Simon Coveney (Cork South Central, Fine Gael)
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Question 83: To ask the Tánaiste and Minister for Health and Children her plans for home care packages for the elderly; and if she will make a statement on the matter. [35376/05]

Seán Power (Kildare South, Fianna Fail)
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It is a priority of mine to support people to stay in their homes and communities and move away from the practice of placing people in residential care as a first option. This is the expressed wish of the majority of older people. I would like to see the further development of home care packages for older people.

The Mercer report on the future financing of long-term care in Ireland, which was commissioned by the Department of Social and Family Affairs, examined all issues surrounding the financing of long-term care. Following on the publication of this report, a working group chaired by the Department of the Taoiseach and comprising senior officials from the Departments of Finance, Health and Children and Social and Family Affairs has been established.

The objective of this group is to identify the policy options for a financially sustainable system of long-term care, including improvements in community care and home care packages, taking account of the Mercer report, the views of the consultation that was undertaken on that report and the review of the nursing home subvention scheme by Professor Eamon O'Shea. This group will report to the Tánaiste and to the Minister, Deputy Brennan, before the end of the year. It is expected that the report of the group will be submitted to Government in the near future.

Liam Twomey (Wexford, Fine Gael)
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None of my questions was answered. Put simply, who is entitled to this care, when will the scheme commence, how many people will be able to avail of it and in what areas will it operate? I was told I was wrong when I accused the Tánaiste six months ago of cutting 2 million home help hours from the home care budget. I have still not got a clear answer to how what I said was wrong. It appears that we are robbing Peter to pay Paul in regard to home care plans. It is simply a case of taking home help hours from one group of patients, dressing them up as home care packages and giving them to a new group of patients.

Are patients to be responsible for the home care packages or will they be given to a private service provider who will then be in charge of the provision of home care services for patients? I would be delighted if the Minister of State could tell me where the 2 million home help hours went.

Seán Power (Kildare South, Fianna Fail)
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We want to make the practice of placing older people in residential care the last option. All the studies clearly show that people are much happier in their own homes and communities among family and friends. Patients also recover more quickly from illness when they are in that environment.

The home help facility has been a wonderful success and has made a great difference to the quality of life of the people who avail of it. A number of home care pilot schemes have been in place and these have worked exceptionally well. In many cases there is not much difference in the cost of residential care compared with a home care package. It is our intention to improve on the provision of home care. The Tánaiste mentioned that we will increase investment in community based services. The home care packages and home help have worked well. We are getting extremely good value for money. It is also what the patients want. We will continue to invest in this area.

Liam Twomey (Wexford, Fine Gael)
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I am sorry but my questions have not been answered. For instance, what can we tell somebody seeking to avail of the home care package who comes into my constituency clinic or those of the Minister of State, Deputy Seán Power, Deputy Ó Caoláin or Deputy McManus, and who will be responsible for it?

Seán Power (Kildare South, Fianna Fail)
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I cannot give Deputy Twomey an answer on the floor of the House but, as I stated, a number of pilot schemes that have been in operation around the country have worked very well. A team is coming together in this regard. I accept this is a general question but I am not medically qualified and the medical situation of a person will have to be taken into account. We are seeking to expand the home care service and the number of packages that are available throughout the country. On who can avail of the scheme, that is very much dependent on the individual needs of patients, if they are high dependency and what exactly are the difficulties. If they can be looked after in their own home it is our intention that we would do that.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Has attention been given to establishing a team of people who would be available to provide home care services for those who need it? At present, the process is only set in train when a need is identified. With all the requirements, there is a delay of several months — certainly for Garda clearance the delay is at least two months. In the meantime a patient with an immediate need has to wait for this service to be provided. I have argued with the Health Service Executive in my area that a pool of people must be identified who would be available to give emergency support for somebody in need of care or to take up new opportunities, which need not be confined to care in the home but would also support people with disabilities who need assistance outside the home for walks or whatever the case may be. Has attention been given to that approach to speed up the process?

Seán Power (Kildare South, Fianna Fail)
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I think Deputy Ó Caoláin will agree it is important that we ensure those people providing help are fit to carry out that important work. I am aware of a company that recently set up here and has recruited a number of staff to provide a home help service. It appears it had no difficulty recruiting staff and that many people were available.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Should the Health Service Executive do that rather than a private company?

Seán Power (Kildare South, Fianna Fail)
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We would like to remove some of the bureaucracy that exists. If it is decided that somebody is in need of a home care package we would like the decision to be implemented as quickly as possible.