Catherine Connolly (Galway West, Independent) | Oireachtas source

I thank the Regional Group and welcome the opportunity to focus on this. The only thing absent in the motion, perhaps, is what led us to this point, which is the ideology promulgated by many parties to the effect that private was best. We privatised the system. It was the ideology of a particular party but I will not go into party politics. It is important to say, however, that it is neoliberal ideology that has left us with this mess on our hands. If we are getting sense at this late stage, or mar a deir said i nGaeilge, "ciall cheannaithe", meaning "bought sense", that is good.

This is a theme we return to all the time, like climate change, housing and domestic violence. We have statements ad nauseamabout it but what we really want is action. I welcome the fact that the Minister of State has taken action. She did so back in 2021 when she listened to the various debates and set up in March 2022 the workforce advisory group on home carers. I have read its report. The Minister of State received it in September of last year and it was published in October. I give her full marks for that and the work that was done. It is a very interesting read and it really encapsulates how we got to here. We have a mess on our hands. I pay tribute, as always, to the carers, without whom this economy could not function, not to mention thrive.

I always say when speaking here that I wish economists would examine the value to our economy of care and carers' work, without which it could not function. Of course, the profession is 90-something percent female, which is another indicator of why the pay is so low and no value has been put on it.

What is the mess we have? We have a health service executive providing good money per hour. That same executive is providing good money to the private and not-for-profit sectors but it is not being passed on. The Minister of State said the rate was €28.50 per hour. I can tell her that there are many carers in Galway who would love €28.50 per hour. What has happened under the neoliberal ideology is that we are now helping private companies, however big or small, to make a profit. That is exactly what Government policy is. The Minister of State has inherited that. I realise she is on record as saying she would like change so as to have more direct provision. I welcome that.

The findings of the review are absolutely stark. I have only a minute and a half left, so I will not be able to go through them. Pay and conditions are referred to. The pay is way too low. We should ensure a national living wage. Currently, there is no mechanism for care workers employed by for-profit or non-profit organisations to engage in collective bargaining. The hourly rate paid by the HSE to providers from which it commissions home support and that provide care at a profit is significantly higher than the rate paid by those providers to their care workers. There is something seriously wrong with this.

The report makes 16 recommendations. They are good and include putting measures on a statutory footing. Of the 16 recommendations, only one, on overseas workers, has been implemented. I welcome its implementation. Although all the recommendations caught my eye, No. 11 did so in particular. There should be a significant increase in the proportion of home support hours directly provided by the HSE. We are talking around in a circle in that we were providing direct home support through whatever entity is now the HSE but then changed things to ensure the companies would make a profit and not provide a proper service. The care was commodified. Professor Kathleen Lynch has clearly outlined the commodification of care services. That is what we are doing. If the Minister of State is going to lead us back to where we were, I will fully support her.

On the ideology, it is often important to identify that we did modify care services. It used to be a matter of getting somebody assessed for home care but it is now a matter of getting the carer. There are geographical differences in that carers cannot be got in rural Connemara, for example. On top of that, there is terrible language, such as "a person entitled to care". Such a person is not entitled to continue with the same carer, so he or she could have up to three or four different carers in the day, provided by different institutions or entities. All this is based on a neoliberal philosophy or ideology that has made a product out of care rather than an essential service. My colleague from Galway, Deputy Grealish, is nodding his head in agreement. I would welcome a change to the ideology on what are the essential ingredients of a democracy. The most basic one is to provide carers directly through the HSE and give them a living wage.

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