Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

I welcome the tabling of the motion by Deputy Mary Butler and her colleagues.

Its most important aspect is that it puts a focus, at least for a short while, on the major challenge that dementia poses for the country. Due to the incredible demographic changes facing us, we have no choice but to be proactive in putting in place the kinds of service that are required currently and will undoubtedly be required in future. Not enough was done in the recent budget in this regard. Those parties that were involved in putting the budget in place must take responsibility for that. Choices were made on how limited resources would be spent. At a time when there is a need for public services to be repaired and such glaring shortages in services, particularly in health and in light of the housing crisis, it seems like a bad decision to support a proposal to give €335 million back to some of the better-off people in society by way of cuts to the USC.

The damage done throughout the recession and by the austerity measures that were imposed have wreaked havoc on many public services. The priority should have been to repair that damage and ensure that our public services were returned to a reasonable standard and equipped to deal with the demands that would be placed upon them in future. Nowhere is this more noticeable than in the health service, given the demographics with which we are dealing. There is a significant additional demand for services, but the budget will go nowhere near meeting it.

It has been suggested that some 55,000 people suffer dementia. We are unsure, as there is an absence of reliable data. If one accepts this figure, which has been cited by some of the NGOs working in the area, it is set to treble in the next 30 years. Of those nearly 160,000 people, at least half will be over 85 years of age. This poses considerable challenges for our health and community services. We must start being serious about preparing for this eventuality.

Dementia is associated with the increased use of medical services. Cognitive impairment and confusion are significant co-morbidities for many older people. A significant number of people who are occupying hospital beds have some element of dementia, although it may not be the initial reason for their being in hospital beds. This figure has been placed at approximately 25% of the hospital population. Being in hospital results in a decline in the person's condition, so we should not be placing these people there. Rather, the emphasis should be on community care. Older people want to remain in their own homes and communities. We should facilitate this instead of maintaining a situation in which people have a statutory entitlement to nursing home care but no similar entitlement to home care packages. This is what we must do. It makes sense, achieves better health outcomes and provides better value for money. We need a greater emphasis on home-care packages, as the budget's provision will only meet half of the demand. For this reason, 17 NGOs joined together recently to demand additional investment in home-care packages.

The involvement of Atlantic Philanthropies in the funding of this strategy has been welcomed, but why is it involved? Is it appropriate that we must depend on philanthropy in order to provide basic health services for older people? Surely this is not a defensible position. It should not be the case that our taxpayers' money is being used for other purposes instead of for meeting the most glaring need in our community. We should move away from relying on philanthropies and instead use our own tax resources to fund the essential services that are required by people with dementia.

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