Bríd Smith (Dublin South Central, People Before Profit Alliance) | Oireachtas source

I will follow on from what Deputy Kenny talked about. I know him a long time and knew him when he was a young fellow doing this sort of care work. I know the pride with which he did his job and the type of people he looked after for long periods. He looked after people with whom he built up relationships. There were people who were wheelchair-bound and people who suffered with their mental health. The whole point of the type of care that was delivered, as the Deputy said, through the HSE and the public sector was that the carer built up a relationship with those who they cared for.

I have been involved in a few special committees during my time in the Oireachtas, which is a short time. One of them is currently getting ready to issue its report on the recommendations of the Citizens' Assembly on Gender Equality. For one session we had before us Professor Kathleen Lynch, who has written a brilliant book on capitalism and care. She pointed out a number of strong home truths on the same lines as Deputy Kenny has experienced in his life. One of the things she points out is care itself is not about providing just the physical facilities but about having a relationship and having an affection and a sort of a friendship with person for whom you care. It goes to the heart of what people need in their lives in terms of their need to flourish. We learned a lot about that during Covid.

The other committee I was involved in was the Special Committee on Covid-19 Response that sat I do not know how many times during 2020 and examined the care sector in particular and what was happening in our nursing homes. I remind Deputies that 56% of all Covid deaths in the State at that time took place inside the nursing home system, which was totally disproportionate as this group of elderly people comprise 0.65% of the total population. A recommendation that came out of that long-sitting, long-suffering committee was "that a public inquiry be established to investigate and report on all circumstances relating to each individual death from Covid-19 in nursing homes". We fought for that recommendation to look at what was going on in the private sector because Professor Lynch's statistical study shows 70% of all nursing home beds are now owned by for-profit companies and a huge subsidy takes place in the State. With regard to the overall care relationship between the State and the for-profit sector, the proportion of public expenditure allocated to private for-profit care rose from 5% in 2006 to a handsome 40% in 2019, and that is not the latest figure. Though it is not defined as profitable, it is currently at approximately €718 million annually with 599 businesses registered as delivering care. What is that if not the commercialisation of the most human action one can carry out in one's life, which is to care for another, particularly when they are vulnerable or disabled? That is the corporatisation of care and the State is very much guilty of implementing that.

I welcome the Sinn Féin motion as we need a serious think about how we are delivering it. Approximately ten years ago the HSE was washing its hands locally of the home help system that existed in all our communities. It was so localised we had a special dedicated office in Lower Ballyfermot and another in Upper Ballyfermot. It was mostly run by nuns and voluntary elements of the HSE but they worked closely with mainly local women, and sometimes men, to deliver hours of care to their neighbours. That was real care because those working knew the people. They knew the elderly men and women they were looking after. They had grown up alongside them.

They loved them, had relationships with them and bent over backwards for them. They were available to those people out of hours and were paid a reasonably decent hourly rate to care for them. When the home help system was removed, all of that went under the radar. All of those women and men, if they wanted to stay in the industry, were expected to pay for their own training and uniform and to work for a for-profit company that provided them with an app whereby their work was timed. They were asked why they spent longer than 15 minutes with Mrs. Murphy around the corner when they should have only helped her to shower and take her tablets. I reiterate that what people really need are relationships, affection, care and friendship. If we move away from that model, we are doing society a huge disservice.

As part of my work on the climate committee, I read a lot about the alternatives to our burning of the planet. There are many theories about how we could do things differently in society. Many people have written about what they call the care and repair of society. Central to that is for society to move to spending significant public money on looking after each other, which requires training and paying people properly to give the sort of care our vulnerable and elderly people deserve. We will all get there some day. It would be fruitful and productive to take that approach. This debate helps us to understand that is where we need to go.

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