Jim Daly (Cork South West, Fine Gael) | Oireachtas source

I move amendment No. 2:

To delete all words after "Dáil Éireann" and substitute the following:"acknowledges that:

— Ireland has a duty to protect persons with disabilities and their caregivers, in line with the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD)and provide necessary support for the child and for those who care for the child, in line with the United Nations Convention on the Rights of the Child (UNCRC);

— the vision of the Carers’ Strategy is to recognise and respect carers as key care partners, who are supported to maintain their own health and wellbeing and to care with confidence and empowered to participate as fully as possible in economic and social life;

— the Health Service Executive (HSE) Disability Services budget for 2019 is €1.9 billion, providing 8,568 residential places, 22,272 day places, 182,506 respite overnights, 32,662 day respite sessions, 1.63 million personal assistant hours for 2,535 people, and 3.08 million home support hours for 8,094 people; and

— an additional €10 million was provided to the disability sector in 2018, to enhance respite care and alternative respite services including extended day services, summer camps and Saturday clubs;

notes that there are a number of sources of data on family carers in Ireland, and that Census 2016 found that:

— 195,263 or 4.1 per cent of respondents indicated that they provided regular unpaid personal help for a friend or family member with a long-term illness, health problem or disability, including problems due to old age;

— the total number of family carers increased by 4.4 per cent between 2011 and 2016 and the total number of family carers aged 45 or older increased by 11.3 per cent; and

— there were 13,000 family carers under the age of 25 in 2016, a decrease of over 1,000 compared to 2011;

recognises that:

— the health system relies heavily on family and other unpaid carers, who make a profound difference to the health, wellbeing and quality of life of those that they care for;

— two in five family carers receive Carer’s Allowance or Carer’s Benefit;

— the rate of Carer’s Allowance has increased every year since 2017;

— since 2016, Carer’s Allowance continues to be paid for 12 weeks after the death of the person being cared for, an increase of six weeks, and since 2017, this extension was also granted in cases where the cared for person permanently moved into residential care or a nursing home;

— the means test for Carer’s Allowance is one of the most generous in the social protection system, in that €332.50 of gross weekly income is disregarded in the calculation of means for a single person and the equivalent for someone who is married, in a civil partnership or cohabiting is €665 of combined gross weekly income;

— the work of family carers is indispensable in ensuring that people requiring care across the country can receive such care in their own homes and communities, while maintaining their independence and sense of self-worth;

— providing care to loved ones can have a significant impact on the health, physical and mental wellbeing, finances and familial and societal relationships of family carers;

— a range of social services and supports are necessary to enable family carers to provide care to the best of their ability;

— the Government is committed to the full implementation of the National Carers’ Strategy, 2012, a whole-of-Government response to the challenges faced by family carers through the development of 42 actions under four national goals;

— five progress reports published by the Department of Health, along with a series of independently conducted assessments of progress on the implementation of the strategy from the perspective of family carers, have found that a majority of actions have progressed in a way that has led to a positive impact on the lives of family carers although more work remains to be done;

— the provision of Carer’s Allowance, Carer’s Benefit, Carer’s Support Grant and Domiciliary Care Allowance, at a cost of almost €1.2 billion in 2019, offers an important income support to family carers;

— since 1st June, 2017, all children in receipt of a Domiciliary Care Allowance are eligible for a medical card without a means test;

— increasing the income disregard for Carer’s Allowance from €332.50 to €450 for a single person and €665 to €900 for a couple would cost the Department of Employment Affairs and Social Protection approximately €73 million, with income tax and Working Family Payment offsets, the net expenditure would be €55 million;

and

— it is a condition of receipt of Carer’s Allowance and Carer’s Benefit that the carer must be providing full-time care and attention, and the current limit of 15 hours of work or study per week is considered to represent a reasonable balance between meeting the care recipient’s requirement for full-time care and the carer’s need to maintain contact with the workforce;

further recognises that:

— over the past four years there has been a considerable increase of nearly €140 million in the home supports budget which has grown from €306 million in 2015 to almost €446 million in 2019, with demand continuing to grow, and a combined 18.2 million hours of general and intensive home support for older people will be provided this year;

