Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

Táimid ag plé leis an scéim seo, a cuireadh ar bun ag Fianna Fáil agus an Páirtí Daonlathach ar dtús, arís eile anocht. Ní raibh cearta na seandaoine san áireamh ag an am sin, faraoir géar, agus is cosúil nach bhfuil anois ach oiread. Is oth liom a rá go bhfuil an fhadhb sin ag éirí níos measa. An é nach gcuireann an Rialtas tábhacht ar sheandaoine?

The number of people awaiting payment approval under the fair deal scheme has increased by over 300%, which is a staggering number, since January of this year. As of 9 October last, some 2,182 people were approved for the fair deal scheme but were awaiting payment approval. Waiting periods now exceed 15 weeks. To add insult to injury, we have been informed by the HSE's performance report that 75% of people classified as delayed discharges within Irish hospitals are awaiting long-term residential nursing care.

This means that not only are our older citizens not getting the care they deserve, other unwell citizens are also being denied access to care in our hospitals.

The Minister, Deputy Varadkar, when referring to this group stated in the Dáil on 15 October:

These are people who are well enough to leave hospital, but do not have a nursing home or home care package in place for them to do so. They are often elderly people and are citizens, not bed blockers. They should not be left in hospital, where they are at a higher risk of a fall or developing an infection.

I fully agree.

The Fianna Fáil motion lays out some of the major challenges that face Ireland. The rate of growth of Ireland's over 65 population is nearly double that of the EU as a whole. The number of over 65s is projected to increase by approximately 20,000 per year between now and 2021. If God spares me, I will be among them. It has been recognised for some time that this increase in our older population will lead to an increased usage of services, and I want to emphasise that these are deserved and totally necessary services. These demographic pressures equate to an additional funding requirement in the order of €200 million per annum over the coming years. A minimum of an additional 7,600 beds for long-term residential care will be required between now and 2021. This comes at a time when the 2014 Health Service Executive service plan reduced funding for the nursing homes support scheme by 700 placements under the fair deal scheme when compared with 2013. Let me say that again - 700 fewer placements at a time of increasing need. Where is the logic in this? Where is there any modicum of the fairness that is referred to in the title of the scheme?

We need investment in social care packages specifically to ensure that we can help someone who does not need a hospital bed to move to a more suitable setting. This is not only beneficial for our older people, it is also cost effective. Also needed is hospital release planning through links with primary and community services, as well as short-term community nursing home beds and more funding for long-term nursing home places. We are unsure as to what the Minister and Minister of State intend to do despite their assurances that they have a plan. I would ask the Minister of State, Deputy Kathleen Lynch, that she and her senior colleague might reassure this House and all those families who are waiting on news what concrete steps they now intend to take.

We need to move the focus to entitlements of care. The fair deal scheme was fundamentally flawed since its conception. From the outset the scheme effectively removed the universal eligibility for a place in a public nursing home as provided for under the Health Act 1970. The Minister of State will recall making the same case at the time. On debating it in 2008, I raised concerns that I and many others, including the Minister of State, had with the scheme at the time. I am sad to say our worries have been confirmed again and again. Perhaps we should not be overly surprised as the Bill was framed without consultation with older people and older people's representative organisations.

The scheme itself is intrinsically flawed, as it does not cover short-term care such as respite, convalescent care or day care, although these types of care may be available in some nursing home settings. In budget 2015, some €25 million has been allocated to address the problem of delayed discharges from acute hospitals. I understand that the Minister, Deputy Varadkar, cannot provide specific details on how this funding is to be utilised. What portion of this fund is to go towards the fair deal scheme? Is there to be any additional funding for home care packages and what of additional funding for community intervention teams?

The saddening vista we see is one where our senior citizens are not given the supports they need to stay in their own homes. Often, they end up deteriorating both physically and mentally and cannot stay at home, the place that is best for them and where they would be most happy. This short-sighted failure is a further example of a penny wise and pound foolish policy.

When this Bill was introduced originally, we flagged concerns about funding. The capping and cutting of funding has shown that neither this Government nor its predecessor was serious about caring for the older members of our society. It is extraordinary that it was not set up with a budget linked to easily predictable population need.

Sinn Féin could not support the 2008 Bill as it was a move away from universal entitlement. It was also not rights based. Nor was it comprehensive in terms of providing for the wide range of care that older people require. It is no substitute for comprehensive State-provided care of older people, including fully supported and resourced care in their homes, in the community and, where necessary, in nursing homes.

I have had many constituents contact me and outline the great difficulties they have with this scheme. Many of them have been waiting for over 15 weeks and have even been informed by the HSE that the scheme itself is "broken". How terrible a system is that it requires for others to pass away before someone can access the care he or she needs. Families have reported to me that it costs up to €14,000 to cover care in private nursing homes. When family money runs out, what sometimes happens is that the older person is returned to an acute facility, an entirely inappropriate place for him or her and a very poor use of acute service beds. It makes no financial, moral or, indeed, common sense for these elderly citizens to be placed on these waiting lists. I implore the Minister and Minister of State to ensure that this will not be the case in the hopefully not too distant future.

Access to quality services enables older patients to return home after a hospital stay. Unfortunately, we see that there were 2.3 million fewer home help hours last year when compared with 2008. Last year, an extra €5 million was allocated to social care packages specifically to get delayed discharges out of hospitals. Unfortunately, this dealt with only a relatively small number of cases.

I understand that the review announced by the former Minister for Health, Deputy Reilly, in 2011 has reported but that the findings have not yet been released. Someone somewhere has decided that the public cannot be allowed to see a report into the functioning of this scheme. I for one had thought that we had moved on from a culture of cover-up and subterfuge. Unfortunately, it seems in this regard that I was incorrect. This is very concerning. Surely it would be in the public interest that we would have access to the findings of this report so we might focus on the shortcomings of the scheme to ensure improved care for those needing long-term residential care.

What needs to happen is that we move entirely from this flawed scheme to a rights-based system whereby those vulnerable citizens can receive long-term care when they need it and thereby reduce the reliance on acute hospital beds. These serious shortcomings are indicative of short-sighted planning, a problem that has beset our health services historically and one that punishes both young and old alike.

For those who are currently awaiting funding approval, we in Sinn Féin urge the Government to ensure the waiting lists are ended. We demand the publication of the review of the scheme and we strongly urge the Minister and Minister of State that they make us aware of the plans they have to remedy this very serious and worrying situation. A Airí, iarraim oraibh gníomhú ar son ár seandaoine agus cinntiú go mbeidh cúram ar fáil dóibh.

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