David Cullinane (Waterford, Sinn Fein) | Oireachtas source

First, I want to commend the Women's Parliamentary Caucus, and the chair and vice chair, on their work on this comprehensive motion that raises a number of issues across the formal and informal care sectors. I welcome the debate today on behalf of Sinn Féin. I express our support for a rights-based approach to care, and the right to care.

I am glad that the Minister of State supports the principles in the motion but I have three major problems with the Government's doublespeak on these issues. First, Government parties have failed for nearly 20 years to ratify the optional protocol to the United Nations Convention on the Rights of Persons with Disabilities. Second, the Government has failed to regulate the home care sector, to provide for statutory access to home care, and to reverse the privatisation of that sector and the long-term residential care sector. Third, the Government has failed to move from an eligibility-based health and social care system to an entitlements-based system, as we all agreed should be a part of Sláintecare.

The fact is, this Government sees rights as a dangerous risk to the Exchequer, as is evident in its abysmal record on services for people with disabilities. There are 6,500 children on waiting lists for an overdue assessment of need and 5,000 of them are waiting over a year. When their parents had the audacity to challenge the Government's failures under the Disability Act 2005, as the Government saw it, it forced them to back down or take the State to the courts, with all the financial risk that this entailed. Eventually, some brave parents did exactly that and they won. The consequences for the HSE have been enormous because it is not capable of servicing the level of need that is out there due to decades of neglect. There are 15,000 children waiting just for initial contact with their special disability team. Some 10,000 of them are waiting over a year. Nearly half of those children live in north Dublin or in the south east. They are in East Wall, Ballymun and Blanchardstown, or Waterford, Wexford, Carlow and Kilkenny, some of the most underserved and disadvantaged communities in this State.

Children from hard-working, working-class families whose parents cannot afford private care have been deprived and forgotten. When the Government inevitably says, as the Minister of State did, that an assessment of need is not required for access to services, the Minister of State is deliberately speaking beside the point because there is no access to services either, not to mention that it is required for the Departments of Education and Social Protection.

When I ask the HSE how many children and adults are waiting for other disability services, I get the same predictable reply that there is no centrally-maintained waiting list for these services. One could be forgiven for thinking that this Government just does not want to know. Behind every number is a child or an adult and parents in need of services and support who are being completely ignored. Is it any wonder that Fianna Fáil and Fine Gael have refused to ratify the optional protocol to the UNCRPD, for fear that someone might force them to recognise the rights of people with disabilities, to plan for their needs and provide the supports and services they deserve? This attitude underlines exactly why there should be a legal right to care, a legal obligation on the State to provide care, and legal recourse where the State fails to provide that care.

As with disability services, this Government has failed to deliver sufficient quality care for older people or put in place a statutory home care scheme.

These people have worked and contributed throughout their lives and expect little but get even less. The Government has not adequately regulated the home care sector. It only belatedly mandated a living wage for home care workers this summer and paid for it by cutting the overall budget provision for home support hours. The Government failed to link these standards to home care services for people with disabilities, which means it now expects providers and carers to do the most complex work for less pay. By delaying the regulation of home care and cover of travel and subsistence for carers on the same basis as direct HSE employees, the Government is punishing the non-profit community sector for offering higher employment standards at a time when enough home care workers cannot be recruited or retained. Not only has the Government failed to take advantage of the non-profit sector, it has also pitted it in a race to the bottom against for-profit providers. Over decades, Fianna Fáil and Fine Gael have repeatedly offered up the care economy as a cash cow for wealthy investors. This Government has no notion of rights-based care. One of the few provisions in law for a rights-based approach is for children in the assessment of need. The Government's track record since the enactment of the 2005 Act, which provided for that right, is awful. A High Court challenge found that the Government was in breach of the law. That speaks volumes.

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