Breeda Moynihan-Cronin (Kerry South, Labour)

I am delighted to have the opportunity to speak on this issue. It is a bit disingenuous of the Minister to say that we never compliment those in the health service as we do so at every opportunity. However, today the staff of the HSE came out to say that they have lost confidence in the system. Therefore, it is not only the Opposition that is saying it has no confidence in the system. The Government has a big problem on its hands and sticking its head in the sand will not solve it.

The first issue I want to address is the new home care package lauded by the Minister for Health and Children whenever we raised the issue of people leaving hospital without having somebody to look after them if they are not going into nursing homes. A constituent of mine who lives alone in a very rural area recently came out of hospital. His family got a letter from the HSE to say he was granted a home care package valued at approximately €60 per week and there was no problem with that. The letter was approximately four or five pages long and informed the family that it would have to make the arrangements for the people involved in the care package. The grant of €60 per week was to cover an initial period of six weeks. The letter provided a list of private providers who would provide care, but when the family rang the two companies in Cork, it was told they only cover urban areas. What will happen to this man who lives in a rural area and has no home care? This amounts to privatisation of the home help service.

I will read a paragraph from the letter which I find interesting:

A list of private companies providing Home Care in the Health Service Executive South is attached for your convenience. The Health Service Executive makes no recommendation with regard to the suitability of any supplier and you or your representatives must satisfy yourselves that the provider selected by you can provide the care that is needed and to the standard you desire.

The HSE will pay for the service and provide a list of companies, but it does not want to have anything to do with standards. Have we learned anything from the nursing home debacle? We are going backwards. The HSE is more or less privatising the system and telling elderly people they must decide what standards they require and satisfy themselves as to that standard. The HSE wants to wash its hands of the problem, which is not acceptable. The Minister must take another look at this area. A system that asks an individual living almost 100 miles from Cork to ring up and arrange private home care with a company in the city, for him to be told care is only provided in urban areas, will not work.

This system was lauded by Government and we were told it was the answer to all the problems of elderly people coming out of hospital. It may work in the cities, but it definitely does not work in rural areas. I have serious reservations about the standard of care provided. I do not suggest there is anything wrong with the companies, but it is not right that patients must decide what is a satisfactory standard. The HSE is paying the money and it should decide on standards. There will be more investigations if this is what is happening.

Another issue I want to deal with is that of orthodontic waiting lists in Cork and Kerry. The senior public orthodontist for Cork and Kerry has announced that he has closed the waiting list for public orthodontic patients because there are more than 1,000 patients on the waiting list. Two dentists who left to continue their studies have not been replaced. The average wait for an orthodontic patient in Kerry is now four to five years, which is too long for a child in need. This is another stark failure on the part of the Government. I have been raising the issue in the House for the past ten years with no improvement.

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