Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I move:

That Dáil Éireann:- recognising the right of older people to live in dignity and independence, and to age well, in their own homes and communities and for as long as possible;

- knowing that 91 per cent of older people rely on the State pension and related supports to protect them against risk of poverty;

- understanding that home help and home care packages are vital, not only to enhancing the quality of life of older people and supporting their preferred wishes, but also to reducing pressures elsewhere in the health care system, including acute hospital services;

- commending the work of home helps, home care providers and carers who care for the needs of our older people and those in infirmity;

- acknowledging that the demand for these services, and for additional supports such as meals-on-wheels, day and respite care, will continue and will increase as the demographics and complex needs of older people change;

- accepting that the Government, despite the economic challenges, must maintain and improve, by all means possible, the social fabric of Irish society, caring for and cherishing people with disabilities, their families and others in need;

- condemning the recent Government decision to cut up to €1.7 million in funding for home care packages and approximately €8 million in funding for home help hours between now and this year’s end, equating to some 450,000 hours of support for those in need, and which, further to cuts implemented in January, will see almost 1 million hours of home help hours withdrawn over these 12 months; and

- recognising the devastating impact these cuts will have on the quality of life and general well-being of those affected;

calls on the Government to:

- immediately reverse the cuts to home help hours and home care packages and to return funding to pre-Budget 2012 levels;

- maintain, develop and enhance home care front line services and to guarantee continued reliable access to community care for older people; and

- draft, publish and implement a national positive ageing strategy before December 2013.

For those availing of these services the importance of them cannot be exaggerated. Having a home help person in the home for a couple of hours daily to provide social interaction, practical help and real support is invaluable to the beneficiary. These people facilitate older and infirm people living an independent life with dignity and, as is their wish, in their own home. They are a fundamental corner stone of the community-based primary care approach to health care and well-being, one which this Government, at least in words if not deeds, claims to espouse.

Those deeds tell a different tale. Since a peak of 12.5 million hours in 2008 this and the previous Government have led a sustained attack on vital home help services. If the proposed cuts go ahead as planned a staggering 20% of hours will have been removed from the service over four years. Significantly, this process of cuts has accelerated under the watch of the Minister, Deputy Reilly. Since coming to office he has signed off on the removal of almost 1 million home help hours. These figures are a damning indictment of the Minister’s approach, his ideology and his management of our health services.

The Minister must recognise that home help personnel make an immeasurable contribution to the quality of life, health and overall well-being of recipients, the social fabric of this State and to the economic viability of our health services. He did so while in opposition. In 2011, as spokesperson on health for Fine Gael, he told reporters at the launch of the Irish longitudinal study on ageing, TILDA, that home help "maintains people at home, giving them dignity and independence and also saving the taxpayer a lot of money". One can only speculate as to what has changed his mind in the mean time, as he is now apparently content to see those availing of home help services live without the same degree of dignity or independence he once lauded.

The current strategy seems to be one of burning the candle at both ends. It is absolutely clear that home help services, through home help hours and home care packages, save this State hundreds of thousands of inpatient and long-term care bed days. As the Minister proposes to cut services at one end in community care, services at the other end are being cut too. Acute hospital and public nursing home beds, respite services and convalescent care are all being cut. Reports earlier this year indicated that more than 93,000 bed days were lost in our acute hospitals in the first four months of 2012 because hundreds of patients were unable to leave due to delayed discharges. The system has already seized and these cutbacks will add exponentially to this.

At a recent meeting of the Oireachtas Joint Committee on Health and Children, the designate HSE director general, Mr. Tony O’Brien, passed off these latest home help cuts as not affecting those in receipt of service. This is a complete and astounding misrepresentation. We are seeing services for individuals cut to the bone. For example, 30 minute services have been cut to 15 minutes and weekend services have been curtailed for families in receipt of the carer's allowance. Mr. O’Brien and his colleagues in the HSE might argue that, technically, services are not being withdrawn, but those who rely on them know the true story is very different. It is absolutely clear that anyone who thinks that 15 minutes is an appropriate allocation has neither an adequate understanding of nor the slightest appreciation of the role and importance of these services. It is an insult. Similarly, the numbers of those affected by these cuts is underestimated due to the exclusion of those on waiting lists or those who would otherwise be due a home help or home care package in the next number of months. The non-allocation or delayed allocation of services is a well-used tactic to hide the full extent of these cuts.

