Ruairi Ó Murchú (Louth, Sinn Fein) | Oireachtas source

It is not the first time we have dealt with home support and home care packages. I thank the Regional Group for putting this vital issue front and centre. It is a pity we are still talking about this. We all speak about how we want to facilitate people to be able to live in their own homes. The problem is that we are not very good at putting in place those pieces that allow this to happen.

I will throw out, and not for the first time, that housing adaptation grants could facilitate people to leave step-down hospitals or hospital beds. I do not like the term "bed blocking" but these people are being forced into these circumstances. Louth County Council has made a request to the Government for €570,000. At present it is not taking applications for housing adaptation grants. I have spoken to the Ministers of State, Deputies Rabbitte and O'Donnell, and others about the fact that we need a review of the entire system. Even where people get the money and are able to wait a long time for very necessary adaptations that relate to severe mobility issues for older people and disabled people, in some cases the grants are not sufficient to deal with the need. I have been dealing with the Minister of State Deputy Rabbitte on the particular issue of a child coming of age with severe disabilities. We are speaking about hoists. Louth County Council has done what it can but it is insufficient. The Minister has managed a workaround but we need to be able to deliver it. The longer this goes on, the more difficulties it creates for individual families.

To come back to the particular issue of home care, the problem in north Louth is that there are significant difficulties getting full home care packages for those who need them. They may get partial packages. There are families who will get part-time packages when full-time packages are required. CHO 8 states it is difficult to get home care assistants to travel to north Louth. At times the RCSI Hospital Group, in order to free up its beds, has put on its own services. This is a lot easier to do for people who live in the vicinity of Beaumont than for those who live in north County Louth. It is a particular issue. Communication is never particularly great with CHO 8. I do not know how many times I have raised the added issue of these adaptation grants. We really need to get real about all of this.

I will raise the particular issue of a 15-year-old girl who was diagnosed with autism at the age of seven and has also been diagnosed with neurofibromatosis type 1. This is a terrible genetic condition that causes tumours to grow on the nerve endings. People can imagine the difficulties it causes. She is regularly hospitalised for high blood pressure. She is awaiting a home care package to assist her mother who has three other children with disabilities. They are also waiting for a profiling bed and other additional equipment. We have been in communication with the HSE on this. It is an issue that needs to be escalated. I will speak to the Minister of State and whoever else I need to on this. It is a real pity we have people in these circumstances. The problem is that it is never just one but many. We cannot even put ourselves in their shoes with regard to the life they need to lead. We are constantly speaking about facilitating families and making sure people can live in their own homes. Unless we put these parts into play, it will not happen.

We know about the tender of €31 per hour of care and that there are still some issues that need to be ironed out. There is still instability in the sector.

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There is a request to look at all the terms and conditions of the sector. How long have we been talking about this cross-departmental strategic workforce advisory group, or CDSWAG, which is a hell of a lot easier to say? We really need these recommendations to be put in play. We have all talked about the issues, particularly with regard to travel expenses. We just need to make sure we can bring it to a place where people have a liveable wage, we have something that is attractive, and the people who want to do it are in a position to do so.

Some of my colleagues have already spoken on the necessity of social welfare reform. We know we need to make sure we have workforce planning and throughput coming through. Beyond that, we will have to incentivise people. The Minister of State, Deputy Butler, spoke about how we need to look at tax implications and whatever else for people who work in the health sector who may be willing to provide home care for the weekend if it is financially worth their while. We know we need to look at the hours for those on social welfare payments. We have many other things that need to be dealt with. At this point in time, we have a system that is not fit for purpose and we are failing people.

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