Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I move:

That Dáil Éireann:- recognising the right of older people to live in dignity and independence, and to age well, in their own homes and communities and for as long as possible;

- knowing that 91 per cent of older people rely on the State pension and related supports to protect them against risk of poverty;

- understanding that home help and home care packages are vital, not only to enhancing the quality of life of older people and supporting their preferred wishes, but also to reducing pressures elsewhere in the health care system, including acute hospital services;

- commending the work of home helps, home care providers and carers who care for the needs of our older people and those in infirmity;

- acknowledging that the demand for these services, and for additional supports such as meals-on-wheels, day and respite care, will continue and will increase as the demographics and complex needs of older people change;

- accepting that the Government, despite the economic challenges, must maintain and improve, by all means possible, the social fabric of Irish society, caring for and cherishing people with disabilities, their families and others in need;

- condemning the recent Government decision to cut up to €1.7 million in funding for home care packages and approximately €8 million in funding for home help hours between now and this year’s end, equating to some 450,000 hours of support for those in need, and which, further to cuts implemented in January, will see almost 1 million hours of home help hours withdrawn over these 12 months; and

- recognising the devastating impact these cuts will have on the quality of life and general well-being of those affected;

calls on the Government to:

- immediately reverse the cuts to home help hours and home care packages and to return funding to pre-Budget 2012 levels;

- maintain, develop and enhance home care front line services and to guarantee continued reliable access to community care for older people; and

- draft, publish and implement a national positive ageing strategy before December 2013.

I welcome the opportunity to propose this motion on behalf of Sinn Féin. The motion calls for the immediate reversal of the proposed €8 million in cuts to home help hours and up to €1.7 million in cuts to home care packages. These cuts will have, and are already having, a devastating effect. That is no overstatement.

For those availing of these services the importance of them cannot be exaggerated. Having a home help person in the home for a couple of hours daily to provide social interaction, practical help and real support is invaluable to the beneficiary. These people facilitate older and infirm people living an independent life with dignity and, as is their wish, in their own home. They are a fundamental corner stone of the community-based primary care approach to health care and well-being, one which this Government, at least in words if not deeds, claims to espouse.

Those deeds tell a different tale. Since a peak of 12.5 million hours in 2008 this and the previous Government have led a sustained attack on vital home help services. If the proposed cuts go ahead as planned a staggering 20% of hours will have been removed from the service over four years. Significantly, this process of cuts has accelerated under the watch of the Minister, Deputy Reilly. Since coming to office he has signed off on the removal of almost 1 million home help hours. These figures are a damning indictment of the Minister’s approach, his ideology and his management of our health services.

The Minister must recognise that home help personnel make an immeasurable contribution to the quality of life, health and overall well-being of recipients, the social fabric of this State and to the economic viability of our health services. He did so while in opposition. In 2011, as spokesperson on health for Fine Gael, he told reporters at the launch of the Irish longitudinal study on ageing, TILDA, that home help "maintains people at home, giving them dignity and independence and also saving the taxpayer a lot of money". One can only speculate as to what has changed his mind in the mean time, as he is now apparently content to see those availing of home help services live without the same degree of dignity or independence he once lauded.

The current strategy seems to be one of burning the candle at both ends. It is absolutely clear that home help services, through home help hours and home care packages, save this State hundreds of thousands of inpatient and long-term care bed days. As the Minister proposes to cut services at one end in community care, services at the other end are being cut too. Acute hospital and public nursing home beds, respite services and convalescent care are all being cut. Reports earlier this year indicated that more than 93,000 bed days were lost in our acute hospitals in the first four months of 2012 because hundreds of patients were unable to leave due to delayed discharges. The system has already seized and these cutbacks will add exponentially to this.

At a recent meeting of the Oireachtas Joint Committee on Health and Children, the designate HSE director general, Mr. Tony O’Brien, passed off these latest home help cuts as not affecting those in receipt of service. This is a complete and astounding misrepresentation. We are seeing services for individuals cut to the bone. For example, 30 minute services have been cut to 15 minutes and weekend services have been curtailed for families in receipt of the carer's allowance. Mr. O’Brien and his colleagues in the HSE might argue that, technically, services are not being withdrawn, but those who rely on them know the true story is very different. It is absolutely clear that anyone who thinks that 15 minutes is an appropriate allocation has neither an adequate understanding of nor the slightest appreciation of the role and importance of these services. It is an insult. Similarly, the numbers of those affected by these cuts is underestimated due to the exclusion of those on waiting lists or those who would otherwise be due a home help or home care package in the next number of months. The non-allocation or delayed allocation of services is a well-used tactic to hide the full extent of these cuts.

We cannot avoid the backdrop to what is unfolding. Make no mistake about it, these cuts are being introduced principally as a result of the Minister’s failure to deliver on his own commitments and that of the Government. He failed to deliver the €124 million in savings on the drugs bill this year, as mooted late last year. He failed to deliver expected savings from the cost of private care in the public health system, again as mooted late last year. These two items alone would have negated the need for these heartless cutbacks affecting some of the most vulnerable in our society. The then HSE chief executive, Mr. Cathal Magee, reminded the Minister of this fact repeatedly before his resignation. Instead the Minister’s inaction led to the health budget falling far short, yet again. The more things change the more they stay the same.

Finally, I make special mention of those many thousands of home help workers, mainly women, who have been faced with cuts to their hours and wages and ever-increasing challenges to balance their family budget. I acknowledge the presence of a number of those very special workers in the Gallery. The crisis in the health budget does not occur in a silo. Its effects are far-reaching. Widespread reports and evidence of the privatisation of these services is consistent with the Minister’s approach. I would have thought it is not consistent with the approach of the Minister of State opposite, Deputy Kathleen Lynch. The much vaunted commitment to primary care, care in the community and care in the home has long been tempered with the caveat that these services should be delivered through the private sector. I commend the resistance shown by workers and service users alike to that disgraceful trend.

This Sinn Féin motion recognises the role and importance, socially, health-wise and economically, of home help services and calls for the immediate reversal of these cuts. I urge all Deputies to support the motion in clear recognition that these cuts do not make sense. Vulnerable older people will be forced from their homes into expensive institutional care and workers will be forced into greater hardship. The Minister was delighted to announce yesterday savings of some €16 million on the drugs bill before this year’s end, a fraction of that promised earlier. Nevertheless, this is twice the proposed cut to home help hours. The Minister should now give proof of his commitment to community care and care in the home and use this money to reverse these cuts immediately. I urge Deputies present to use their respective good offices to urge the reversal of these disgraceful cuts to home help hours and home care packages. I urge all Deputies, both Opposition and Government, to support this motion.

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