Jackie Cahill (Tipperary, Fianna Fail) | Oireachtas source

I commend the Deputies in the Rural Independent Group on bringing forward this motion in Private Members' time. I thank my colleague, Deputy Butler, for the work she has done on this issue. The way in which we look after older people and the degree to which we facilitate them to live longer in their own homes will determine the quality of our society. These are issues that matter greatly and have a direct impact on people's lives. Fortunately, we are now living longer and most of us will live independently for the rest of our lives. Fewer than 5% of the population will require care late in life and every effort should be made to accommodate them in the comfort and security of their own homes. Home care provision is the most cost-effective way for the State to honour its responsibility to older people. Of far greater importance, it also results in the best outcome for the people concerned.

Currently, older people and their families have two options. They can avail of a fair deal package, which is available on a statutory basis, or they can seek to access a home care package, which, unfortunately, is discretionary and, in many cases, grossly inadequate. It makes sense for all concerned that home care provision be placed on the same statutory footing as the fair deal scheme. As things stand, the home care package regime is not patient-driven and there are significant geographical disparities in the availability of services. Often it depends on where a person happens to live as to whether he or she may avail of home-based care. In my own county of Tipperary, due to a lack of qualified home carers in the area, there is little or no service available. Families have no choice but to look to the fair deal scheme far sooner than is necessary. Moreover, there is no transparency regarding eligibility criteria and the decision-making process, with such matters entirely at the discretion of the health service. As a result, many infirm older people have little choice but to opt for nursing home care, at a far greater cost to the Exchequer. Day care centres and respite care are likewise extremely important for elderly people. Respite care gives families who are looking after a person on a home care package a break of one or two weeks, which is vital for the long-term well-being of the persons carrying out the care. Day care centres, too, provide an invaluable service and must be properly funded.

In 2015, the Health Service Executive estimated that an additional 2.2 million hours of home help and a further 3,500 home care packages for older people are required. There was no provision for that in the service plan for 2016. Those additional resources must be provided for older people.

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