— the HSE reviews people on the waiting list as funding becomes available to ensure that individual cases continue to be dealt with on a priority basis within the available resources and as determined by the local frontline staff who know and understand the clients’ needs, and who undertake regular reviews of those care needs to ensure that the services being provided remain appropriate;

— the HSE provides over €21.6 million in annual funding through service level arrangements with community and voluntary organisations who provide services to support family carers including in home respite services, peer-to-peer support and training courses;

— the Minister for Health and the Minister of State for People with Disabilities intend to revert to Government in due course with revised proposals to reflect discussions at Cabinet and further discussions between the Ministers on the best way to progress the Transport Scheme, and it is notable that with regard to transport there are improvements in access to a range of transport support schemes available to persons with disabilities in the State and on-going work is being carried out by Government Departments, agencies and transport providers to further improve access to public transport services, and under the National Disability Inclusion Strategy, the Department of Transport, Tourism and Sport has responsibility for the continued development of accessibility and availability of public transport for people with a disability;

— in 2019, funding of €71.25 million was allocated by the Department of Housing, Planning and Local Government to the Housing Adaptation Grant for People with a Disability, Housing Aid for Older People and Mobility Aids Grant, comprising €57 million Exchequer funding, an increase of some 8 per cent on the 2018 figure, with the balance of €14.25 million being contributed by the local authorities and the responsibility for the apportionment between the three grant schemes is a matter for each local authority; and

— since September 2018, free GP visit cards have been extended to persons in receipt of the Carer’s Allowance, and a key point in the decision to exclude Carer’s Support Grant recipients from the GP visit card scheme is that the grant is not directly comparable to either the Carer’s Allowance or Carer’s Benefit, it is a once-off yearly payment of €1,700 made by the Department of Employment Affairs and Social Protection and is not means tested; and

further acknowledges that the Government commits to:

— fully implementing the National Carers Strategy, and developing a new Social Care Strategy, in line with the vision of Sláintecare to deliver a universal health service that offers the right care, in the right place at the right time;

— establishing a new stand-alone statutory scheme and system of regulation for home care services;

— including representatives of family carer advocacy organisations in the development of policy that has an impact on the ability of family carers to care for their loved one(s); and

— continuing to grow supports for family carers to allow them to maintain their health and wellbeing and to continue caring with confidence."

I thank Deputies for their contributions. In particular, I acknowledge the passion of Deputy Penrose in respect of the matter, which was evident when he spoke. I have often said that one of the characteristics I most admire in a Deputy is consistency on an issue. I acknowledge that the Deputy has been extraordinarily consistent on this issue over many debates. He has raised the matter in debates when its relevance was not direct and never lost an opportunity to highlight the position of carers. I acknowledge him and the wider Labour Party for their continued focus on the issue.

The State recognises the role that family carers play in society and is committed through a range of healthcare and income supports to support carers in their caring role and to alleviate the financial burden of caring. Over the past 15 years, the number of recipients of carer's allowance has increased by 347% and the number of recipients of carer's benefit has quadrupled. In addition, the carer's support grant increased by 23% in 2016. Since 2011, total payments across carer's allowance, carer's benefit, carer's support grant and the domiciliary care allowance have increased by more than €426 million, or 56%. While there are many positive and rewarding aspects of caring, it is evident that caring is a significant challenge, affecting all aspects of a family carer's life. The needs of the cared for person can place great demands on the energy and time of the family carer and, given that many provide full-time care, have a significant impact on their relationships with other people, their professional lives and their physical and mental health and well-being. According to census 2016, there are more than 195,000 family carers in the State who provide regular unpaid personal help for a friend or family member with a long-term illness, health problem or disability, including problems due to old age. Family carers are, therefore, an integral part of the provision of health and social care in Ireland. Just as they offer unconditional care and support to their loved ones, they deserve our continued recognition, respect and support.

