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

I thank Sinn Féin for bringing this motion to the floor of the House. I also welcome those in the Gallery who have come to listen to the debate. I hope they will get a resolution to this issue.

It is clear from the PwC report that the current fair deal scheme, commonly known as the "unfair deal scheme", is rapidly becoming unsuitable for our social care needs. Providers are warning of a tidal wave of nursing homes leaving the scheme. What does a tidal wave of nursing homes leaving look like? People are already struggling with a cost-of-living crisis, having to pay more and more on costs to look after the older people in their lives, their parents and grandparents and also people with disabilities. There are fewer beds in hospitals and more visits to emergency departments. That means more pressure on the healthcare system, which is already creaking under the pressure. People who worked all their lives are left out in the cold because the Government is reducing supports for them in their old age, putting less money into the fair deal scheme and making what are effectively cuts to their State pensions because increases have not kept up with inflation.

PwC found that since 2020, State spending on public nursing homes has grown significantly, while funding for the fair deal scheme has declined. This is not just about losing nursing homes and beds. We are creating a two-tier system, whereby nursing homes in the public system receive, on average, 60% more funding per resident per week than those in the fair deal scheme, according to two official reports published before Covid.

This is a massive difference in resources, and what does that mean for the residents and staff in these private and voluntary nursing homes? The report found that 60% of operational expenditures were staffing costs, and there was a clear difference in terms and conditions between equivalent roles in the private and voluntary nursing home sector, and publicly funded HSE organisations. If one has a high turnover, low pay, understaffing and poor working conditions, we know that this is going to have an impact on care for the residents. A 60% average difference in funding is massive. It is a clear double standard, and it is creating a clear two-tiered system for residents and staff in the public sector, and those in the private and voluntary sector.

The State will have a €65 billion budget surplus over the next three years, just in corporation tax alone. I have heard time and time again statements from the Government about how that money cannot be used to build the houses or hospitals we need, because we have an ageing population and we must save for our older people. The Government is speaking out of two sides of its mouth. It wants to save money for our ageing population, but when we are faced with a breakdown in the system which it wants to look after that ageing population, it is not prepared to meet the costs needed.

The Economic and Social Research Institute, ESRI, found that a 10% increase in per capitalong-term residential care bed supply could result in 19,000 fewer inpatient bed days per annum. Despite only accounting for 34% of acute cases, older persons represent 55% of hospital bed days. A proper social care system for the elderly would save money in the future, and so would implementing it before this gets even worse. There is a solution. The Government must fund the fair deal scheme properly in the short term to meet its costs and start to put the proper infrastructure in place now so that we can move to a proper, publicly funded social care system. It must guarantee that there is no two-tier system in care, that all staff get proper pay and conditions, and that we have a proper State-funded response to our ageing population, including me in the future. The Government would have the money, the ageing population is what it is supposed to be saving it for, and the Government should start spending it.

I strongly support the amendment put forward by the Social Democrats which proposes to carry out a review into the impact of nursing home privatisation and to introduce legislation to provide for a statutory right to home care.

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