Donna McGettigan (Clare, Sinn Fein)

Recently, Home and Community Care Ireland, HCCI, published its new report and witness for home and community care throughout the State. Home and Community Care Ireland is an umbrella group for home and community care providers across Ireland. Its report is based on the latest available statistics. The report makes for grim reading, with almost 5,000 people currently waiting for home care, but what is of particular concern for me is that my constituency of Clare has a waiting list of 304, which when calculated per 1,000 people of population equates to 2.386 per 1,000 or 157% of the national county average. The lowest waiting list per 1,000 of population is Dublin, with 0.076. County Clare's waiting list is more than 3,000% higher than that.

HCCI has compiled reports on waiting lists for a few years but they were based on the total number of people on the waiting list in each county. Under that measure, Cork had the highest waiting list. This is the first report that calculates the HSE waiting list as a percentage of the population of each county. Since it is the first report of its kind, we cannot even say for sure how long this problem has persisted in County Clare. More importantly, we do not know why the waiting list is so much worse in County Clare, so that is the first question that needs to be answered. What is causing the excessive waiting lists in County Clare? If the Government does not know, what does it intend to do to research the problem and find out its causes?

These 304 are not just numbers. Behind each of them is a person who has been approved by the HSE for home care hours and yet cannot avail of this vital service to keep them in their own home for longer. Without this help, people's health can deteriorate, making them more likely to need hospital care or nursing home care. They may also face difficulties in being discharged because they cannot be sent back to their own home if the home care is not available to them. A spokesperson for HCCI said that they have heard of examples of where people have died while on the waiting list, only for their families to be later offered home care for them. This must be utterly heartbreaking for family members. They must feel like their loved one was completely let down and neglected by the State in their time of need.

The HSE issued a statement to the media in response to the HCCI report. We should not be reliant on the HSE to issue statements in the wake of a report like this about the lack of services that people have to endure to try to find out what is going on. The HSE statement may have been its best guess as to why the people of County Clare have been so neglected but a number of its assertions simply do not add up. It states that the mid-west has an ageing population and that is a contributing factor. However, other counties with higher age profiles have lower waiting lists. The Central Statistics Office gives a ratio for the number of people over 65 years of age to those under 65 in each county. County Leitrim, for example, has an age ratio of 28.4, according to the latest census data compared to a ratio of 25.1 for Clare, yet its waiting list is 1.254 and ours is 2.386. Let me be absolutely clear: the waiting list in Leitrim is far from acceptable. No one should have to wait for the care services they need.

The HSE's statement also implied that County Clare is a rural county but so is County Kerry. It has a waiting list of 0.676 per 100,000 compared to our 2.386, so ours is more than three times the waiting list of Kerry, even though both counties are rural.

The HSE is responsible for managing the waiting lists and for managing decisions to allocate home care to people in the first place, yet it seems it is not able to adequately account for the large difference between the waiting lists in each county. Even if we in County Clare does have a higher ageing population than anywhere else, and even if we have a more dispersed rural population than anywhere else, as the HSE seems to assert, it is still the job of the Government to ensure that Irish citizens have proper, full and prompt access to appropriate home care when they require it. Every Government has had access to census data for years, which was supposed to be used to plan for future needs, so why do we find ourselves in this unacceptable situation?

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