Joan Collins (Dublin South Central, Independents 4 Change) | Oireachtas source

Before I speak on the motion, I would like to express my deepest condolences and sympathy to Vera, Paul and the family on the loss of their daughter, Ava. We should put that on the record of the Dáil.

Last June this House passed a Private Members' motion brought forward by Deputy Connolly. It called on the Government to:

- immediately reinstate all respite beds closed as a result of the Covid-19 pandemic;

- undertake a comprehensive audit of respite services, funded in whole or in part by the Health Service Executive, to establish the current provision of respite beds and the level of unmet need;

- as part of that audit, establish the level of provision of respite services in rented accommodation;

- provide the funding required to ensure on-going and sustainable capacity in respite services; and

- ratify the Optional Protocol to the UNCRPD.

Fewer than 5,200 people received respite care last year, down from more than 6,300 families in 2018. Some 120,000 overnight respite sessions were provided in 2022, down from 160,000 in 2019. There was no audit, no improvement in respite services, and no ratification of the optional protocol.

I do not see where any progress has been made on Deputy Connolly's motion. There has long been sustained calls for the importance of the work of family carers to be properly recognised in this country, by Members of this House, by civil society groups and, most importantly, by family carers, many of whom rely on inadequate fixed incomes from the State and underfunded public services. Those who get help from public services find underpaid and overworked healthcare workers, thousands of whom work for less than the minimum wage due to the massive amount of work put upon them, and services falling apart due to closures, underfunding and massive staff vacancies. Neither the workers in our care services nor the family carers, who more and more are filling gaps in our State's failing public services, are paid properly for the hours they work, if they are paid at all.

In many cases, people are receiving less money in real terms for this work than they were a decade ago. The respite care grant was €1,700 a year in 2012. It was replaced by the carer's support grant at €1,850. If we take the World Bank's inflation numbers, that €1,700 would be €1,983 now. If we want to take the consumer price index, it would be €2,016. Many family carers work 24-7, 365 days a year, without time off, without respite, without holidays and, in many cases if they do not meet the income threshold, without any pay. Family carers are not entitled to a single day off from their work, and the services they rely on to get respite are rapidly falling apart.

This is not a new story. The chaos in our public services is being felt more frequently by more and more people. From our care services to our hospitals to our social welfare supports to our housing supports, we find a lack of staff, a lack of funds, overworked and underpaid staff, family members having to step in to fill gaps, and people left to the mercy of a worsening housing crisis, a worsening health crisis and a worsening cost-of-living crisis. Frankly, our services are falling apart. Last week we heard of a Tipperary family that was told their one-year-old child would have to wait until 2028 for an appointment for an assessment of need. We saw the national disgrace that was the child and adolescent mental health services, CAMHS, report earlier this year. I know from work on the Joint Committee on Autism that there is an average vacancy rate of 34% across CHOs, which equates to approximately 700 full-time jobs. The vacancy rate for occupational therapists is 40%. It is 39% for psychologists; 28% for social workers, and 29% for nursing positions. I know of CDNTs with vacancy rates of more than 50%.

For some months, in my constituency three-month and ten-month developmental checks have been delayed or suspended in the Old County Road primary care centre because of a lack of public health nurses. The Curlew Road health centre in Drimnagh lost all its public health nurses when they were moved to Armagh Road to fill shortages there.

Last week, I raised the topic of foreign nurses brought to Ireland on the general employment permit, the majority of whom are from India. Many of them are qualified to work as nurses under the Nursing and Midwifery Board of Ireland but they are obligated to do a Quality and Qualifications Ireland, QQI, level 5 course on the role of healthcare assistant that costs up to €1,700, which many of them cannot afford. Their income is fixed at €27,000, set just below the €30,000 figure required to qualify to bring over a spouse, which means they cannot settle here. They are working in private nursing homes, filling the gaps of healthcare assistants who went from the private sector to the public sector to get better pay. The pay in the public health service is upwards of €33,000. Either their wages need to be raised from €27,000 to €30,000 or the threshold figure of €30,000 should be reduced to €27,000. I prefer the first option.

We cannot treat people like this. We cannot go out and poach people from other countries and then not give them decent pay or hours or the opportunity to bring their families over to support them. They are here to do a service for our country and we cannot treat them badly like this. I cannot think of a public service in this country that is not suffering from the same problems. There is money but not enough staff and there is no prospect of things improving because it is getting harder and harder to buy a house, pay rent or afford to live in this country. One would think that all of these failures by the Government could not be an accident. The people who have faced the brunt of these failures are family carers. There are 1 billion unpaid care hours carried out every year, which saves the Government €20 billion per year. It is €20 billion of unpaid work the Government is happy to let ordinary people carry out to cover up its policy failures and €20 billion the Government does not have to put into services, recruitment, paying staff or grants to pay carers what they deserve. Those who need care have no recourse because the Government refused to sign the optional protocol in the UN Convention on the Rights of Persons with Disabilities. If the people who have to live through the chaos in our services were able to bring the Government to court, it would have to start paying out some of that €20 billion it has been saving by pushing unpaid work onto carers.

I echo what Family Carers Ireland called for before the Joint Committee on Autism this morning. It called for a national audit of respite provision to be undertaken by the HSE, for a national respite register and for all full-time family carers to be given the right to a minimum of 20 days of respite each year, in line with the statutory annual leave afforded to paid employees. It also called for the implementation of the recommendations of the Citizens' Assembly on Gender Equality on reforming the carers' allowance, including changes to the means test; increasing the hours carers can work or study; reimbursing the costs associated with care; increasing respite provision; and providing a dedicated pension for family carers. It also called for reform of the carers' allowance scheme towards a payment based on needs, not means, along the lines of participation income for carers; and for the replacement of Article 41.2 with wording that recognises the societal value of care and obliges the State to support the essential work of carers.

I thank Deputy Tully for introducing this motion this evening. I support Family Carers Ireland's calls. I call again for the Government to implement Deputy Connolly's motion from last June. Nurses and healthcare workers deserve better pay, better hours and better conditions. Family carers deserve to have their work recognised and to get paid for their work. They also deserve proper, guaranteed time off and respite, as well as public services that are properly funded and managed, which support them and on which they and their families can rely.

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