Paul Gogarty (Dublin Mid West, Independent)

Without carers, especially family carers, the burden on the State would be far greater. Over the years we have heard stories of people being placed inappropriately in geriatric wards or people who need more intensive care being sent home early because of insufficient spaces. Carers play a valuable role and unless we totally change our definition of what constitutes society in Ireland, it will never be every family for themselves and every individual without a family around them for themselves. We do see the value of supporting one another and this has a cost that has to be recognised. Many hours are put in for far less than the commercial cost of care, even allowing for the nature of the voluntary work and the ties that bind people caring for one another. That has to be said. Families will always care for each other whether or not they are getting any sort of contribution, but that is not the point. Families have a lot of pressure and they are the forgotten heroes.

An indispensable contribution is also made by care workers in alleviating pressure on hospitals and long-term residential care facilities. Carers, paid and unpaid, are under pressure. Those on lower incomes are disproportionately affected by the current system of means testing and some illogical decisions. I have one constituent, for example, who works 20 hours a week and is also a half-rate carer. When she went on maternity leave, her carer's allowance was cut because of the double rule, even though in the months following she would be caring for her relative and minding a child. One way or the other, the caring work continued, but she did feel the pressure as a result.

There is also the issue of insufficient respite hours, as Deputy Richard O'Donoghue has mentioned. The Minister of State referred to the €62 million allocation but when this is spread out, it does not really give enough support . The carers' guarantee in the programme for Government is, of course, welcome. I also welcome the fact the Government is supporting this overall motion but looking at this sector holistically, we are adding unnecessary costs and burdens to the State when targeted funding could probably save money overall. For example, because of inadequate funding to service providers, we have staffing shortages. This may affect the rural areas more but it is also an issue in urban areas, with insufficient hours allocated and sometimes home care visits rostered at hours totally unsuitable to the person receiving the care. Heavy traffic can also mean that an allocated hour is cut short by 15 to 20 minutes.

The HSE has increased its dependence on outsourced companies to provide valuable services. Some of these companies are more focused on the monetary aspect and I have found it difficult to engage on behalf of constituents to try to get a response when raising issues. Others provide a dedicated service and there is absolutely no questioning the commitment of the workers themselves. If the pay is poor, however, we will not get the level of staff required. It is worth focusing for a while on the differential between the section 38 organisations, funded by the HSE, where pay is subject to public service agreements and where the workers receive the same pay increases as other public sector employees, and the section 39 organisations, which receive grant funding from the HSE and whose employees are not considered public servants. They are not subject to public sector pay scales and their pay is negotiated between individual organisations and employees. Going back to the 2008 financial crisis, there were pay cuts across the sector, including in section 38 organisations. Section 39 staff, however, did not get the same level of pay restoration, which has led to a significant pay gap. There have been some efforts to address the pay gap but the section 39 organisations continue to struggle with attracting and retaining staff due to lower pay and conditions compared with the section 38 organisations. The pay disparity has led to reduced capacity to deliver services as section 39 organisations have often struggled to recruit and retain the skilled staff.

If we do not provide the means to support people in the home, there is often increased pressure on nursing homes, with increased numbers of people needing to avail of the nursing home support scheme, the fair deal, yet the HSE does not respond. Caregivers Ireland organised weekly protests outside Lucan Lodge in an effort to get the HSE to take over the facility as a going concern but this did not happen and families were forced to scramble for places. Unfortunately, a number residents passed away within weeks of being moved. That is not service.

This motion addresses the financial challenges leading to many nursing homes closing. I support this aspect, but we do need a full rethink and a proper cost-benefit analysis of the entire homecare system and support structures. It is saving the State money, money that we apparently do not have in the bigger scheme. We need to focus funding in the best way possible to support families caring for loved ones and ensure that the dedicated staff are able to continue working in the service. I very much welcome this debate and do hope the Government will respond, as well as accepting the Independent Ireland motion.

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