling one's house, therefore, is not a viable proposition. Irrespective of who remains in a house after the owner enters a nursing home, even if nobody remains in the house, 5% of the value of the house is regarded as income. This is codology in respect of people in rural areas who enter nursing homes.

The Government amendment notes the Government is committed to introducing legislation which, inter alia, will establish the social services inspectorate function on a statutory basis. The Minister for Health and Children, the Minister of State, Deputy Sean Power, and the Taoiseach promised in the Dáil that the legislation would be introduced last autumn, but we are still waiting. In the meantime, many people in nursing homes may be suffering from treatment similar to that exposed in the "Prime Time" programme.

There were numerous promises in 2001 to introduce a nursing home inspection regime. The Government committed in the health strategy, Quality and Fairness — A Health System for You, Sustaining Progress, the social partnership agreement for 2003 to 2005 and An Agreed Programme for Government, dated June 2002, to the establishment of a social services inspectorate on a statutory basis and to the extension of its remit to other social services, including residential services for older people. This was stated by the Tánaiste in the House on 4 April 2005.

Research has shown that most people would prefer to live out their lives in their own homes and communities. However, nothing is geared to help this happen, particularly in rural areas. County councils and the Health Service Executive ran out of money last year. I could quote letters referring to there being no money for the essential repairs grant for the elderly. Sometimes people are forced into nursing homes as a result of their not being able to carry out such repairs. Letters refer to there being no money for the disabled person's grant. I knew of some people who applied for it but who passed away before it was sanctioned. They might have been looking for a downstairs bedroom or bathroom as a result of their being unable to go upstairs, but no money was made available for the necessary work.

Home help hours have been cut back seriously. I recently dealt with the case of an 88-year-old woman in my area of Clonbur whose son was trying to keep her in the house for as long as possible. Up to last September, he was receiving eight hours of home help but the number of hours was then cut to four. He struggled as best he could and I have been struggling ever since to have the eight hours help restored. If I succeed, he will be able to keep his elderly mother, who suffers from Alzheimer's disease, in his own home.

When I contact the Health Service Executive about this problem, officials tell me they cannot allow eight hours because of the embargo on recruitment. When I asked the Minister about this on 25 January, I was told the Department had not imposed an embargo on recruitment for home help services. She also stated €30 million has been provided for the home help service in 2006, which will provide 1.6 million extra home help hours. When I contacted the Health Service Executive, the officials said they never heard of this. Will somebody please send the Minister's message to the executive, particularly in my area, and tell it there is no embargo on the recruitment of home help staff, who would enable people to stay in their own communities for as long as possible?

This generation is losing out greatly and it will be regretted by our grandchildren and others that we are putting our elderly relatives in nursing homes and institutional care rather than keeping them at home. The value of elderly persons in the community and their experience of life cannot be measured, nor can the value to grandchildren of having an elderly person in the home or an adjacent home.

If more resources were allocated for home help, the essential repairs grant for the elderly and the disabled person's grant, we would have a better community entirely. There is no point in stating fancy figures, such as the €150 million allocated in the budget and the Social Welfare Bill for the care of the elderly, because the results are not seen on the ground. Is the money going into administration? Where is the €30 million the Tánaiste referred to in Question No. 352 of 25 January 2005? The Health Service Executive knows nothing about it when I ring it up. I have rung it on five or six occasions about the aforementioned case in the north Connemara area. This is only an example and one could multiply it by thousands to indicate the number of people being refused home help hours who are attempting to keep their parents or loved ones at home rather than in institutional care.

The Government and the Department have a lot to answer for in terms of their neglect of the elderly. Maybe Ministers are so busy with their own lives and Departments that they do not realise the hardship being experienced. However, I am sure they, as Deputies, realise it because they must note the problems raised in their constituency offices, just as I and other Deputies encounter the real problems old people face in both urban and rural areas. It is the wish of most families to keep elderly people in their communities rather than put them in institutional care. They should be given the necessary State support rather than be forced to deal with the red tape of the Health Service Executive.

In the case to which I referred, the Health Service Executive officials said they could identify a person willing to work evenings, thus supplying the necessary home help, but that there was an embargo on recruitment as the executive area had its full complement of whole-time staff. I was told this on 20 December, at which time it was stated circumstances may change in the new year. We are now a month into the new year but the position has not changed. Will the Tánaiste get on to somebody in the executive, such as Mo Flynn, with whose office I dealt today, to inform officials in the various executive areas that the €30 million is available and that there is no embargo on the appointment of the staff necessary to allow relatives keep their loved one's in their homes for as long as possible?

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