Liam Quaide (Cork East, Social Democrats)

I commend the Independent Technical Group on its motion before the House today. I welcome the discussion of issues that are of such fundamental importance in the pursuit of a fair and inclusive society, and in how we value or fail to value the lives of our disabled citizens and our elders and, essentially, who we are as a society and as a republic. In this context, the means test for the carer's allowance, which is an essential support for those providing care to relatives, usually with chronic illness or disabilities, is unjust and should be abolished. Under intense pressure leading up to the election, abolition of the means test was included in the programme for Government, but we have yet to see clear movement on this. The carer's allowance is designed to support people who give up their own time and income to provide unpaid care for a loved one. This care work is essential to the health and well-being of some of the most vulnerable people in our society.

However, the current means test penalises low-income carers, often pushing them deeper into financial insecurity, rather than acknowledging their commitment, their hard work and the burden they are actually lifting from the State. The means test for carer's allowance currently takes into account both the income and savings of the carer and his or her partner. This system, although initially intended to target support to those most in need, has proven to be a further financial and psychological burden for many carers who fall just outside the eligibility threshold. The means test fails to reflect the true financial needs of carers, particularly when they are forced to reduce their working hours or leave employment entirely for the care of a loved one. Many carers who are providing essential care are left without the financial means to support themselves, even though they play a vital role in the healthcare system and make a huge contribution to our society.

Carers, particularly those in low-paid or part-time jobs, often live on the edge of poverty as a result of this. The current system does not take into account the increased costs that carers face, such as medical expenses, mobility aids and additional transport costs, all of which further aggravate their financial hardship. By abolishing the means test, the Government could provide all carers with a guaranteed minimum income, thereby ensuring that they can continue their work without facing this level of financial distress. The means test undermines the principle of equality by treating carers as though their contributions are secondary to the economy. Care work should be properly valued, not means tested. Everyone who provides care should be treated with dignity and respect, not subjected to financial hardship.

Nursing home care should be a last resort for older adults whose physical and cognitive needs are reaching a point where they can no longer live at home. I welcome the emphasis placed by the Minister of State, Deputy Kieran O'Donnell, at the outset of his tenure on the importance of facilitating older adults to live at home for as long as possible, and his commitment to a fair deal for home care. However, it is important that we see a clear timeline soon on the creation of this scheme. Older people have the capacity to live full, authentic lives, defined by connection, a sense of humour, community, purpose, creativity and intimacy, in stages of life where physical and cognitive decline are also taking place. There is a real human rights issue with the current system of mostly private nursing homes, many of which provide for basic care needs at huge financial expense but are not tuned in to the wider needs of the whole person.

There has been a consistent trend in the policies of successive Governments toward privatisation of both home care and nursing home care. Private companies account for approximately of 80% of all nursing homes, and provide 60% of all home care hours. The outsourcing of these core services to commercial for-profit entities results in poor value for money, low pay and precarious work conditions for the people who staff them. That does not bode well for the provision of care for our older citizens. The Government needs to act on the promises of Sláintecare and reverse the increasing privatisation of health and social care. At any one time, there are approximately 700 people in hospitals throughout the country waiting to be discharged, but who are unable to return home as there is no home care support available. As of the end of 2024, 6,000 people had been approved for a home care package, but were not receiving one as resources were not available.

Crucially, and this is a real human rights issue that is very close to my heart, we need to end the scandal of young adults with brain injury and intellectual disability stranded in nursing homes because community residential services are not available to them. This is a desperately sad situation, and another example of how much of a distance is opening up between our economic prosperity on the one hand, and the vindication of our disabled citizens' basic rights on the other.

I previously spoke in this Chamber about my work in the Peter Bradley Foundation, now known as Acquired Brain Injury Ireland, in Glenageary and Dún Laoghaire many years ago. Its residential services have had a transformative effect on the lives of people who would otherwise have ended up in nursing homes or living precariously in the community. Unfortunately, one of the despairing aspects of our work involved telling so many people who had been referred to the Peter Bradley Foundation that they were being put on a waiting list for residential services that were not available because there was a limited spread of services throughout the country, and it remains so.

In May 2024, there were in excess of 1,200 people with disabilities living in nursing homes. The ombudsman, Ger Deering, has warned that Ireland will look back with regret at how we treated these citizens. His office authored a report, Wasted Lives, on their plight. Mr. Deering has appealed to the current Government to include improved funding for the HSE to relocate these young adults. He said he was "deeply unhappy" with the funding allocated in budget 2025, and he warned that "a huge amount of work" in implementing the recommendations of the Wasted Lives report may have to stop as a result. People with acquired brain injury and intellectual disabilities should be able to avail of long-term specialised residential care in the community where that is needed. They should be able to live somewhere they can call home, where they can feel safe, form healthy relationships and pursue meaningful goals. They should be supported to fully take part in their local community.

It is very welcome to have this discussion today on an area that is of such fundamental importance to our values as a society, to human rights and to the essence of what we mean by "community". This is a subject that touches the lives of all families in the State. How we support our disabled citizens, our carers and our elders to enjoy life to their fullest will define - more than anything - who we are as a society.

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