Jim Daly (Cork South West, Fine Gael) | Oireachtas source

I thank the Acting Chairman for the opportunity to raise the issue of home help. By way of illustration I present the Minister with a case that is on my desk since early December 2015. Margaret is just out of hospital following major open heart surgery. She has had a number of strokes and has a tumour on the brain. She cannot work the nebulizer she needs to ease her asthma. Her husband, Pat, who has had two strokes, has cancer and many open wounds which need dressing three times a week. The only person who cares for this couple is Margaret's sister, who is 74 years of age.

I made representations to the HSE for home help hours for this couple in early December. I received a letter on 29 January stating that the request had been assessed by a professional who agreed that the couple required home help and recommended one hour five days a week. However, at the end of the letter I was advised that due to a lack of resources the couple would be wait-listed, which is the new buzzword for any application for home help, until resources became available. I heard back from the HSE on 21 April to say they had finally been allocated the home help. From 3 December 2015, when I got involved, until the end of April, the couple got home help of one hour, five days a week. This raises the question of why home help is not a service that is available seven days a week in the first instance. In pursuing some research recently I asked the HSE the number of people not only in west Cork but in the whole country who are currently wait-listed for home help. I understand that 1,700 people are wait-listed for home help at this point. I also asked the HSE what it would cost to allocate the home help hours needed for these 1,700 people, and it informed me on 11 May that it would cost approximately €10 million to eliminate the current waiting list for home help hours. The sum of €10 million in the context of the overall budget of the HSE is the equivalent of €14,000 in my hand and somebody asking me for €10 out of that €14,000. For those who are mathematically minded, 0.07% of the budget would eliminate the current waiting list.

The people we represent are very frustrated by this anomaly in the system. People who pay their taxes, go about their daily lives and do their work are frustrated that the HSE is cutting corners in home help, given that it would take people out of hospital, keep other people out of hospital, and relieve many problems associated with the build-up of patients in acute emergency departments and the trolley crisis. Yet this €10 million, which is a paltry sum in the greater scheme of things, is the budget that the HSE has targeted for reduction. It should not be a budget exercise; it should be demand-led. I hope the HSE management and the Minister will understand this and go forward in this knowledge.

In the previous Dáil, the Ministers, whether by design or choice, became Ministers for hospitals. I ask the Minister to take on ministering for primary and social care and home help issues. I would go so far as to say that the hospitals are working perfectly well. I am very proud of our hospitals in Ireland and the way they work. Anybody who is lucky to get into a hospital will say they get a great service. However, I understand from medical managers that about 50% of people in hospitals should not be there. They are taking up acute hospital beds. A little-known but important statistic is that in Cork University Hospital, 3% of medical patients occupy around 30% of the bed days. In other words, over a third of the entire hospital capacity is being taken up by 3% of patients, many of whom do not need to be there. The number of patients in hospital for more than 30 days is quite staggering. Some 50% of the capacity of St. Vincent's Hospital in Dublin is taken up by people who are there more than 30 days. It is important to address and eliminate this pressure point in hospitals. The hospitals work well for the people who get in. We need to free up capacity. We must start by having a Minister who will focus on primary care and home help and encourage people to stay at home by giving them this facility. I ask the Minister, for God's sake, to please ensure that home help is available seven days a week. The elderly, the vulnerable and the sick, about whom we all care deeply, are not sick and vulnerable five days a week; they are in need of care seven days a week. I hope the Minister will get that point across to the HSE and ask for the €10 million to address this anomaly, which would free up much capacity and eliminate many of the knock-on effects of overcrowding in the emergency departments.

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