Seán Fleming (Laois-Offaly, Fianna Fail) | Oireachtas source

I thank Deputy Kelleher for tabling this important motion regarding the care of the elderly and, in particular, the fair deal scheme. As he stated, everybody should recognise that the rate of growth for Ireland’s over 65 population is almost double that of the EU as a whole and the number of over 65s is projected to increase by approximately 20,000 per year between now and 2021. That speaks volumes and should set alarm bells ringing to identify the task that needs to be addressed in caring for the elderly, especially those who require access to facilities under the nursing homes support scheme. A minimum of an additional 7,600 beds for long-term residential care will be required by 2021. Important work is taking place in the community and that is the other side of the house in the context of the operation of the HSE. I have never witnessed another organisation with two separate silos similar to hospital services and community services. Last week, the Minister for Public Expenditure and Reform talked about people working together and getting out of the silos, including all the Secretaries General, Departments and the HSE. However, there is a strong silo mentality even within certain Departments and this needs to be eliminated.

This year, the HSE service plan reduced funding under the fair deal scheme by comparison to 2013 and provided 700 fewer placements under the scheme this year. That is the reason problems are being experienced. Deputy Kelleher pointed out that at the beginning of the year approximately 500 people were waiting to have their applications approved under the scheme. However, it is not a question of having one's application approved. One is approved and informed where one is on the list. One then has to wait for the funding to come through. The average waiting time is 16 weeks but the majority of cases I deal with take up to 20 weeks. That means that a few applications might get through quickly in some parts of the country where people might be lucky but in other parts it means people must wait at least 20 weeks.

The final paragraph of the Government's amendment states the review of the scheme, which is under way, will consider the future funding and sustainability of the scheme as well as how community and residential services should be balanced. The review will be completed in the coming months, following which the Government will consider how best to meet the needs of older people in the future. It is important that the Minister talks to the service providers and people who run nursing homes as part of the review because they provide the front-line service. I have met a number of them over recent months and they feel they are being locked out of the consultation process that is required. They have been told they will be informed about the details but they are being treated like subcontractors. However, these are the people the families of Ireland, and not just the Government, are relying on to provide places. The Government has tried to outsource the provision of care of the elderly to the private sector in nursing homes over the past few years rather than providing care through the State and HSE services, which used to be the case historically.

People are not looking for something for nothing. When the scheme was introduced, applicants had to pay a 5% contribution for up to three years. They could pay 15% of the cost of their care or it could be deducted from their estate when they passed away. The contribution was increased to 7.5% some time ago, giving an overall contribution of 22.5%, which means it has increased by 50% over the past few years. It is as if the Government is using the access to the additional money that has been made available as another reason to cut the HSE's budget and that is not fair. The stress for families and their elderly relatives is enormous. The problem this has created is people are being kept in hospital beds because there is nowhere to discharge them.

I blame the Economic Management Council and not the Minister or the HSE for the budget cutbacks introduced by the Department of Health and the HSE. The council cut the daylights out of the HSE budget every year. When the executive went over budget, the Minister came back to the House with a Supplementary Estimate. The same has happened this year with approximately €600 million required. If one planned properly, one could achieve a more even and consistent outcome throughout the year. The Minister not only needs to reverse the cuts introduced this year, but to provide additional funding to address the increasing numbers of elderly people trying to access the scheme.

I could not believe the Minister when I participated on an interview panel with him on RTE television a few weeks ago. When the presenter asked why he was not providing more funding, he replied that the budget is capped. It was almost as if he had nothing to do with it. He is a member of the Government that capped the budget. On live television he said it had nothing to do with him because the budget is capped. Thankfully, the Government had choices in the budget which is one the of the first times in recent years it had the opportunity but it chose to give tax increases to higher income earners. That is where the Government parties went wrong in the budget. Everything that has flowed from it has been wrong. As I said during the debate on the Social Welfare Bill half an hour ago, the budget can be summarised in one simple sentence. When I was asked the day after the budget what was in it, I said it was simple. If one is in a household with an income of in excess of €70,000, one will be better off but if one is in a household with an income of less than €800 a week, one will be worse off.

I refer to the story of one family to illustrate the silo mentality in the HSE. I was contacted by a family who brought an elderly relative into hospital two weeks ago. She was weak and the staff in the accident and emergency department were fearful that the family would leave her in there overnight because a number of people were sleeping there while other elderly people who should have been discharged were on the wards upstairs. The staff told the family that they needed to contact the community health nurse, have a hospital bed installed in their house and seek home help. Are these staff living in the same world as the rest of us? It is next to impossible to secure these services at local level but the staff just wanted the elderly woman out of the building because they could not cater for any more elderly patients. This is the result in the reduction in the number of places.

I visited the accident and emergency department in Naas General Hospital last Thursday. I could not get in the door because trolleys were lined up end to end on both sides of the corridor. The unit was a fire risk, a health and safety risk and so on because it was so full. There is such overcrowding that elective surgery ceased in the hospital last month, which has caused chaos. This is because people have nowhere to be discharged. The Government's solution on budget day was to give a tax cut to the wealthy, which will trickle down and help old people if they live long enough.

I refer to another classic example, about which the Minister of State will be well aware. Two or three years ago I was thrown out of the House for raising the issue of Abbeyleix Hospital, which had 30 patients at the time while having a 50 bed capacity. The hospital has been run down and there are only a few respite care patients using it now. The same happened in St. Brigid's Hospital, Shane, County Laois.

There are many facilities throughout the country which, with a little investment, could not only cater for the small number of respite patients they have but up to an additional 50 patients. With a little investment the two institutions referred to could be brought up to HIQA standard. The decision must be made to keep these units open. If the only patients in these units are respite patients then the decision will be made to abolish respite care some Monday morning. We know that is the plan, which is senseless given the lack of beds in the private sector for elderly people.

I am asking that the Minister of State confirm that the unit concerned will remain open and that Abbeyleix Community Hospital and St. Brigid's Hospital, Shane, will be upgraded as soon as possible. The people about whom we are speaking are in the main elderly and they should be treated with dignity and respect. We all know that one can judge a society by how it treats its elderly people. By that criterion, this Government is not passing any test.

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