John McGuinness (Carlow-Kilkenny, Fianna Fail)

I preface my remarks by acknowledging the huge amount of work and funding the Government has put into the health services and in particular into the general area of care of the elderly. I acknowledge also that when the Minister was appointed I was of the view, and to a degree I remain of the view, that there is need for political goodwill on all sides to ensure she fulfils the policies that are vital to improving health services throughout the country. Without that, through constant political debate and sniping we may undermine her position and prevent a speedy delivery of the health services that could otherwise be achieved.

I am deeply disappointed with the progress being made to date, particularly by the Health Service Executive in the way it is dealing with the development of health services and in particular the responses given to questions from Members of this Parliament. The replies are inadequate, inefficient and, at best, inaccurate. That is not good enough because if we do not have the information we cannot go back to the constituents we represent and help them deal with their problems.

On the "Late Late Show" last Friday night Brendan Gleeson made some direct comments and was very passionate in the way he delivered those comments. I share his view. The treatment of our elderly citizens in terms of some services is shameful, despite the amount of money being allocated. We are not doing enough. For example, home care and home attendant hours are being cut and changed. In some cases the elderly person being looked after, who has built up confidence in the person coming into their homes, finds that person has been replaced or has left the scene altogether.

I am aware that over €3.8 million is being expended in my area in respect of that service but it is not enough. Much of that money is being used up by bureaucracy. I do not know the difference between home attendant and home care hours but I know that both services provide great comfort to the elderly person at home and much support to the family concerned. However, home care attendants and home carers draw their funding from different pots of money and are being pushed from pillar to post in their effort to provide that service. I ask the Minister to examine that specific area and ensure these hours do not continue to be cut and that the necessary funding is put in place to ensure a sufficient number of hours' help are available to the people who need it in our constituencies.

The disabled person's housing grant was referred to throughout the debate. It is a shameful position for any of us to be in to have to tell the family caring for an elderly person that the funding for the stair lift, the extra accommodation downstairs or whatever will probably come through in 18 months' time. Telling that to a person in their late 70s or early 80s who is ill is not good enough because all the family and the person want is a quality of life for the remaining time they have on this earth. It is unforgivable that the HSE and the Government would state this to any person who has made that application. It is not how the elderly should be treated.

While EPG grants are there to comfort people in their later years and while the projects involved are of great assistance, coming up with the balance of the money owed is often an insurmountable problem for the people concerned. Some other imaginative scheme will have to be put into place to ensure that these necessary aids are obtained almost immediately. That can now be achieved because of the amount of money in the system. Subvention of hospital care is also of great concern. Charges have risen to €600 or €700 per week, far beyond the reach of most families. Families have met financial hardship in attempting to support a family member in such a setting. The Government and the HSE do not do enough to help people being cared for in these private homes. There is a need for more funding in this area and a review of the bureaucratic system that administers the service. There is a need to look at the person and the family involved to ensure that the greatest amount of support is given. The family should not be put through further stress and strain in coming up with the money, sometimes having to borrow it.

I put down a parliamentary question asking when the Minister would approve the €2.6 million necessary for a 30 bed unit for the care of the elderly in Kilkenny city. The paperwork on the project has not been submitted to the Department for approval. I got a reply stating that it is a matter for the HSE, but that is not the case as the Department must approve it. I cannot understand why we must go around in this bureaucratic circle. If half of the bureaucracy was removed and the cost savings were put to projects such as this, it would allow greater efficiency in the service and provide money for projects needed in almost every constituency.

Will that project be examined again? Will the €2.6 million be made available? The issue has been debated politically for the past 30 years in Kilkenny and a resolution has been found, if only the money was invested in the project. When the Minister looked at the project several years ago following a visit to Kilkenny, there was a cost of €2 million to care for people in the psychiatric services who were elderly and needed care and for those from the broader community who needed general care. In excess of €1 million has already been spent to fulfil the first part of that project and €2.6 million is needed to complete the project. I ask the Minister of State to take note of this.

I know the Minister of State, Deputy Power, will visit Kilkenny and the hospital in Castlecomer, which has four long-stay beds and is the only hospital in that part of north Kilkenny. The aged population has increased significantly, as has the demand on services. When he visits the area, he will discover that the community has contributed much money to ensure that the project is continued. The people are asking for more long-stay beds for the care of the elderly in that north Kilkenny community. I ask the Minister of State to look favourably on their request.

Many elderly people in my constituency live at home and have no alarm system. Greater funds need to be awarded to the different projects led by groups that provide alarms, as it is absolutely necessary. I urge the Minister of State to ensure that the home heating fund operated by the local authorities is increased substantially so that elderly people's homes are heated.

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