Seán Crowe (Dublin South West, Sinn Fein) | Oireachtas source

Adequate home care provision allows older people to live with dignity and respect in their own homes. Additional supports also contribute to, and are vital for, independent living. The Government has often repeated there is a commitment to introduce a statutory scheme to support people to live in their own homes and Government members cite the fact that it is in the programme for Government. Like others, I want to see it in legislation and being budgeted for, rather than in meaningless statements in the Dáil or Seanad. When parliamentary questions are put down on home care packages, we hear the same line again and again. This is not a new idea. The Sláintecare report was specific about ending the overreliance on market mechanisms to deliver new healthcare services through the expansion of public nursing homes and home care. That programme for Government is almost due for renewal and we have seen precious few results, despite the usual flurry of activity and noise the Government believes is just as good in many cases. A public consultation was held, and a pilot even tested almost two years ago. We are supposed to believe that recruitment to key posts is ongoing, even though the work of the strategic workforce advisory group itself has been hindered by the recruitment freeze in the HSE. We are told time and again that the Department of Health is still researching funding models. Genuine fears were expressed yesterday by Alone that this will only be a replication of the fair deal scheme, which it described as being inappropriately bureaucratic and unfair in such a situation. This is all to be published or done in coming months and the next election has to be held by March 2025. There are not many months left for this element of the programme for Government to be introduced.

The health committee is currently discussing the licensing of professional home support providers. Rather than ending the overreliance on market mechanisms, it would do the opposite by designing the home care regulatory system around the private market, further embedding privatisation. It is a charter for privatisation even though the health committee heard yesterday that delivery of an equitable statutory scheme will not be possible while there is an overdependence on private sector providers. This is another sector of the health services effectively privatised, forcing people who worked all of their lives to either fork out the money or turn to families who may not be in position to provide care themselves or afford that care.

Without access to affordable residential care or care in the home, people are forced into a hospital system that cannot afford to accommodate them and is unsuited to their needs. The awful phrase "bed blockers" is often used. Too many people are stuck in hospital beds when appropriate care can be delivered elsewhere. Hospital stays should be an option of last resort when people just need a little help to live a semblance of an independent life in their own homes. It should not be the last resort. Thousands of delayed discharges of elderly patients are creating bottlenecks in our hospitals each year because people have nowhere else to go. It creates a knock-on effect through the services, leading to cancelled appointments and surgeries because of a lack of beds. It is the worst lack of joined-up thinking. It also represents an abandonment of our duty to our older and more vulnerable citizens that it is often beyond the ability of many families to afford home care.

If we want to pay more than lip service to independent living, delivering care in the home, universally and free at the point of access should be one of the highest priorities for Government. Ireland has an ageing population, as others have said. We are lucky that our loved ones are living longer, but this presents its own challenges. We have to be proactive and plan for greater demand into the future rather than scrambling and failing to provide what is needed today. We must do better for our older citizens and ensure they have prompt access to home care. Leaving them waiting for support could have a detrimental impact on some individuals and is not right or in any way fair. The Government must stop burying its head in the sand on this issue, and finally prioritise older people and those with disabilities to ensure they get the support they deserve rather than simply trying to privatise anything that stays still long enough, just as it did with nursing homes and dental care. There is a lot more to do.

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