Charlie O'Connor (Dublin South West, Fianna Fail)

I do not wish to share my time because I have had too much excitement this week sharing time. I welcome my friend and near neighbour, the Minister of State, who knows I would prefer to use my contribution to discuss issues of concern to him, including Tallaght Hospital. It is a major challenge to follow my fellow Dubliner, Deputy Byrne, and I compliment her on her fine address. She should not misunderstand that Government backbenchers are concerned about the issues she raised. I have also lived in Dublin all my life. She is much younger and I hail from a different era. Health has always been an issue in Dublin life and I always lament the demise of the various hospitals in the inner city, where I was raised, such as the Mercer's and Adelaide hospitals. If Governments of all persuasions had their time over again, perhaps different actions would have been taken and we would be examining this issue from a different perspective.

The Bill aims to introduce a new scheme of State support for individuals who require long-term nursing home care. It provides for a care needs assessment of individuals to ascertain whether they need to be provided with long-term residential care services and a financial assessment to determine the contribution eligible individuals may have to pay towards the cost of long-term residential care services. The Bill allows for the deferral of part of the contribution in specified circumstances and provides for a system of review and appeal.

I live in Tallaght, the third largest population centre in the State. It is a young population. I was raised in Crumlin and I often visit the area, which contrasts greatly with Tallaght. People in Tallaght, Firhouse, Greenhills, Templeogue, Brittas and Bohernabreena are ageing and that always presents a challenge. Sometimes people say one should be good to one's children because they will choose one's nursing home. In my case, my sisters have taken the initiative and they keep telling me where they will be put me. This issue will face us all, as Deputy Byrne said, and it is important that we pay attention to it. The Minister of State will be aware of the lack of significant nursing home capacity in my area. St. Brigid's nursing home in Crooksling, Brittas, County Dublin, has been around forever and it provides a brilliant service for women who need it. Kiltipper Woods is a newly established nursing home, which has gained a tremendous reputation in recent times, and it is a great place to visit.

Everyone is concerned about the conditions in nursing homes. From 1994 onwards I was a member of the Eastern Health Board and I served as chairman of the south western area health board. I sometimes lament the passing of the health boards but that is another day's work. However, as members of the health board, we had the opportunity to visit nursing homes and we did good work to ensure we were satisfied conditions were as they should be, as patients deserve that. Many of my constituents go outside the constituency because of the lack of nursing home capacity. The Cherry Orchard and Brú Caoimhín nursing homes attract many people from my constituency. Increased capacity will be required and that will be a challenge down the road.

It is important we support those who want to ensure conditions are ideal and patients are comfortable and safe. My uncle lived on Kevin Street all his life and he only moved into a nursing home in Bray when he was 92. He was lucid up to the time he died aged 93 and I recall asking him how he was getting on. He said it was a great place and it was comfortable but the only difficulty he had was it was full of old people. I always look on that story positively because he was happy. He quickly overcame the upset of his wife dying and having to leave his home in the inner city. He was happy there because he could ramble around Kevin Street, Aungier Street and Patrick Street where he was born. Suddenly he found himself in a different environment. Thankfully, because of the way the home was run and because the staff were caring and paid special attention to him, he was happy.

The best way to look after the elderly is in their own homes. When my father was sick, he lived with my sister during his latter years in Kilnamanagh before he entered St. James's Hospital. He was happy to be at home but that presents other challenges. Every family must face this scenario and not only those in the farming community. My family was no different in that regard. It is important that we continue to support these services from these benches to ensure the Department understands the need to fund all the relevant schemes year in, year out. Much is made of the pressure on home help services. The home help headquarters in my constituency is in the Tallaght Welfare Society offices on Main Street, Tallaght, and it provides services to more than 200 elderly people and others who cannot cope on their own. This means they can stay at home and it takes pressure off hospitals.

Tallaght Hospital will always face challenges, as I stated last night during the cancer debate. Its catchment area embraces not only Tallaght and Clondalkin but stretches into counties Kildare and Wicklow all to the way to Carnew on the Wexford border. In fact, I have just had a few words outside with the president of Tallaght Hospital, Archbishop Dr. John Neill. We are proud of what the hospital does.

The difficulty of people holding up beds — I do not want to use phrases that will upset people — arises in Tallaght Hospital, St. James's Hospital, St. Vincent's Hospital and in all the Dublin hospitals. It is important that we understand the challenge that presents. The Minister must understand the need to continue to create an environment, with home help and with other supports for families, where we can keep people out of hospital as much as possible. From family experience, I know hospital management will always state that the safest place to be is out of hospitals, although I know that sounds like a contradiction. Unfortunately, many elderly people go into hospital and stay longer than they really should, and that creates all sorts of other problems.

In the context of those remarks, I also want to make reference to what has already been said about the various programmes which help provide services for people who stay at home. Colleagues have echoed my experience in the South Dublin County Council area. I will not be any more critical of my council than of any other. Together with the Minister of State, Deputy Curran, and other colleagues, I would be able to tell the Minister that not a week goes when we do not make representations on behalf of families who seek approval for such services and try to get them implemented as quickly as possible. When people suddenly find themselves in need of such services they cannot get their heads around the delays caused by bureaucracy.

