Dara Calleary (Mayo, Fianna Fail) | Oireachtas source

I thank Deputy Kelleher for giving us the opportunity to discuss the issue, which Deputy Niall Collins and many others have said is a major bone of contention at clinics across communities.

Since the Minister's arrival in Hawkins House, he has approached the role with some degree of candour and straight talking which contrasts greatly with his predecessor. However, we will get a chance to adjudicate on how effective that has been when we see the service plan next week. At the heart of that service plan must be a real commitment to overall community care and, within that, elder care.

The Minister spoke about his wish to keep open beds particularly in areas where surgery is needed, which we all support given that waiting lists are growing at an exponential rate. However, this was what was happening under the fair deal scheme when it was working well. I pay tribute to the hospital management in County Mayo where they had a very good step-down process for Mayo General Hospital using the three community hospitals in Ballina, Belmullet and Swinford and using the community nursing homes. However, because Mayo General Hospital was so good at doing it, it found that its budget was cut and it was penalised for being able to deliver on target. Unfortunately the system of step-down beds, which is essential particularly in large rural counties such as mine, has deteriorated considerably during the year. Substantial waiting lists are beginning to build in the Saolta university hospital group for things like orthopaedics, ophthalmics and surgery that could be done were beds available.

The change in Mayo is particularly stark. We have gone from 18 people waiting this time last year to 71 today. That represents 71 families across the county who may not have the money and are being forced to leave their families to be in hospital beds they do not want to be in or have to stump up very large sums of money in order to give their loved ones the care they need. That is not fair. When talking about economic recovery and fairness, the fact that 71 families are waiting for the go-ahead to allow their loved one to stay in a nursing home does not represent recovery. That is surely not the kind of recovery anybody in this House would support.

The Minister spoke about community care. Deputy Troy made a point earlier about the HSE's unique ability to work in silos where the H does not talk to the S, the S does not talk to the E, and the E does not talk to anybody. Community care in terms of home help hours seems to operate separately from the fair deal scheme even though they should be absolutely linked.

Home help hours in my county have been cut. In some instances, people get 30 minutes a day. The carer is hardly in the door before it is time to go again. If home help is to be effective, it must be related specifically to the client and not provided on the basis of an idealistic management information system where the person providing the home help is running around like I do not know what trying to get a half hour done here and a half hour there. Home care packages should be tailored to the needs of the patient and not to the budget of the relevant community care department. Unfortunately, at the moment the budget is winning out.

Deputy Smith raised an important point. Housing aid for older people and adaptation grant schemes are operated by local authorities. I pay tribute to Mayo County Council, which uses a good system for housing adaptation in particular. If people need their house adapted to get them out of hospital, this is done quickly because the council manages its budget to ensure money is available. I brought the Minister of State's predecessor, Áine Brady, to the county to see how it works. However, unless there is togetherness in the system, the scheme will not work and we will end up with the appalling delays being experienced under the fair deal scheme.

I listened to the usual choir of Fine Gael backbenchers with their choral notes from the party press office during the debate. It was the usual performance. Three years later, the story has not changed but the singers have worsened and the tune still does not make sense. This happened on their watch. The delays and the moving around of funding, which has resulted in the delays, happened under the former Minister, Deputy Reilly, their deputy party leader. No matter how much crowing and complaining they do, they cannot ignore that reality. The thousands of additional families who are waiting on a decision under the fair deal scheme and who cannot access a bed in a nursing home tonight can only look at one man who made the call and that is the Minister, Deputy Reilly. When the current Minister for Health publishes his service plan, he must make sure the decisions he makes do not have such an impact on people and do not result in a 300% increase in the number of people awaiting care, as is the case in my county.

I refer to the issue of GPs, who are essential to community care. The Minister recently referred to receiving various offers from Canada to work there for large sums. The difficulty in securing and protecting a rural GP service is real. Unless he and the HSE look at the system differently and reintroduce the rural practice allowance as a matter of policy rather than the HSE having to apply for an allowance for every post depending on who applies for it, these posts will not be attractive. The Minister should make this attractive. It is a fantastic challenge for people to work in a rural area but it is also a professional challenge, which requires financial and systems support that is not available currently unless people go looking for it.

The Government has made a number of attacks on older people, including in respect of medical cards, the telephone allowance and the bereavement grant. Every support for older people has been targeted by the Government parties. I do not know what older people did to them but they clearly did something.

Medical cards are also an important element of community care. The Government cannot say there is a recovery when the parent of a child with Down's syndrome is forced to go on the national airwaves to have their medical card application dealt with. That happened last week. I had been dealing with this case through the system. The mother had no more patience and she spoke about her case on the national airwaves. It worked because the local Government Deputy contacted her within minutes of her appearance on the radio and the Minister's office contacted her within hours. Parents of children with Down's syndrome should not have to do that. The Minister should do something for the parents of children with disabilities in his service plan next week.

See this speech in context