Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

Sinn Féin is committed to the provision of health care services and social care services as a right, with equal access for all based on need and to the greatest extent that resources allow. This right is especially relevant for older people and the provision of support for older people is becoming increasingly important as our population ages. Ireland's elderly population is set to reach 1.4 million over the next 30 years. This obviously poses great challenges. However, I believe this should be viewed as an opportunity, with older people contributing to our society.

The issue of how we care for our elderly has been a pressing one for some time. The national positive ageing strategy was published in 2013 and one of its four national goals was to “Enable people to age with confidence, security and dignity in their own homes and communities for as long as possible”. However, this commitment and many others contained in the strategy have not been delivered on, much to the detriment of our older people and their families.

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The need for this issue to be addressed as a matter of urgency was heightened recently when RTE broadcast a documentary, "We Need To Talk About Dad", which has been mentioned by a number of Deputies during this debate. In the documentary, the presenter and fashion designer Brendan Courtney shared with viewers his struggle and that of his family to care for his father, who is unable to care for himself following a stroke. I have no doubt that this programme resonated with people all over the country. In the wake of the broadcast, a poll suggested that 85% of Irish people would prefer to be cared for at home in their old age. The reality of the situation is that sufficient resources have not been provided to allow all of those who would wish to be cared for in their own homes to enjoy such supports. This is a damning indictment of successive Governments, which have made it impossible for such an entitlement to be realised due to cutbacks in home help hours, home care packages, housing adaptation grants, carers' supports and other services. As a result of the austerity policies of successive Governments, more people than necessary have had to go into long-term residential care. If one qualifies for a nursing home place under the fair deal scheme, the State is legally obliged to ensure one gets a bed. However, this is not the case for those who require home care packages. There is no legal obligation for the State to ensure such people get what they require. The provision made for them depends on the resources available. As we are all too aware, the resources are miserly.

Sinn Féin has recognised the need for additional investment for many years. In each of our alternative budgets, we have proposed costed measures that would increase home care packages and home help hours by 10%. We have committed that during a term of Government, this figure would increase by a further 10% on the baseline year in years two and three, with a resulting increase in spending of €93 million. This is the kind of investment that is needed. The system as it stands does nothing to support these people. Instead, a significant number of people are faced with no choice other than to go into residential care. I am speaking from personal experience in this regard. A greater emphasis on community-based care has the potential to reduce the number of older people requiring nursing home care, thereby drastically reducing the amount of money spent on long-term residential care. A critical element of this argument is that the provision of home care services on a statutory basis has the potential to generate huge savings and free up many valuable hospital beds. According to research conducted in Britain, when the Partnership for Older People Projects increased low-level supports to people aged 65 and over with low to moderate dependency, overnight hospital stays decreased by 47% and the use of accident and emergency departments decreased by 29%. For every extra £1 spent on the services provided by the Partnership for Older People Projects, additional savings of approximately £1.20 have been made on emergency bed days. This shows that investment in our home care services makes sense.

Ageing support is a human right. Older people have the right to choose how best they will be supported as they age. That is why we will be supporting this Bill, which gives people who have applied for the fair deal scheme a choice of home care package, as long as the cost is equal to or less than the cost of long-term residential care. We have concerns about the extension of the nursing home support scheme to include home supports. As I mentioned earlier, the nursing home support scheme was designed specifically for long-term residential care. Although home supports are inadequate and under-funded at present, they are provided free of charge to the end beneficiary based on an assessment of need. Sinn Féin believes they should continue to be provided on that basis. I understand that this Bill calls for home care services to be provided using State support from funds to be voted by the Oireachtas for the purposes of this legislation. I recognise that this Bill contributes to the debate on the need for a statutory entitlement to home care in Ireland. It merits a welcome on that basis alone. I believe family carers should be consulted on all of these matters. Their important role should be fully recognised and State supports for carers should be enhanced.

The amendment that has been proposed by the Minister of State, Deputy McEntee, calls for this Bill to "be deemed to be read a second time on this day six months, to allow the Minister of State for Mental Health and Older People to consult with the public and other key stakeholders". I would guess that this amendment has been tabled as a result of the Minister of State's announcement last week of a public consultation on the issues around home care for the elderly. I welcomed this initiative when it was announced, while noting that it has been a long time coming. We are willing to support the amendment because we believe it is important to consult the public and the key stakeholders. However, we will hold the Minister of State to the six-month deadline. There cannot be an open-ended delay. I will call for interim updates on the progress of the consultation process. Perhaps the Minister of State will indicate in her concluding remarks whether she is willing to accede to this request. Colleagues of all political views hardly need to be reminded that time is of the essence for the issue we are addressing. However, I am reminding the House of that now and I will do so again if necessary.

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