We cannot avoid the backdrop to what is unfolding. Make no mistake about it, these cuts are being introduced principally as a result of the Minister’s failure to deliver on his own commitments and that of the Government. He failed to deliver the €124 million in savings on the drugs bill this year, as mooted late last year. He failed to deliver expected savings from the cost of private care in the public health system, again as mooted late last year. These two items alone would have negated the need for these heartless cutbacks affecting some of the most vulnerable in our society. The then HSE chief executive, Mr. Cathal Magee, reminded the Minister of this fact repeatedly before his resignation. Instead the Minister’s inaction led to the health budget falling far short, yet again. The more things change the more they stay the same.

Finally, I make special mention of those many thousands of home help workers, mainly women, who have been faced with cuts to their hours and wages and ever-increasing challenges to balance their family budget. I acknowledge the presence of a number of those very special workers in the Gallery. The crisis in the health budget does not occur in a silo. Its effects are far-reaching. Widespread reports and evidence of the privatisation of these services is consistent with the Minister’s approach. I would have thought it is not consistent with the approach of the Minister of State opposite, Deputy Kathleen Lynch. The much vaunted commitment to primary care, care in the community and care in the home has long been tempered with the caveat that these services should be delivered through the private sector. I commend the resistance shown by workers and service users alike to that disgraceful trend.

This Sinn Féin motion recognises the role and importance, socially, health-wise and economically, of home help services and calls for the immediate reversal of these cuts. I urge all Deputies to support the motion in clear recognition that these cuts do not make sense. Vulnerable older people will be forced from their homes into expensive institutional care and workers will be forced into greater hardship. The Minister was delighted to announce yesterday savings of some €16 million on the drugs bill before this year’s end, a fraction of that promised earlier. Nevertheless, this is twice the proposed cut to home help hours. The Minister should now give proof of his commitment to community care and care in the home and use this money to reverse these cuts immediately. I urge Deputies present to use their respective good offices to urge the reversal of these disgraceful cuts to home help hours and home care packages. I urge all Deputies, both Opposition and Government, to support this motion.

Seán Crowe (Dublin South West, Sinn Fein)
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During the last general election I called to a door on one of those wet miserable nights. Up to that point, people were not really engaging. I came across a woman who was a carer and who was livid about the cuts in services. I met some carers about a half an hour ago who spoke about the difficulties they faced in what they were being asked to do. Many of them said they were basically being asked to work for nothing and that it was wrong. They were also being asked to make a choice in regard to patients, in many cases elderly ones, who they were looking after. The choice was whether to spend more time with them, which is the human thing to do, or to go home to their families. In many cases, the carers spent more time with the patients at the expense of their own family life.

I spoke to that woman after the general election and she said she noted in the programme for Government that the Government would maintain, if not increase, services. I spoke to her recently and she was again livid but with this Government. The change she voted for did not happen.

I spoke to her about a family I called to in my constituency. The man was released from hospital, he could not walk, was carried up the stairs and left there. His wife used a walking stick, was an alcoholic and could not look after herself while his son was a drug addict. That man was sent home to those conditions. I visited the house. There was no fire lighting and the man was starving.

I raised the issue with the Health Service Executive in the area and asked how this could happen in this day and age. People informed me that individuals looking for care or care in the community have no rights. That strikes me as crazy. This man was released from hospital, which cleared a bed, but was he released to be sent home to die or was he supposed to be released into an environment in which people looked after him? There are 7,500 people living in that same area but it does not have a primary care centre or a doctor. This man was released into that environment. Meals-on-wheels are not delivered to that area. Thankfully, help arrived eventually but it was a long time coming. We have money for many things but people cannot understand why do not prioritise this area.

We seem to be contradicting ourselves in what we are doing. A decision was made to close St. Brigid's, Crooksling, which looks after women with dementia, many of whom are high dependency, and patients in Tallaght hospital were told they could not be moved there. I am glad that decision was reversed and it will remain open. It did not make sense. The home was supposed to close because of a lack of money but more was spent keeping patients in beds in Tallaght hospital. It would cost a fraction of that amount to keep those elderly women in St. Brigid's. What we are doing does not add up. People deserve our help. We need cross-party support for the work the Minister of State, Deputy Lynch, is trying to do. We need to legislate and give people rights.

Dessie Ellis (Dublin North West, Sinn Fein)
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I am ashamed to be a Member of a House which has to debate whether we give dignity and care to our vulnerable older citizens. Life is a cycle. As they grow older, people become more dependent on others to support and to help them. It is natural, especially for generations which lived and worked without the strong protection of legislation on health and safety or workers' rights. How many of our parents slaved in England or elsewhere in terrible conditions, with no consideration for their health from the bosses? How many worked at home for decades in such conditions, unprotected by a State which was not the Republic dreamed of by their fathers and mothers before them? Fortunately today, the needs of many of these people are cared for. They have support from a family member or a home care professional, allowing them to live in dignity, in their home and with whatever level of independence they have succeeded in maintaining.