In light of the vital role played by family carers in Ireland, the first ever national carers' strategy was published in 2012. The strategy represents a whole-of-Government response to the challenges faced by family carers and sets out the strategic direction for future policies, services and supports provided by Departments and agencies for carers. The strategy is designed around a core vision that recognises and respects carers as key care partners who are supported to maintain their own health and well-being, care with confidence and empowered to participate as fully as possible in economic and social life. Oversight of the strategy is led by my Department, while the HSE's multi-divisional carer strategy group continues to support the process across the service divisions to progress the actions in the strategy. The strategy provides for the implementation of 42 actions under four national goals that aim to recognise the value and contribution of carers and promote their inclusion in decisions relating to the person they are caring for; support carers to manage their physical, mental and emotional health and well-being; support carers to care with confidence through the provision of adequate information, training, services and supports; and empower carers to participate as fully as possible in economic and social life.

Ireland has a duty to protect persons with disabilities and their caregivers under the United Nations Convention on the Rights of Persons with Disabilities, UNCRPD. Reflecting the strength of the Government's commitment to the convention, the HSE's disability services budget for 2019 is €1.9 billion, which is an increase of €350 million since this Government entered office. In addition, the provision of carer's allowance, carer's benefit, carer's support grant and domiciliary care allowance, at a cost of almost €1.2 billion in 2019, offers an important source of income support for those caring for a family member due to old age or disability. The HSE provides in excess of €21.6 million in annual funding through service-level arrangements with community and voluntary organisations to provide services to support family carers, including in-home respite services, peer to peer support and training courses. The significant contribution made by community and voluntary organisations is hugely valued in both social care and health service provision. Organisations such as Family Carers Ireland play a crucial role in advocating on behalf of family carers, offering an excellent nationwide system of supports tailored to meet the needs of family carers in every area of the country. I commend and thank them for their efforts in highlighting the issues faced by family carers and for representing them on the national stage.

Funding has been secured through the Dormant Accounts Fund for information and training supports for family carers. This is assisting carers to provide the best care possible to the care recipient, reduce the risk of injury to the corer and care recipient and to help family carers cope with the emotional and psychological aspects of their role. Funding is also being made available to provide for the dissemination of resource information for family carers, develop support networks and support groups to assist with the transition back into social and economic life at the end of the caring role and to implement measures that assist in promoting carer self-identification. Identifying carers and their needs as early as possible is of critical importance if they are to be supported in their caring role. The introduction of the carer's needs assessment tool will be a key step in helping to identify carers at all stages and will play a role in identifying the supports required. My Department secured dormant accounts funding, which will enable the assessment tool to be piloted in a HSE community healthcare organisation this year. The pilot study will greatly benefit the development of a comprehensive, standardised family carer needs assessment to identify needs. It will do so by providing an opportunity to refine and improve needs assessment.

It is worth noting the five progress reports by my Department covering the period, 2012 to 2017, and a series of independently conducted assessments of progress on the implementation of the national carers' strategy from the perspective of family carers, which found that a majority of actions have progressed in a way that has led to a positive impact on the lives of family carers. The goals of the strategy continue to apply and its guiding principles, namely recognition, support and empowerment of carers, remain as valid now as they were in 2012. Rather than spending our time on the development of a new strategy, we should focus our efforts on ensuring the full implementation of the current strategy. That is why the Government remains committed to delivering the existing strategy and my Department and the HSE, through its multi-divisional carer strategy group, are focused on meeting the health sector commitments in the strategy. I encourage all Departments and agencies to continue to build on the progress achieved under the strategy to ensure a genuine whole-of-Government response to the wide range of needs of carers is maintained.

The Committee on the Future of Healthcare's Sláintecare report supports a significant shift in our model of care to one that is focused on prevention and early intervention and which will provide the majority of care in the community. The Government's Sláintecare implementation strategy sets out an ambitious programme of reform to deliver this vision. In line with the vision of Sláintecare to deliver a universal health service that offers the right care in the right place at the right time, my Department has commenced preliminary consideration of the scope of a social care strategy. The strategy, which is in the early stages of planning, will enhance support and focus for the key goals of current policies, including the national carers' strategy. We cannot underestimate the devotion and dedication of family carers to their loved ones. They are entitled to our respect, but also to our support. The Government is committed to looking after people who spend their time looking after others, not because it saves the State money elsewhere, but because family carers ensure that cared for persons can continue to live in their own homes and communities for as long as possible. Family carers work exceptionally hard. As such, the Government records in the House its desire to recognise them, thank them for the work and reassure them that we will continue to offer a range of supports that will enable them to continue caring with confidence.

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