Liam Twomey (Wexford, Fine Gael)

I wish to share my time with Deputy McCormack.

There is no commitment from the Government to care of the elderly. What the Government has been doing in terms of elderly care is seriously lacking, particularly given that it has been in power for the past nine years. There is a growing sense that the Government suffers from inertia, complacency or does not know what it is doing, as far as care of the elderly is concerned. The Government lacks focus and direction and this is reflected in its record in the health service.

One of the first reports I ever read about political involvement in the health services was entitled, Quality and Fairness — A Health System for You, published in November 2001. That report is similar to many others that have been published about the health services. The health strategy made numerous references to care of the elderly, as did the primary care strategy. The national task force on medical staffing seems to have disappeared. The Prospectus report examined the financial systems within the health services, but very little has happened in that area. The author of the Brennan report criticised the Government for not implementing her recommendations. We also had the radiation oncology report on the delivery of cancer services to the people of Ireland but again, very little has been done.

If one looks at the reports published in more recent years, one gets a good picture of where the Government is going. In the Travers report, the former Minister for Health and Children, Deputy Martin, clearly stated he felt he had no responsibility for the health service. It is some indictment of the Government that a Minister would say that he had no responsibility for what was happening on his watch. The Ferns Report showed shocking abuse of children in our society. Bearing in mind that the Government has been in office for nine years, when representatives of the One in Four group appeared before the Joint Committee on Health and Children, they stated clearly that there are still enormous deficits with regard to the protection of children in our society. The Madden inquiry examined the issue of organ retention. The hygiene audit report highlighted the filthy condition of some of our hospitals. The litany of negative reports has now been crowned off with the Lourdes Hospital inquiry. Almost every report from the Department of Health and Children in the past two or three years highlights what has gone wrong with our health services. We have moved on from the days when Deputy Martin published 150 reports on how he would make the health services better. Now the Government is publishing reports highlighting the problems in the health service. The last report published by the Government on mental health services, A Vision for Change, not only highlights the Government's idealistic nonsense of what it will do for the health service, it also highlights the diabolical state of mental health services. There is no commitment from the Government for care for the elderly, a lack of commitment mirrored across the health service.

The social services inspectorate was to be introduced as part of the 2001 health strategy. Today, however, the Government informs us that it will be part of the forthcoming Health Information and Quality Authority legislation. I hope we will see it, as much has been promised in the legislation, apart from its actual publication. Long before the disclosure of Leas Cross and hiring experts to examine what went wrong with care for the elderly, a policy for funding care for the elderly was promised. Today, the Government informs us that it is still under consideration after nine years. It is unbelievable how slow the Government is when making a decision on any important issue.

Is the Government aware that the elderly population will increase every year from now on? Only when care for the elderly becomes a crisis might it dawn on someone in Fianna Fáil or the Progressive Democrats what is happening. Legislation was promised in the 2001 health strategy for people to learn about their entitlements in the system, yet it is still not crystal clear with a few million euro here and a few million euro there. Usually it is taken from one service for another with no funding being actually given. The Government has no focus or plan for the health service, especially for care for the elderly. It is as if Ministers pick up the newspapers in the morning, see where the latest crisis is and throw a few million euro at it.

Cancer rates will increase, yet elderly people are discriminated against in the treatment they receive for cancer. Is there a sense that the service must be rationed because it is not freely available? Will more orthopaedic consultants be recruited to replace broken hips because the Government has not realised osteoporosis, brittle bone disease, is a preventable illness? With health promotion and proper screening, those orthopaedic consultants may not be needed. The Government always waits for the crisis to occur before thinking what to do. A person who fractures a hip, not only loses his or her independence and self confidence but invariably ends up in a nursing home at an even greater cost to the State.

The home care packages are simply a repackaging of home help hours because the Government was exposed to the fact it had cut home help hours. It is not a suitable alternative, particularly with the problems concerning VAT. The process is too slow. Why does the Government not move on and sort out these problems?

Heart disease is a growing problem. Again, there is discrimination in how elderly people are treated for the disease. No proper screening policies are in place. Heartwatch, a secondary prevention programme run by the Government in an ad hoc manner, is not really satisfactory because it is not properly resourced. Diabetes is increasing, yet there is no national strategy in place. Nothing but waffle comes from the Government. It is irritating for Members on this side of the House listening to Ministers rehashing old statements. Why does the Government not publish reports and inform us how it will implement them?

Telling old people that they have a medical card when they are over 70 years or that they might receive €200 a week in the pension is simply a softener for the next general election. That is not good enough anymore. The problems faced by the elderly are too large for that approach. The Government must show where it is going. A small percentage of elderly people will need long-term nursing home care. The majority live well and have reasonably good qualities of life in their own homes. However, if we are to help the small percentage with a poor quality of life, we must begin planning for it now and not massage figures. Last year's budget gave €150 million for care for the elderly. It has been reduced to €110 million this year. The Government is splitting its funding figures each month. I am beginning to have déjÀ vu with what happened with the doctor-only medical cards and the ten-point plan for accident and emergency services. It will be the same for the care for the elderly.

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