Public representatives should not have to get involved in these issues. When one thinks about it, TDs, and, in fairness, even councillors, get involved in these issues because the system is not working when it should work. Officials in the Departments of the Environment, Heritage and Local Government, Health and Children and in the local authorities should understand this problem. There will always be pressures at a time when there are economic challenges and there will always be choices to be made, as we heard from the Government benches last night. As far as these programmes are concerned, however, the agencies cannot have it every way. If we want to keep people out of hospital and safe in their own homes, we must try to create a situation where all of the supports, services and programmes are in place. If we provide those services, we will take the pressure off families.

I hope Deputy Catherine Byrne does not mind me mentioning her. At meetings of the Joint Oireachtas Committee on Social and Family Affairs, she often talks about her elderly mother. I bring to my own politics my life experiences and it is good to hear her doing that too, and I wish her family well. We have faced challenges in our families. We should not be afraid to speak up in the Dáil, certainly from the Government benches, and promote the ideal that necessary systems and programmes should be in place. Families who have elderly relatives to care for and get through difficult health situations need as much support as possible. The world will never be perfect, and it will always be a case of a lot done, more to do, but it is important in the context of this Bill that we would provide those supports.

Like others, I receive quite a number of representations at my clinics, through mail and calls to my office, on the issues related to this Bill — not so much this week because my office, like everybody else's, is jammed with other stuff. I do not mind people contacting me. I am always happy to receive communications. I am particularly excited when I get letters but sometimes, when matters are contrived and wound up, one wonders about the merits of those systems. My staff and I will continue to deal with these matters and where anybody makes contact with me at my Tallaght or Dáil office, I will try as far as possible to get back to them.

Many people have contacted me about this Bill, which has caused some concerns. I heard that reflected across the Chamber and it is important that we would not be afraid to face up to those issues. US President-elect Obama said last week in the midst of much else that was good that he will always listen, especially when he disagrees with the other point of view. I have been saying during the week that there is a lesson in what he says for every politician in the world and I am not afraid to take that advice.

It is important that the Minister, Deputy Harney, would also take account of the points being made on this Bill, and I suspect that she will do so. I will spring to Deputy Harney's defence, not for the sake of it but in fairness to her. I was glad to hear aspects of her work praised from the Opposition benches. Deputy Gilmore yesterday put on record — I hope he will not mind me repeating this — his admiration for aspects of her work. It is important that we acknowledge that. She does a difficult a job, and I suspect that is what people are saying on this legislation. The presence of Deputy Jan O'Sullivan reminds me that I listened to her this morning make reference to points of concern, which is fair enough. When this Bill is tweaked on Committee Stage, generally speaking it will be acceptable.

I listen to the various groups such as Age Action Ireland which have come in to joint Oireachtas committee meetings. We will certainly continue to listen to them. It is important that we would do so, reflect as far as possible the points they make to us and try to make progress on the issues of concern in any community. If one walks any street, in Clondalkin, Crumlin, Lucan, Limerick and certainly in Tallaght, that is what people will say to you.

Since the Bill was published in October 2008, people have welcomed the fact that it seeks to introduce a new scheme of State support for individuals who, as I stated earlier, require long-term nursing home care. I noted, in doing a little research for this contribution, that the Bill aims to provide for the establishment of a scheme to be known as the nursing home support scheme under which financial support may be made available to persons in respect of long-term residential care services out of resources allocated to the Health Service Executive for the purpose of the scheme. I will not bash the HSE today. There are aspects of this business about which people will be happy.

I understand also that the Bill provides for a care needs assessment to ascertain whether individuals need to be provided with long-term residential care services. I hope that process will be consumer friendly. It would be important that it would take a caring approach to the needs of families in so far as State agencies can care. On any given day here in the House we deal with all sorts of business where there is a need to take that approach. Sometimes we receive complaints about bureaucracy. It is important that we would address that. My friends in the Citizen Information Centre, CIC, system, particularly the one in Tallaght village, tell me they get such calls from people asking how to get around the system and sometimes such callers are worried when faced with officialdom.

I am also glad that the Bill provides for a financial assessment of individuals to determine the contributions they may have to pay towards the cost of long-term residential care services provided for them and also, importantly, to allow for the deferral of payment of the contribution in specified circumstances. It is important that the Minister would as far as possible continue to clarify the issues relating to the regulation. These points were raised in responses I received from people in and outside of my constituency.

It is similar to the medical cards issue which I do not want to go over again. Opposition spokespersons are entitled to keep raising it but I know from my work and involvement in my constituency that a great deal of tension, frustration and confusion was caused by people thinking from reports — I do not want to pick on the media — that they would be affected. People told me they would lose their medical cards. Without knowing their bank balances I would know enough of their circumstances from my contacts with them to know they would not be affected. However, I admit they were upset and concerned and this had to be worked through. I am glad the Government's response was positive.

It is important to emphasise that we understand this legislation will cause interest, concerns and questions to be raised. I have expressed my strong support for the Bill but questions have been raised and people are entitled to ask them. I hope the Minister will continue to deal with these issues. I look forward to supporting the Bill, which I commend to the House.

See this speech in context