Matt Shanahan (Waterford, Independent) | Oireachtas source

I welcome the presence of the two Ministers of State at the Department of Health here this morning to debate this motion. I thank Deputy Grealish for proposing the motion, which is very important. I also thank Cáit Nic Amhlaoibh in our office. The Ministers of State will be well aware that, in the Programme for Government: Our Shared Future, there is a plan to introduce a statutory scheme to support people to live in their own homes by providing them with access to high-quality and regulated home care. Unfortunately, this has not happened to date. The home support service, formerly called the home help service or home care package scheme, aims to support people to remain in their own homes for as long as possible and, most importantly, to support informal carers. It also aims to support people with a disability who need home help. The Ministers of State will be well aware that we have a significant demographic bulge coming through in our population. We can be thankful that more people are going to live longer although this means that more people are going to need home help. At present, more than a quarter of all people aged 65 years or older in our country live alone.

As other Members have outlined, and as the Ministers of State are well aware, we have a chronic shortage of home help capacity and home help hours. This is leading to two very significant pressures. It is resulting in delayed discharges from hospital and putting pressure on our residential care homes, thereby reducing the ability of our people to live at home, which is what we want to achieve. We also have a second problem, the shortage of people who are available to work in the sector. Our economy is now at full employment and, unfortunately, this sector is not seen as attractive for many, particularly in the private sector. As has been highlighted, there is also no access to a supplementary pension. That is very important to people who are working. We also have to acknowledge that the HSE has been very quick to target those in the private sector. This is a big problem for private companies that are trying to hang onto their staff. This also applies to section 39 organisations.

There were 6,432 people on the waiting list for home support at the end of March. Notwithstanding the significant additional funding the Minister of State, Deputy Butler, has outlined, we still have a tremendous waiting list. In our motion, we propose 14 recommendations but I will concentrate on five, if I may. One relates to the idea of developing a nationwide cluster model for older people with security of tenure and rent fixed to increases in the State pension. This is very important, particularly as we now have a larger number of people who, unfortunately, will not own their own homes and who will be in rented accommodation for all of their lives. We need to put something on a statutory footing in that regard.

A second recommendation is that steps be taken to increase the use of new technologies to assist in the care of older people, such as voice recognition software, remote health monitoring and so on. The age bracket for this needs to be reduced. There are a lot of people who could avail of monitoring technologies in their homes and who need assistance but who are younger than 65 years of age. I know of a number of people who cannot access that funding because they are under 65. It is a significant impediment to them staying at home. These are people with mobility issues and so on. They should be given wearable dongles and all of that without having to pay for it. I ask the Ministers of State to look seriously at that.

Another recommendation is to increase the means test limit for the carer's allowance and establish a high-level group to scope out and develop a roadmap for the delivery of a non-means tested participation income for family carers. This is very important. I know the Ministers of State have acknowledged this but we need to see further action. I hope the commission can look at the matter.

The financial threshold for people on State benefits should be increased in order that they can work and earn more money working in the home care sector. This is the quickest remedy that could be applied to get staff into the home care sector. We have a lot of informal carers who are available and potentially are in receipt of State benefits at present. We need to find a way to activate them. They would increase the working population.

They will also take pressure off the system. I ask the Ministers of State to speak to the Minister for Finance about it.

Finally, we must ensure that industry and public sector travel expenses are made available to home care providers who provide home care for older and vulnerable people in rural areas to help to create a balance between rural and urban travel services. Travel expenditure is one of the significant problems in rural home care, as the Ministers of State are well aware. The allotment of time between when a carer arrives into a house and when they have to leave to go to the next house is also an issue. Even though people are being told that they have an hour or an hour and a half of care, they do not, because the travel time is eating into that. Certainly, remuneration and adequate travel expenses would do a lot to support people, particularly in our rural communities. I know people who are working in the sector, as I am sure the Ministers of State do too, and travel expenditure is the issue that comes up the most. I am glad that the Government has accepted our motion. I hope we will see the main recommendations that we have made in it being accepted and enacted by the Government.

See this speech in context