Pat Deering (Carlow-Kilkenny, Fine Gael) | Oireachtas source

This fair system is a vast improvement on what was in place previously. Those who can get into the system can get nursing home care. This allows families to prepare for the future. It is important to acknowledge that there is a particular difficulty at the moment. It is unfortunate that there are long delays in allocating funding. Money was reallocated last year because people like Deputy Kelleher and me wanted more money to be provided for home care so that people could be looked after in their homes. That was appropriate at the time and it is appropriate for the future as well.

The main problem at the moment is not caused by a lack of funding; it is caused by the increased demand on the system. Unfortunately, a recent ESRI report suggested that an additional 888 places will be required each year between now and 2021. We have all heard those real figures. We need to remember what we are spending our money on at the moment. We are spending €1.3 billion per annum on nursing home care and community services. It is quite a lot of money. It is important to remember that it accounts for 10% of the overall health budget. I am speaking from personal experience, as Deputy O'Donovan was previously, when I ask whether we are getting value for money. I would like to mention another interesting statistic. As I have said, we are spending €1.3 billion annually to look after 78,000 people, which is a large number of people. We spend €5,500 per person in home care packages, whereas we spend €42,000 per person in nursing homes. Is that a fair way of allocating funding?

I remind Deputies that the Government amendment to the motion before the House recognises that "people should be supported in the care setting that is appropriate to their needs and that most older people prefer to stay in their own homes and communities for as long as possible; it is incumbent on Government to take account of this in decisions on how services and supports are structured". The vast majority of people I know - I am sure this applies to most Deputies - would like to be able to stay in their homes for as long as possible. That is where we should be spending our funds. It is possible that some people stay in nursing homes for longer than they should. We should try to encourage more people to stay in their homes. We can get far better value for money in that way. We need to be having this discussion. Should we be putting more money into the community, rather than into institutions like public or private nursing homes? I think we should be encouraging more people. We will need to have this discussion going forward. It is not just a matter of putting money into it and hoping it will all go away tomorrow morning, because that will not happen. We need to plan for the future in a structured way, by putting money into the system where it will have a better effect.

The people and associations involved in nursing home care previously sought the creation of a discussion forum involving all stakeholders to consider where we are going for the future. I ask the Minister of State, who previously opposed this proposal, to reconsider it. It would be important for all the stakeholders to come around a table to discuss in small, detailed terms where they see themselves in the future. I refer not just to next year and the year after, but to the period ten or 15 years from now. It has been pointed out that the demographics are going in one direction only. We need to plan for that. As the Minister of State said and as Deputy Kelleher acknowledged, no plan was put in place in the past. We had the money ten years ago, but it did not happen. We now need to make sure we have a structure in place to ensure our parents and all the elderly people who kept this country going over the last number of years will be looked after in the future.

It is important to remember that there are a number of very good facilities in this country. Deputy O'Donovan spoke about step-down facilities. The district hospital in the town of Carlow, which is in my constituency, is very important. It is used as a step-down facility. If older and smaller hospitals that were used for certain purposes in the past were used as step-down facilities now, it would take the pressure off the main hospitals and alleviate the problems caused by bed-blockers, which is a phrase I do not like to use. If we could upgrade the facilities to the standard required to ensure spaces are available in these hospitals, it would take the pressure off the main hospitals. We need to have a discussion about where we are going with our elderly for the future. It is not sufficient to table a short-term motion about returning the money that was supposedly taken out of the system previously to be put into another part of the system. I encourage the Minister of State to facilitate a genuine discussion, involving all stakeholders, about where we are going for the future. I commend the amendment to the House.

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