Michelle Mulherin (Mayo, Fine Gael) | Oireachtas source

I welcome the Minister's forthright approach to universal health insurance. He has accepted the findings of an ESRI report on the particular UHI model which was being considered. It was found to be unaffordable and, therefore, the Minister will not pursue it. This is about taking stock and it is a practical and reasonable position to take. All the while, the Minister has confirmed his commitment to equalising universal health care, thus bringing a two-tier system to an end. However, as well all know, this will not happen overnight. It is not like declaring war. One cannot declare universal health care; it is something that has to be knitted and weaved together. One must put the foundation stones and the building blocks in place first. Reasonable people know it is more than just about having universal health insurance to provide universal health care. It is also about addressing issues such as capacity, resources and the management of those resources.

I welcome some of the reforms the Government has already undertaken on the path towards universal health care. These include free GP care for under-sixes and over-70s, as well as pushing forward with free GP care for under-12s. In addition, the development of primary care centres will handle chronic illnesses in the community rather than being treated in accident and emergency departments. If such conditions are not controlled and managed at primary care level, it can result in blocking acute hospital beds.

Hospitals groups have been established to achieve excellence of treatment by creating a confluence of expertise and sharing resources between hospitals in those groups. I also wish to compliment the Minister for additional funding for the fair deal scheme for nursing home care. In October 2014, 79 people in County Mayo were waiting to get into nursing homes. I was acutely aware of it, with many people contacting my office. Some people had to spend their own resources, which they simply could not afford to do. A year later, only four people were on the waiting list which is now down to two to four weeks.

There is continuous recruitment of nurses, doctors and consultants. I was listened with amusement to Deputy Boyd Barrett who mentioned the high cost of consultants. As we all know, however, wages and salaries paid to consultants, doctors and nurses here are not as attractive as in other countries. To compound that, is Deputy Boyd Barrett actually suggesting that we should tax them more and use it to pay for the health service? He is not in the real world at all; he is talking about a fantasy land with oppressive rich people. We need to get these consultants, doctors and nurses because they make for a good health service. We also must compete in an international market because our graduates are much sought after.

Community services catering for those with dementia and Alzheimer's will require additional resources in future. In addition, we must take care of the carers because invariably such medical conditions are progressive, so those affected require care on a 24-7 basis. Some €27.5 million was pledged for the provision of integrated dementia services, which was to be co-funded by the Department of Health and Atlantic Philanthropies. I am concerned, however, because there are approximately 48,000 people with dementia and Alzheimer's in this country. Some 63% of them are being cared for in the community, which in effect means in their own homes. This money is, however, predominantly being spent in big centres of population, so only 500 families might benefit of the 30,000 people who are living with dementia at home and being supported by a community care policy.

I understand that only 56 of those packages have been authorised, despite all that funding. I am concerned because in County Mayo, we have an estimated 1,835 people with dementia but I am not aware that any of this funding is going to the county. The county has an ageing population and a proportionately higher number of older people compared to other counties. Given the projected figures for a rising number of people suffering from dementia, there will be an increased demand for such care services. I would like to know what the regional spend is in this regard and how much is being spent in County Mayo. The Minister may not have the answer to hand but it is important because there are many dementia patients in County Mayo.

Caring for the carers means that as well as having integrated care packages, we should also provide respite for carers. I am particularly concerned about a 12-bed respite care facility, Marian House in Ballindine, which is run by Western Alzheimer's. It provides respite for 510 families in Counties Mayo, Roscommon and Galway. There is a waiting time of between eight to 12 weeks for them to get respite. It is tailor-made care for people with Alzheimer's. HIQA has been into that facility and has said it must have €500,000 worth of works carried out to the premises, or it will have to scale down or possibly shut down in March 2016. What assistance is available to such respite care homes under section 38?

I urge that assistance be made available to them. I understand that they deal with the HSE. There is no service within the HSE that is comparable with the service provided by Western Alzheimers. It is doing a job where a gap in services provided by the HSE has been identified. It would be very much to the detriment of Mayo, Roscommon and Galway if such a service was to close. It would put huge pressure on these families, which are often put to the pin of their collar emotionally and financially in caring for their loved ones in their own homes.

The Minister may not be in a position to take any of those questions now or answer them in a fulsome way but I ask for a fair distribution of funding for integrated care packages tailor-made for people with dementia throughout the country - not just in Dublin or Cork. Some of that funding should come to Mayo and the west. I ask the Minister to look at respite care and the problems facing Marian House in Ballindine and take it up with the HSE. I am very concerned about it. There are a lot of volunteers in the community whose families have benefited from the service provided and who give passionate and strong testimony about the invaluable service and understanding provided by Western Alzheimers. I would like to see it continue. A lot of local fund-raising goes on as well but I do not know how it can possibly manage €500,000 between now and then. It needs some help and I am asking the Minister to take up this issue.

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