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

-----when it talks about what it is going to do now with its 19 seats.

One of the points missed in this motion is that care of the elderly is multifaceted. It includes public, community-based facilities, private nursing homes, community-based facilities owned by the voluntary sector and the home-based services. I have raised before with the Minister of State and her predecessor the amount of money paid year in year out to the private home care packages. I feel strongly about this issue. The person coming into one’s home is paid €9 an hour but a company is charging the HSE €27 an hour. That is a huge discrepancy. We are only waiting for another “Prime Time” programme investigating private home care providers and the disparities between them. Some are excellent and some are hopelessly inadequate. I implore the Minister of State in respect of the HSE service plan, which is included in the programme for Government, to consider that issue as a matter of urgency to ensure that the remit of HIQA is extended into the private home care provision sector and where possible it is used only as a last resort. I have seen it in my own home. The Law Reform Commission brought forward proposals on legislation.

There are challenges in each area. I commend those in the community and voluntary sector who have done much, particularly in the community hospital network. Many of our community hospitals are old union and county homes and in many cases old workhouses. I cite the example of St. Ita’s Hospital in Newcastle West which has been revamped by the community. The friends of the hospital have put it far ahead of the HIQA requirements for 2015.

There is a looming time bomb within the Department for the other community hospitals around the country that will need to come up to HIQA standards. I urge the Minister of State's Cabinet colleagues to examine the capital programme as a matter of urgency. I invite the Minister of State to visit Dromcollogher and district respite centre in my constituency, which is unique in Ireland in the provision of short-term respite care. Many of her constituents from Cork North-Central and the adjoining constituencies of Cork East and Cork North-West avail of its services through Mallow General Hospital. If such services were not provided, there would be more bed-blockers, or elderly people who cannot be released from general hospitals because there is nowhere for them to go. I think there should be more of these centres, rather than fewer of them. A legislative framework should be put in place to cover them. That, in turn, should be adequately reflected in section 38 and 39 service level agreements.

There are challenges. It is not acceptable for elderly people to have to wait 15 weeks. In many cases, they are left in acute general hospitals because their family members cannot look after them or because they have no family. A neighbour might apply for the fair deal in some cases. While the system is not perfect at the moment, I think it is as good as it can be for the budget that is available. That is why it behoves all of us to make sure the budget is adequate. If the Minister of State will be looking for efficiencies, as I believe she will, she should examine the private care providers that are contracted to the Department of Health and are charging an average of €27 an hour, in some cases, while paying their staff €9 an hour. The efficiencies that are to be made in that regard can be put back into the fair deal scheme. I think that is the first place the look. I ask for that to be done.

It is very hard to listen to the proposers of this motion. I think there is a willingness on behalf of the Minister of State. She has not run away from this issue. She has not buried her head in the sand. This will not be fixed overnight. People who look after elderly people at home are lying awake at night wondering what will happen to them. They are concerned about the day when they will be unable to put those they look after on the toilet, or change their incontinence pads. They worry that a catheter or a hoist will have to come when they become physically incapable of doing certain tasks. Those people are looking at this debate and wondering whether a solution will be found to assist them. That is all they are interested in. They are not really interested in the politicking of it. They want to know whether beds will be available for their loved ones when they are taken out of regional or general hospitals like those in Limerick and Mallow and have to go into nursing homes. They want to be reassured that their loved ones will be looked after and allowed to die with dignity. For too long, our elderly people have been allowed to die undignified deaths in many cases. We need to correct that wrong.

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