Áine Collins (Cork North West, Fine Gael) | Oireachtas source

I welcome the opportunity to speak on this important issue. Because of the ageing demographic profile of our citizens, there is no doubt that the nursing homes support scheme needs to be kept under constant review. A review of the scheme is currently under way and it will consider its future funding and sustainability. An important part of this will be to assess how community and residential services are balanced. The current scheme is very expensive and places a huge financial burden on the taxpayer. In 2014, €939 million was provided in the budget Estimates. However, analysis clearly demonstrates that the funding was inadequate to meet the need. The cost to the Exchequer and taxpayer will without doubt increase in the coming years. The Minister must continually examine new ways of caring for the elderly in our communities.

The nursing home option is probably the least favoured by those in need of care. Being looked after at home or in the community is the preferred option in most cases. In these circumstances, any improvements in the existing or new care systems implemented must provide as much certainty as possible. This certainty is essential for the peace of mind of potential patients, and it is perhaps equally important for the peace of mind of their children and carers.

I encourage the Minister to consider more villages for the elderly where they can live independently but at the same time have their care needs met. If more money were provided by the State for direct nursing home provision, it would save millions of euro by making more acute hospital beds available. The current qualifying conditions for home care packages are very generous and should be kept. One does not need to have a medical card; there is no means test and no assessment of one's income. The supports one receives will be based on one's assessed care needs, subject only to the limit to the resources available in the local health office area. This limit is a problem as it can be difficult enough to get an adequate home care package, even if it would appear far more satisfactory from the patient's perspective and most definitely from the taxpayer's perspective.

The current review of the nursing homes subvention scheme must be combined with a new approach to home care packages. The carer's allowance and carer's benefit are very useful in helping people to remain at home. The scheme in this regard, as it currently stands, is very broad. It is not based on any continuing medical needs assessment of the individual once the initial determination has been made. A review of the system that emphasises the amount of care required based on the medical assessment could lead to greater assistance being provided to carers looking after a person who would otherwise have to go into a nursing home. A close examination of this system could also be beneficial from the perspectives of the carer and taxpayer.

Sheltered housing units provide security for elderly people in transition. A clear and obvious mistake being made at present is that the sheltered housing organisations are continuing to build one-bedroom houses. Every house for an elderly person needs a room where a relative, carer or child can stay. The new building regulations will ensure that houses are more suitable for elderly people and people with disabilities in the future. All these avenues must be continually assessed and changed to make it easier for people to remain at home.

My one concern about this motion is that it may place undue emphasis on nursing home subvention. There can be other methods and means of effecting improvements to ensure the care of the elderly and disabled. Nursing home subvention will always be one component of the long-term solution but our primary objective as a society should be to care for our elderly and disabled in the best possible way, as close to their community as possible. We must appreciate that it is our sons and daughters who will be paying for our care through the taxation system, as is absolutely correct. Therefore, it is essential that we develop not only the best care system but also the most economical one for the generations to come. It is essential to construct the necessary infrastructure to enable us to offer the best care to the elderly.

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