Mattie McGrath (Tipperary, Independent) | Oireachtas source

I am also pleased to be able to speak to the Bill and I compliment an Teachta O'Dea on putting forward the Bill and the research he has done. The Minister, Deputy Harris, has just left but I thank him for earlier receiving a deputation of a powerful group of enablers in Tipperary, some of whom are recovering cancer survivors. They have put in much passion and energy into providing a new, state-of-the-art cancer care centre in Tipperary called Circle of Friends. I thank the Minister for engaging with them. Those people will show the way for the Health Service Executive, HSE, in many areas related to this issue. It is about community, what we can do and ní neart go chur le chéile. Not everything can be done by the HSE and the Department. That is why the Bill is very timely and understanding. Deputy O'Dea has demonstrated he is aware of the major logjams that exist. We must also thank Mr. Brendan Courtney and his family for giving oxygen to this major issue, which all of us, including the Minister of State and her backbenchers, face every day in our clinics.

We must support people and families in the home as long as we can. There is a right to homes, water and everything else, but surely a person has the right to be able to stay in his or her home for as long as possible. There is nurturing and bonding within a family with a sense of pride, love and satisfaction when somebody moves on, regardless of whether those involved are siblings, husbands, wives or grandchildren. It is very important that grandchildren can engage and everybody is involved with the care. Apart from the care aspect, these people will not be in rooms in nursing homes. I have nothing against nursing homes. I have seen stickers on the back of cars stating, "Be nice to your children, they choose your nursing homes." It is a nice, catchy slogan but I do not like it. Families in all communities like to be able to care and it is a much better experience. Outcomes are much better also and people often recover. People who are kept at home with supports often recover.

I salute from the bottom of my heart the legion of home help and home care people and the work they do. At times they have been diminished and they rush to and fro and from place to place. It may sound like there is no compassion in the administration but I know there is. The likes of the home help co-ordinator, Ms Brigid Farrell, in Tipperary do their best but there are limited resources and time. These people are so unhappy to go in for 20 minutes or half an hour as they are hardly in the door when they have to go. They go beyond the call of duty by going back to the families in their own time. They stay longer and they work harder. They love the work and they should be supported.

Figures have been mentioned relating to home care packages. There is €940 million in the current budget run for the fair deal nursing home scheme but there is a third of that, less than €350 million, for home care packages. That balance must shift as it is the natural course of action and it would help everybody. Patients will recover and families will have extra help. There are new groups like Home Instead Senior Care that must be brought into this area. I am not diminishing the work of home help workers but there are private companies that offer these services, and they should be allowed to be funded and paid by the State, albeit with a modicum of restraint.

I cannot say enough about family carers. I cannot say enough about Councillor Richie Molloy, who is a manager in south Tipperary, and his team. I should also mention the Alzheimer's disease and other support groups. Like the group I met today, these people come together on a voluntary basis. Some of the people have been sick themselves but they give much time and energy to sufferers and allow them to get involved with so many therapies and meeting other people. Whether it is knitting, reading, walking or the many counselling services they provide, it is done voluntarily. They want to help the HSE but we need more understanding from it and the Department. There is a six-month consultation promised and I hope these people will see serious engagement. They are the carers and groups helping sufferers of Alzheimher's and Parkinson's disease as well as others. I hope they will be consulted and treated with the respect they deserve as they have much to offer.

Deputy Harty spoke about a former Member, Dr. Jerry Cowley, and what he did in Mulranny, as well as what Deputy Harty did in Clare. In my village we have a wonderful voluntary housing scheme and although we have not yet got into the caring, the process could be expanded and the energy is there to do it so people could be treated when sick. If these people are sick now in my area, unfortunately, they must go to hospital. The accident and emergency department crisis could be eased considerably if people had a place to go to. There are not enough step-down beds and we know about the row we had about the hospital in Cashel that was closed some years. We spent €22.4 million on it but there is not a bed in it. Although it has no surgical equipment, we have the best facilities in the form of modern offices, tables, chairs, desks and computers. It is a scandal and I am delighted that Deputy Kelly and I agreed for once and the Committee of Public Accounts will investigate it. Such issues should not exist. If small amounts of that money were put into enabling the enablers - those who do the caring, such as the Carers Association - we would have a great country and great care for people.

We must support our GPs, who are the front line for a sick person. If any of us get sick at night, a GP is the first person called. I have a GP in Cappawhite who is not in great health and he is weary from the cumbersome system. The Minister, Deputy Harris, was in Clonmel visiting two private doctor centres where the doctors have come together. They are Mary Street Medical and Western Road Medical Centre. They have the capacity, equipment and expertise, above all. They are linked with universities. They are offering diagnostic services that could reduce the numbers attending accident and emergency departments. We must think outside the box and support our GPs.

With Tipperary GPs, I might be part of the last group standing that is opposed to free medical care for children under six. What has it done but clog up surgeries even more? If the care is rolled out for those under 16, it will do the same. We will all be nursing home candidates some day, some perhaps sooner than others, but we need a bit of imagination to support community-based services. This Bill is excellent and very timely.

It is great for the communities. The sense of satisfaction and pride they get is extraordinary. I see them at Christmas. I visit many nursing homes and day care centres. I see the satisfaction not only from the clients but from the family members, providers, volunteers and staff who work there. It is good for everyone psychologically; there is a feed good factor for everyone. We must look after step-down facilities and we must put money into them.

Farmers are self-employed. I am not suggesting that it only applies to farmers, it applies to the self-employed as well. They are seriously discriminated against by the fair deal scheme. These people want to pay. As Deputy Cahill noted earlier, major issues arise with transferable land and changes of ownership. I am dealing with such situations in my constituency as well. There is considerable room for recovery.

This Bill is timely. I hope that meaningful consultation will take place. I also hope the Government will listen and engage with all the providers to ensure they are facilitated. I met representatives of a cancer support service today. We see such people in every country. There is a vast amount of voluntary energy. This group has raised €600,000. It needs €800,000 to build new premises. That model can be transferred to this context in order to develop community care centres and supports for various initiatives already in the community. I have in mind Sr. Celestine from north Cork, the area from which the Minister for Agriculture, Food and the Marine, Deputy Creed, comes. Sr. Celestine is doing great work providing sheltered housing and step-down facilities. Many groups throughout the country do similar work. There is a wonderful place in the old convent in Naas. The Minister of State should visit it to see what goes on there. Similar work in going on in other constituencies. Although the name eludes me, the facility is a powerful hub of community endeavour.

All we want is a little support from the Government - "a little help from our friends", to use the phrase from the advertisement on television. Moreover, we need less red tape and bureaucracy. I mean no disrespect to the officials in the Chamber but we have to get rid of half of the officialdom in the HSE. We need to get common sense back. Unfortunately, there is a major imbalance and a lack of common sense. That is why I have said balance is important.

There is a need for balance with home care. Some people need nursing home care and they cannot manage anywhere else, but it is not necessary for many others and these people should not be in nursing homes. We must allow the enablers, families and communities a little help to care for these people by providing more home help hours and allowing more home care packages. We should cut out the bureaucracy and the serious delays and the frustrations therein. We need to support general practitioners as well.

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