Jack Wall (Kildare South, Labour)

I welcome the motion and congratulate the Labour Party spokesperson on health, Deputy McManus, on tabling it. What difference will the Government's strategy on health make to constituents who seek assistance in having care provided for their loved ones? It will not make an iota of a difference to senior citizens because they will continue to attend accident and emergency departments seeking treatment, notwithstanding statements by Ministers that such people should be fined.

The Health Service Executive and Minister for Health and Children have done nothing to facilitate home care for senior citizens. At a meeting on the HSE held in Leinster House 2000 earlier today, I was astonished to hear Fianna Fáil Party Deputies describe the home care package as a disaster. They could not understand how it worked and did not know how to seek information about it. Opposition spokespersons noted that people will have to incur debt to cover the cost of home care packages because the HSE has not yet got its act together to make home care payments.

Similar problems arise with regard to disabled person's grant and essential repairs grant. If people had appropriate facilities, they would be able to stay in their home and would not attend accident and emergency units and hospitals, and would not regularly contribute to overcrowding in our hospitals. The HSE is involved in two aspects of the disabled person's grant. First, it has a role in the assessments carried out by occupational therapists. It may also provide a top-up grant once a local authority approves a grant. This would be good if it worked but the HSE will refuse to award a top-up grant to assist an applicant seeking to have facilities installed to improve his or her quality of life at home because it waits until a local authority signs off on the initial loan. As a result, if the facility sought by the applicant is deemed to be above the threshold specified in the 2000 regulations, the applicant must try to raise a loan.

Senior citizens are not in a position to secure a loan of €8,000 or €9,000 but when they apply to the HSE for a top-up loan they are informed the application will not be considered until the disabled person's grant has been signed off by the local authority. This means the disabled person's grant cannot be drawn down by the applicant because no builder will take on a job if its costs are not fully covered by the grant.

The same problems arise with the essential repairs grant. Senior citizens who wish to stay at home are unable to obtain grants which would enable them to do so. In addition, no new claims for home help services are being accepted because of an unresolved industrial dispute. The poor legislation on nursing home subventions before the House will not address problems in this area but will create further problems for senior citizens who wish to remain at home.

At the same time, prime lands in public hospital grounds are being sold. In my area, independent living units for senior citizens have been provided. Instead of building private hospitals, would it not be preferable if the HSE made land available to provide independent living accommodation for senior citizens? This would give them security and comfort in the knowledge that help was close at hand. There is no logic in the argument made by the Government side. Unless we clean up our act as regards providing care and supports to senior citizens, the crisis in accident and emergency departments will persist.

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