Patrick O'Donovan (Limerick, Fine Gael) | Oireachtas source

I thank the Ceann Comhairle for selecting this issue because Deputies routinely request Topical Issue debates. In the recent past, there has been considerable discussion about the provision of home care and home help. What constitutes home care and home help is very different in different parts of the country. What they have in common is that, in all instances, an elderly person or vulnerable adult is at the centre of the care provision. In 2011, the Law Reform Commission underlined the need for a legislative framework in home care provision. This arose in the aftermath of the investigation and report on Leas Cross, where vulnerable adults and elderly people in a private nursing home environment were subject to obvious abuse. The concern for vulnerable adults, elderly people, their families and home care providers arises in respect of standards, legislation, regulations, inspection, complaints mechanisms and associated penalties where there are obvious failures in the protection of vulnerable adults and old people.

Where would one find a person in a more vulnerable state than an old person at home, bed-ridden, unable to do anything, not exposed to any outside inspection and with no one passing by as someone in a nursing home would have? These people are totally dependent on the home care provider or the person coming in to provide a home care package. The vulnerability of the person can be exposed and exploited and there is an urgent need to ensure we are not just reacting to another investigation with another hidden camera, highlighting another element of abuse or worse, and dealing with the aftermath of someone found dead or seriously injured at home.

The programme for Government refers to this, and a Bill, which was a copy and paste exercise of what the Law Reform Commission proposed in its report, was brought before the House. In recent weeks, with public discourse on what home help is, how it is constituted, how people get medically assessed for it and its standards and assessment regime, it is urgently required not only to protect the elderly or vulnerable person but also for those who go into people's houses. I have a personal involvement in this. Are these people trained and qualified? Do they have the necessary competencies to deliver home care at the level the public health nurse or district nurse decides it is needed?

The Law Reform Commission report states that home care provision ranges from companionship to home care to complicated provision of home care, where a catheter bag needs to be changed, an incontinence pad needs to be administered or drugs need to be administered daily. There may be no family involvement. The State recognises that the best place for elderly people is in the home, if possible. Between now and 2041, the number of people over the age of 65 will double.

We also know that 95% of people over the age of 65 live at home. This is urgently needed and I impress its urgency upon the Minister. I know there is a legislative backlog and that many things have priority, but we had a referendum for one cohort of vulnerable people and we need to legislate for this group.

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