Jennifer Whitmore (Wicklow, Social Democrats) | Oireachtas source

I thank the Independent Group for bringing forward this really important motion. Most families across the country have experienced pressures either from a childcare perspective or from an elder care perspective so this really important motion. I will cover both aspects of this motion today.

Regarding elder care, in January the ESRI found the 74% of all nursing home beds were provided by private providers which is 14 operators providing 40% of all beds nationally. Those figures should have set off alarm bells in the Department regarding the consolidation of nursing home ownership, but instead we get more of the same - express concern but do nothing.

I accept that the commission on care has finally commenced which is welcome but major shortcomings in the current model of care have been evident for some time. The impact of the pandemic should have led to a more community-focused approach to long-term care, but the over-reliance on private nursing homes continues. Increasingly we are seeing this wealth extraction facilitated and even encouraged.

Large nursing home operators, many of which are financed by international private equity, now dominate the market which is forcing more and more independently owned nursing homes to close their doors. Between February 2020 and December 2022, the ESRI found that almost one in five smaller private nursing homes had shut down. This rapid decline disproportionately impacted rural areas. I am equally concerned about the lack of available alternatives to nursing home care such as home care and new models of supported housing. A statutory right to home care was supposed to have been delivered in 2021. This was then pushed out to 2023 and now in 2024 we still do not even have the heads of the Bill. It is not even listed for priority publication in this Dáil term.

While home care hours and funding have been increased since 2020, waiting lists remain stubbornly high. In February more than 5,500 people were approved for a home care package but no carer was available. I do not know if the Minister of State has ever had the experience of getting a letter through the door to say that a loved one is entitled to care but unfortunately there is none to give them. It is heartbreaking when that happens.

These staffing challenges have only been made worse by the regressive HSE recruitment freeze. February's progress report on the implementation of the strategic workforce advisory group report showed that three of the 16 recommendations are on hold due to the recruitment freeze. This includes recommendation 11 to significantly increase the proportion of home care hours provided directly by the HSE. This is just another example of the Government's shortsighted thinking leading to rampant outsourcing of services.

The perennial crisis in health and social care services will not be resolved by starving the HSE of funding. Decades of underinvestment in public healthcare infrastructure got us into this mess and the solution will not found in repeating that mistake. My Social Democrats colleague, Deputy Shortall, has tabled an amendment to that effect and I hope this can be supported when the motion is put to a vote.

Regarding childcare, the fundamental problems that we see in both elder care and childcare in this country pretty much stem from the same basis and that is the fact that these are, and should be, fundamental public services that we are somehow trying to squeeze into a private hole and it is not going to work, When trying to make changes to that system, they are done in a piecemeal fashion and that does not solve the problem. While I welcome the Government's focus on childcare, and I acknowledge the Minister, Deputy O'Gorman, has done a lot of work in that area over the past number of years, it is just never going to be enough. He is never going to fundamentally fix the issue of childcare provision in this country by purely working within the current system because the current model is not the model that will deliver best for parents or, indeed, staff and providers across the country. Ultimately, we should be move towards a public model of childcare provision, which is where the Social Democrats believe we should be going. It is only once we get to that point that these issues will be resolved. I acknowledge there have been efforts by the Government to focus on the cost element. It has not gone far enough. It has not made as much of a difference in people's lives as it should have but I welcome these steps. It is not just about cost; it is also about availability and flexibility. The reality for many families throughout the country is that there just is not the availability of childcare provision. The downside and the pressures this brings on families is placed primarily on the mothers. What it means is that oftentimes mothers are unable to return to work because they cannot either find or afford childcare.

I am going to refer to Wicklow because it is my constituency and not a week goes by where I do not have contact from a parent or indeed a provider in the county who is expressing concern about the direction of travel within childcare and telling me about their own particular experiences when it comes to this issue. I recently spoke to a mother who is a teacher and she cannot go back to work. Despite signing up for childcare provision for her baby when they was born, paying a deposit and being promised a place from August 2024, she found out in the past month that this will not be available for her until 2025. The knock-on impacts of not having that provision available is incredible because not only will that mother be at home now but we are also down a teacher. The impacts are clear. There are fundamental structural elements that need to be changed.

The other issue that comes up frequently for me is flexibility. We have reached a point where many people work from home maybe one or two days per week but if they are with a crèche or a childcare provider, they often have to pay for the full five days. That puts enormous pressures on and negates the benefit of someone being able to work from home a couple of days per week. Something we need to consider when we are looking at the childcare model is exactly what we want and who it should serve. Ultimately, it should serve parents and children. Once we get it right for them, we will get it right for everyone. We need an affordable and flexible service that is easily available to people, not something that they have to essentially put their names down for before the baby is even born.

Another issue I have experienced locally is that the current reforms are preferencing the larger providers and disadvantaging the smaller providers. Even within the larger providers they are disadvantaging the less profitable aspects of it. A number of after-school services close down, which again means that many mothers are restricted in where and when they can work. There are all these small knock-on effects and we need to examine the childcare sector as a whole to make sure we provide a service that is fit for everyone and meets everybody's needs. Ultimately, the Social Democrats and I believe that until we get to a point where we have a fully publicly provided childcare system, we are really just tinkering around the edges and will not get it right for anyone.

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