Frank Feighan (Roscommon-South Leitrim, Fine Gael)
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I ask the Minister for Health and Children how much longer elderly people will have to remain on home help priority waiting lists in counties Roscommon and Leitrim, my constituency area, before home help is made available. Is the Minister aware that persons in their late 80s and 90s are on this list for months? This must be resolved immediately.

In recent months my office and I have dealt with several issues regarding home help which I want to put on the record of the Dáil. Elderly people have been on waiting lists for months and remain on the lists until they can no longer cope and must go into nursing homes. Only very high dependency cases get home help cover for annual leave, which is unsatisfactory. There is no cover for Saturdays and Sundays unless palliative care is required. Primary care teams have been rolled out in Castlerea and Ballaghadereen, and more will follow in Boyle, Monksland and areas of Leitrim, which I welcome, but no extra funding has been granted for home help, which should be part of the primary care team package.

I know a lady who is 99 years of age and living in my home town of Boyle. The public health nurse requested a few hours home help for her and she was assessed and put on the waiting list five and a half months ago. She is still on that waiting list, which is unacceptable. The family of an elderly lady in Leitrim sought a few hours home help. When the HSE assessed her needs, home help was granted but just six weeks later it was withdrawn and she was left to fend for herself again. A person in Ballaghadereen, County Roscommon, who provides care for her family 24 hours a day, seven days a week, sought just two to three hours home help to allow her to do the shopping, make visits to the doctor and so on. An assessment was made and the family member involved was put on this endless waiting list.

A man in Castlerea was assessed and approved for five hours home help last May. He was put on the waiting list and as a result of not getting a few hours home help as a back-up, he is depressed and in care of the psychiatric services. A member of another family asked for a few hours home help but, on stating that if home help was not forthcoming her parents would have to go into a nursing home, was told categorically as this would not be coming out of "their" budget, it would not affect the home help department. An elderly person was in Sligo Hospital. Her family applied for home help and a discharge but she was put on the long waiting list when, but for the lack of a few hours home help, she could have returned to her own home.

Having checked with families before this debate, I know of several elderly people on a waiting list for home help who could not cope with the long list and were forced to go into nursing homes. I have the names and addresses of all these people, of whom there are many more. The Minister of State, Deputy Hoctor, would agree this is unacceptable. We are trying to keep people out of nursing homes and hospitals. This is about value for money. Every day, like other Deputies throughout the country, I am dealing with this serious situation. Everyone claims it is a result of the budget, and that it has nothing to do with them or is the responsibility of another Department. I call on the Minister of State to resolve the situation. If she does, I will thank her and appreciate it. Value for money is the issue. Many families are waiting on extra home help hours. The sooner this impasse is broken through, the better. I thank the Minister of State for attending and look forward to her response.

Máire Hoctor (Tipperary North, Fianna Fail)
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I am taking this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney. I thank the Deputy for raising the issue as it provides me with an opportunity to reaffirm the Government's commitment to services for older people generally and, in particular, to the important area of the home help service, even in these times of economic uncertainty.

Government policy in regard to older people is to support people to live in dignity and independence in their own homes and communities for as long as possible. Where this is not feasible, the health service supports access to quality long-term residential care where this is appropriate. This policy approach is renewed and developed in the latest partnership agreement, Towards 2016.

The Government's objective of continued development of community-based services for older persons is reflected in the funding given to the system in recent times. In budgets 2006 and 2007, more than €400 million was provided to enhance service developments across the sector, of which just over €190 million was for community-based services over these two years. Budget 2008 allocated in excess of €20 million additional funding for community-based initiatives for older people, bringing the total additional funding allocated for this area to more than €210 million for the three-year period 2006-08. These measures have been designed to both enhance existing services that the Government had already put in place and to widen the range of services available to older people.

Home help is the backbone of community-based services and includes a range of essential services that make all the difference to the quality of life of each recipient. In 2006, almost 11 million home help hours were provided. In 2007 the number of hours provided increased to 11.78 million. In the first nine months of this year, to the end of September, more than 9.2 million hours were provided by the Health Service Executive, which is an increase of 3% over the same period in 2007. The executive estimates it will provide in the region of 11.9 million home help hours this year, which translates into more than 990,000 home help hours provided each month nationwide. This unprecedented level of service has been made possible due to the significant new funding — in excess of €55 million — in the past three years, and benefits more than 53,000 people annually. The HSE provided some €4.6 million additional funding in its 2008 service plan to expand the home help service around the country.

I understand the HSE has provided, in the period January to September 2008, a total of 195,000 hours to clients within the Roscommon local health office area. Each person who is referred to the local executive office has a full assessment of need completed. Cases are prioritised based on need and a service is provided in line with allocated resources. A total of 20,600 hours were provided in Roscommon in September in respect of approximately 850 clients, and there are currently 110 clients on the waiting list in that area for home help hours.

Figures in regard to Leitrim are collated for the entire Sligo-Leitrim local health office area and, therefore, current statistics are not readily available separately for Leitrim. I understand from the executive, however, that in 2007 just over 600,000 hours were provided for 2,283 clients for the Sligo-Leitrim area. In the region of 415,000 hours have been provided in this local health office area in the period January to September 2008. A re-assessment of needs in Leitrim is undertaken on an ongoing basis using recognised assessment methods. Clients with high priority needs are approved on receipt of applications. The HSE has indicated there are currently five people on the waiting list for home help services in Leitrim.

In conclusion, it is clear from the information I have outlined that the Government has made considerable improvements nationally to enhance home help provision. There is no doubt demand can at times exceed service resources. However, it is a matter for the HSE to deliver services both nationally and locally in the context of its evolving priorities and overall resources, and taking account of the individual circumstances of each applicant.