However, many who require these supports are not adequately resourced, either losing their care package, some care hours or never being considered for one due to cuts to the service. It is shocking and disturbing that we can spend a single penny of the people's money before we have ensured that our older, more vulnerable and needy citizens are supported, protected and cared for with dignity.

Before entering Government, the Tánaiste, Deputy Gilmore, lauded those who marched to protect their medical cards as a universal entitlement for all people over the age of retirement. He told them of their courage and of how they had earned their place in Irish society through decades of hard work. I am not sure how such sentiments square with a cut of €1.7 million in home care packages and approximately €8 million in funding for home help. Those figures, given the huge cuts going on in Departments generally, can get a little bit lost in translation. How much is €1.7 million in home care packages and €8 million in home help? How far does that kind of money stretch when providing these services to vulnerable older people? The figure of hours cut by this Government in help and support for older people is devastating - 450,000 hours. That is 51 years worth of working hours to help and support our elderly population.

What is worse is that this is just a portion of the devastation this Government is reaping on help hours. In January, 1 million hours will have been withdrawn in 12 months. I do not need to illustrate again just what that means but it will be terrible for many older people who need help.

This Government often accuses my party of being over the top, of exaggerating and of scaremongering but how can it claim this? These cuts are not something we should just put up with. We must shout as loud as we can in opposition to them. They are callous and they are weak positions to take in that the people affected by the cuts are the old and dependent. It is an utter condemnation of this Government and this State that people who have worked all their lives and who have struggled and fought for our future are, when it was their turn to be supported, being given up on.

A total cut of €9.7 million in funding was recently announced. Sinn Féin has repeatedly highlighted large areas for cuts and tax increases which would allow us to pay for the care of our older people and give stimulus to the economy. Growth in our economy caused by stimulus would give us the hope that in the future weak Governments, like this one, would not target so blatantly those who cannot defend themselves.

The Government should listen to the calls of the people working in this sector, those who give everything they have to their clients and who nurture and care for them as if they were their own and for little reward and, certainly in the case of this Government, little respect.

The Government should also listen to the call of the families who are doing their best, as they struggle in these harsh economic times and try desperately to give comfort, support and dignity to their loved ones. It should finally listen to the older people who rely on this care and depend on this funding. The Government parties should listen to them and their pleas that they deserve dignity. The fundamental basis of the idea of human rights is that we all are deserving of the most basic human dignity. Cuts like these strip that dignity for good people who have done nothing to provoke attack. I ask Members to support the motion.

Martin Ferris (Kerry North-West Limerick, Sinn Fein)
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The amount being cut from home care and home help services is relatively small relative to the overall scale of the cuts being implemented but they will have a significant impact across the country. Just as strategic public spending has a positive multiplier effect in terms of the overall economy, cuts have the opposite impact beyond the initial scale of the money involved. Not only will the scaling back of the level of home help have a negative impact on the lives of the elderly who depend on this service for both practical and indeed social support, it will also further cut into the incomes of households which are under pressure and for whom the payments for their service contribute to the ability of low income families to maintain some quality of life.

There are an estimated 800 home helps in Kerry and several hundred more in the part of Limerick which I currently represent. In the context of hours spent helping the elderly and the lost income, a relatively large number of people will be directly affected by this retrograde step. Home helps are gathering petitions ahead of protests being held in Cork on Thursday and in Dublin on Thursday week. Home helps in Kerry have collected a substantial number of signatures and I am certain that the same applies in other parts of the country. I trust too that those members of the Labour and Fine Gael parties who approve of this latest attack on the fabric of society will take the time to meet the protestors when they arrive on Kildare Street and to explain to them why it is necessary in order that they receive further pats on the head from the IMF and EU for repaying the bank debt.

Some of the Kerry home helps have explained how the visit from them to the old person they care for is often the only one they might have in the entire day. That is particularly the case where people are living in more isolated areas across rural Ireland. Home helps have also said that while they are only paid to be there for a certain period and to do whatever errands need to be done, many of them stay with the person they care for much longer than that, and they maintain contact with them outside of their care hours either through telephone calls or visits. They question whether that would happen if the new system proposed by the HSE is implemented and that needs to be examined.

