Fergus O'Dowd (Louth, Fine Gael) | Oireachtas source

This is a very important debate and I congratulate the Minister of State, who is an advocate for the care of older people. She has a difficult job and she fights her corner, and I will certainly always stand up for her in that respect. I have great admiration for her.

The care of older people is critical, but the way they have been treated is appalling. If we look at the facts that Alone put into this debate with a report regarding people who are at home and need their homes to be adapted for their care, the Government allocated €97 million for that in the budget for this year but it is going to cover only 13,000 home adaptation packages, whereas in 2010, 13,500 were covered. There is a huge issue with funding to keep people in their homes. We should keep them in their homes physically because the environment is suitable, with the professional care they need, and keep them out of acute hospitals. Home care is especially important because where it works, there is a significant reduction in the number of acute hospital presentations by people who are elderly or have a disability. According to the Irish Independent this week, only 44% of elderly people discharged from our acute hospitals go home. A total of 22% go into nursing home care and the rest go into the homes of friends or relatives who look after them.

There is a huge issue here. It is an unmet need, and the Minister of State is going the right way in saying the care that is needed into the future should be free at the point of contact. A person should not have to put his or her house into hock to get home care. Most of these people have worked all their lives. They have reared their families. Why in the name of God should they be lumbered with additional penalties because they are getting older? We should support them 100%. I am opposed to charging individuals who, unfortunately, need this care. The tax burden should be equalised and social welfare contributions over the course of one’s working life should meet those future needs in order that the cost will not fall on any one individual who is unlucky enough to be unhealthy in the context of having a significant disability or illness and having to stay at home. Keeping people in their homes is of great benefit to individuals, their families and their communities. They will be in a place they know and love and where they are cared for. Putting them into a nursing home is the last thing that should happen to anybody. It should be almost impossible to get into one because the quality of care should be such that services are provided in the community.

Denmark is a model for this, to the best of my knowledge. I asked the Oireachtas Library and Research Service to do some work on this issue for me. Home care is free at the point of delivery in Denmark. Most of Denmark's nursing homes have been closed because people are looked after at home. Their needs are met there and it is where services are delivered. The number of acute hospital admissions in Denmark is down because John or Mary, for example, is not going into an acute hospital late at night at the weekend. They do not have to go into acute hospitals because they are being looked after at home and their needs are being met there. An awful lot of the people who, unfortunately, will be lying on trolleys in our hospitals in the future will be elderly people who should be at home and should never have been in those hospitals. If we can intervene at an earlier stage, we can support them. I believe that is what the Minister of State wants. It is what I want, too.

There are lots of issues with privatisation. The proportion of people in privately run nursing homes is 85%. Only 15% are in publicly run institutions. We must take over nursing homes, like the one in Lucan Lodge that can no longer be managed by the private company. I do not see why the State should not go in there, take it over, do the deal and provide the quality service that is required. We need a policy of State-supported and State-run services, with the quality of services the State can provide. Every private nursing home has, on average, three times more healthcare assistants but only one third of the nurses needed. When nursing home owners say they are not making money, I do not believe them. They certainly do not have the qualified staff they need, whereas there are such staff in public sector services. They criticise the public sector for excellence in care and that is a reality we have to face as well.

I know my time is short. Can I take more time, a Cheann Comhairle?

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