David Cullinane (Waterford, Sinn Fein) | Oireachtas source

I thank the Labour Party for tabling the motion. The backdrop to any discussion we have on healthcare and healthcare delivery is obviously tainted by the fact that in the recent budget there was very little, if any, new funding for new measures across the healthcare system.

The Government took a deliberate decision in the budget not to provide additional funding for new measures or even to provide enough money for the health service to stand still. We know that will have consequences. We can see it with a recruitment embargo in some areas of the front line already. During the summer months, 2 million hours of home care were sacrificed because of changes to the home support tender. There has not been any significant increase in home-help hours either in last year's budget or this year's budget. Many of the 5,000 people waiting for home-care support are waiting for intensive home-care packages, which they cannot get.

I will pick up on a point made by Deputy Sherlock because it is one I also want to make very forcefully. How did we arrive at the position where the vast majority of care for older people outside of hospitals is delivered by the private sector? That is not a reflection on the private sector. People who operate and work in it are trying to provide the best services for older people and they do their best. I am not calling into question the quality of the care. However, there is a responsibility on the State to provide adequate infrastructure, capacity and supports for older people.

Not long ago, Sinn Féin introduced a motion on nursing homes. The vast majority of nursing home beds are private rather than public. We have not provided anywhere near the number of public beds we need and the same applies to home care. The vast majority of home support is not delivered by HSE personnel but by non-HSE community, voluntary and private for-profit organisations. All the problems are the same. Whether it is nursing homes or home care support, one of the big challenges is recruitment and retention of staff. We have this merry-go-round where we talk about this issue all the time, going around in circles and failing to solving the problem. We need to rebalance the scales as regards public versus private capacity because the best way for the State to control care and ensure older people have the best care and the care they need is to have more public capacity. I support my colleagues in the Labour Party who spoke using very similar language.

Another issue with home support is the number of hours that are available and whether people are getting what they need. There is a big difference between what the established need for a person is and what that person gets. There are many people on waiting lists but many of those who are getting home-care support are not getting the support they need due to staff shortages and because organisations, including the HSE, are trying to cut their cloth according to measure. That flies in the face of Sláintecare and what we need to do to better manage our healthcare services and ensure we are getting bang for buck for the money we spend.

The Labour Party motion notes that we do not have a statutory home-care scheme. Such a scheme was clearly provided for in the programme for Government. I have no idea when it will be brought in but I want it to be brought in-----

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