Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

The Minister of State spoke in praise of home helps and acknowledged the great work they do. I do not know if I could appeal to his heart, so I might try appealing to his head. The home help service represents good value for money because it is a cost-effective way of keeping people out of hospital, which is an expensive place for them to be. We have learned in recent weeks that the HSE has, in effect, suspended the allocation and recycling of home help hours. I do not know whether the Minister of State's office has issued an instruction that home help hours should not be given out. Perhaps a budgetary constraint means that no home help hours will be recycled or reallocated. The net effect is the same for the person in the hospital bed or for the woman - let us face it that it is usually a woman - who has to tell her boss that unfortunately she must reduce her hours to look after her mother. Her mother may have been written up for a number of home help hours, but those hours are not yet available.

Regardless of whether this cut results from a letter signed by the Minister of State or from a budgetary constraint, the net effect of the impact on those affected is the same. They are not getting the home help they need even though they have been told they need it and are entitled to it. That is where the 6,000 people are waiting. I would say that even more people are in a queue to be assessed. When they are assessed, they will probably be found to need home help. This is having a massive effect on broader society by virtue of the fact that the gap has to be plugged. If someone needs home help to be able to stay in his or her house, that need does not go away purely and simply because of a budgetary constraint. That need is still there and that gap is being plugged somehow. The person is either going without the care or is in hospital inappropriately when he or she could be at home, or somebody within the family is shouldering the burden. That is how it happens. The need does not disappear purely and simply because there is a budgetary issue.

I have heard the Minister of State talking about increasing the funding and the hours, but the current approach is just not meeting the need that exists. It is a false economy because people ultimately end up back in hospital. I have seen it in my own family. I am sure Deputies have seen it in their clinics. I have seen it in my clinics as people come in and out. The net effect is that families have to provide unpaid care, people are left stuck in hospital, or patients who want to be at home are stuck in nursing homes. I cannot imagine what it would be like to have worked all my life and paid PRSI in the belief that I was making contingency for my later years, only to find as an older person that I cannot remain in my own home where I would be happy purely and simply because of a budgetary constraint. I fully accept that the amount of money being spent has increased. The fact that 6,000 people are waiting shows that it is not enough. Some of those who are waiting are waiting in very expensive places. We mean it when we say this is a false economy. It is a case of being penny wise and pound foolish.

The increase in the number of people who are living longer should be something we celebrate. I hope to be one of those people. I have been around for a while and I would like to be around for a lot longer. We should be celebrating that. We should not be requiring people to spend their later years at home without the care they need, or in a nursing home when they do not want to be there. The real measure of the performance here is not in the facts and figures, and the 1% of this and the 5% of that. The Minister of State has quoted all the statistics. The real measure is the 6,000 people who are waiting, 600 of whom live in my constituency, because they are at the business end of this. What do I say to their family members when they come into my clinics in Swords, Lusk and Balbriggan? Am I supposed to tell them to wait? If I say I am sorry that their mothers and fathers cannot be discharged from hospital due to a budgetary constraint, they will ask whether it is not more expensive for their mothers and fathers to be in hospital. The simple answer is that it is more expensive for them to be in hospital. We all know cases of people who cannot leave hospital because they cannot get the home help hours. I am not disputing that more money is being spent, but it is being spent on private providers. It is not giving the best value for money. All the while, the Minister of State is ignoring the possibility of directly employed home helps increasing their hours and making a real contribution to alleviating the budgetary constraints he has mentioned.

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