Jack Chambers (Dublin West, Fianna Fail) | Oireachtas source

I wish the Minister of State well in his role. He has a challenging few months ahead, given the ageing demographic. It is fundamental that we move away from the national picture he has outlined. Despite the changing statistics in Dublin West to which he referred, we know from the raw figures that there has been a 20% reduction in provision year-on-year. That is despite the ageing demographic and all of the challenges mentioned by previous speakers. The core issue concerns HSE management. Area managers are incentivised to balance their budgets and not to increase the provision of home care packages. There is a rigid threshold which is not about service delivery but about meeting budgetary targets. From a health service perspective, we need to move the management incentive away from an inhumane, rigid ceiling for different aspects of community-based health care and deliver for the individual. That should be the reward for the manager. Various area managers in Dublin West have been promoted on the back of cuts in the numbers of home care packages and community services, which have resulted in people being put into hospitals and nursing homes, resulting in a greater cost to the State. They have been rewarded for this flaw in the Government's health policy.

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