Michael McCarthy (Cork South West, Labour) | Oireachtas source

Much has been said in recent weeks and months about the HSE budget. It is obvious there is a huge task in that regard, not just in respect of home care services but in a variety of areas. Let us look at the context in which this debate is framed. We are now a number of years into the EU-IMF deal. Some people might reasonably argue that they have heard enough about that, but that is the blank canvas with which we must start. It is the basis for all of our spending. The State has borrowed €11 billion so far this year, or it has spent €11 billion more than its income. One need not be a chartered accountant to know that such a situation is utterly unsustainable. As Ministers head into the pre-budget process, each of them will do their best to protect their budgets. There is huge pressure, particularly in the case of big spending Departments such as the Department of Education and Skills, the Department of Social Protection and the Department of Health.

The Leas-Cheann Comhairle will recall that early in the last decade a cross-party report was produced by the joint committee on social affairs, as it was known then. People from all parties and none subscribed to the report. It proposed the abolition of the carer's allowance because at the time the State could afford to do that. Sadly, and regrettably, we are no longer in that position. This is a very sensitive issue and Deputy O'Brien spoke passionately and sincerely about his own experience of the home help service.

We can all relate to that. No one on this side of the House disagrees with the genuine sentiments expressed in the motion.

We must, however, place the person being cared for at the heart of this debate. Home helps are important and Ministers are essential in the process, but once we investigate the issue, the most significant person is the person being cared for. Based in west Cork, I know the importance of this service. It is critical to allowing a person to stay at home. All people wish to remain in their own home when they are older, and whatever assistance necessary to allow that is justifiable. There is also the added benefit of keeping people out of private nursing homes and community hospitals. When looking at budget decisions, the Minister of State, Deputy Kathleen Lynch, has ring-fenced €30 million for adults with disabilities. That is an achievement given the economic nightmare the country faces. There are times when we must consider the nuances of a story.

The national carers strategy referred to by the Minister of State, Deputy Lynch, and launched by the Taoiseach is an essential part of the programme for Government. This Government values the work being done and there is no question of its commitment to it. That work must be balanced with the needs of the person being cared for in order that he or she can remain at home for as long as possible.

I support the Minister of State's view that maximising HSE supports in communities must be balanced against evolving service and resource pressures. I do not say that lightly because I can only assume the resource pressures are mammoth.

The continuing pressure on resources in the health sector will make it imperative that we target resources towards those most in need. The HSE has assured us the impact of the reductions will be minimised for patients. Decisions on the provision of home help hours will, as always, be based on a review of individual needs. The HSE has said no current recipient of the service who has had his or her need identified will be without a service. That is critical. Annually, 11 million home help hours are provided, with a budget of €195 million. It is a priority for the HSE to minimise the impact on patients and clients of any spending reductions. Many of the proposals, therefore, focus on areas that do not have a direct patient impact, such as furniture, education and training, office expenses, laptops, PCs and so on.

We must ensure, and there is a strong prioritisation of this within Government, that there is better co-ordination of services for older people in future. This is borne out by the recently published national carers strategy and the planned national positive ageing strategy. Further progress is to be made in the regulation of the home care sector and consideration of new ways to fund home care.

The programme for Government commits to the fair deal system of financing nursing home care, to the developing of a national Alzheimer's and other dementia strategy by 2013, and to a review of the fair deal system of financing nursing home care. The issue of older people, their care and the services they need is cross-departmental and does not specifically pertain to the Department of Health. In the most recent budget, when many commentators, in this House and outside of it said it was not possible, the Minister for Social Protection retained basic rates of social welfare for carers and pensioners and maintained the household benefits package. I hope that, in this debate, we will understand the genuine care this Government has for older people in society.

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