Home care workers also point out that the level of care they provide will not be possible within the drastically reduced time allowed for home visits, some of which are being reduced to 20 or 30 minutes. I even know of one case where the time for a visit has been reduced to five minutes. I also know of a case of a man aged 103 living in an isolated area with his wife aged 89. They are totally dependent on home help to get their groceries in, to have some quality of life and to have contact with the outside world. The fact that these cuts will impact on them is an absolute and utter disgrace. I do not know how anybody can sit on the Government benches and say the Government has no choice. We all have a choice. The choice is to look after our elderly and people in need. There is a moral obligation on every elected representative to ensure elderly people, as Deputy Ellis said, have dignity at this time of their lives. How can anybody justify reducing a home help visit to five, ten or 15 minutes? I do not know how the Minster of State can try to justify that. Given her background, I assume she fully understands the people who need help and support.

I trust that some Government Members will have the moral courage to stand up for our elderly people who are being discriminated against at the behest of the banks, the ECB and the IMF. They should stand up to those people and say, "We will do the right thing, we will look after our elderly people and we will ensure they have a home help service to provide them with a little contact and security". Home help provides security for people who live in isolated areas. Government Members will find their conscience if they have one. If they vote down this motion, they do not have one.

Jonathan O'Brien (Cork North Central, Sinn Fein)
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Yesterday, I met home helps in Cork. I am sure the Minister of State is familiar with many of the women to whom I spoke, as she probably knows them personally through her own contact with them in the constituency as well as her role in the Department. She knows as well as I do some of the issues and decisions facing them. One home help has been put in an awful position. She now has 15 minutes to visit the elderly lady she cares for because she has to visit another client with a certain timeframe. She can spend no more than that time with the lady. She raised the issue of mental health and it hit home with me. An elderly lady is living on her, isolated from one end of the day to the other, from one week to the next, from month to month and year to year, and the only contact she has is with her home help. That daily contact goes beyond the care she is given because she has someone to relate to and talk to, which keeps her in good mental as well as physical condition. That should not be underestimated.

While I acknowledge home helps are the Minister of State's responsibility, I am disappointed the senior Minister is not present to listen to the debate. He should be here because the senior Minister in the Department, as we witnessed during the primary care debacle over the past few weeks, ultimately calls the shots. It is a pity he is not here. While €1.7 million is being cut from the funding for home care packages and €8 million from home help packages, we are talking about people who are vulnerable in our society and not figures. The Minister and I share a constituency and we know many of the people who rely on home help services. She is aware of the value carers and home helps give to the most elderly and vulnerable people on the north side of Cork city. I cannot understand how she can stand over cuts of that nature. I am not being political because I am aware of her record in standing up for home helps in the past and that is why it is more puzzling that, given she has primary responsibility for this area, she can stand over cuts of this nature, despite a commitment in the programme for Government to increase services in this area. Perhaps, in her contribution, she will outline the reasons this commitment has been reversed.

I would like to refer to the personal nature of home help. I lost my father seven weeks ago today. He had motor neurone disease and he had a home help for the final two years of his life. The compassion this individual showed to our family was priceless; I cannot put a figure on it. The person came in every day and helped us to wash my Dad and change him as he was paralysed from the neck down. These tasks were emotionally draining for us as a family.

The home help came in and did it with a smile and a sense that it was done not because it was a job but because the person cared about it. At a time when we needed every support as a family, the home help, Sinéad, was a friend to my dad. Our family could never repay the kindness shown by the home helps to my dad in his final months.

When he was diagnosed, he had one wish, to be able to pass away peacefully at home. With his condition, the speed at which he would deteriorate and the fact he would need 24 hour care, seven days a week in his final months, we knew it would be impossible without the help and support of outside people such as the Irish Motor Neurone Disease Association, home helps and Marymount hospice. Only for those people supporting our family, we could not have granted our father his dying wish. That is what we are talking about when we talk about home helps. We are not talking about someone who puts on the kettle, sits down for five minutes and has a chat. We are talking about people who care for some of the most sick and vulnerable people in society. They do it with a smile and have done so for years for very little money or for nothing. They did so because they had a vocation and a passion for it. We are repaying them by cutting hours, giving them no security of income and by not honouring the contracts. It is a disgrace and I cannot get over the fact our society is leaving to fall by the wayside such a group of people with commitment, compassion and experience. We are not fighting for them. Every Deputy should fight on their behalf and there should be no opposition to the motion before the House.

I cannot get over the fact my family was able to grant my dad his final wish with the help of a home help but another family, facing the same challenges we faced, may not be able to grant a father or mother the dying wish to die in peace at home. That family may not be able to get the same care, attention and love we got from our home help because €8 million is being cut from the budget. How much will be cut next year or the year after? When is it enough? We are talking about people's lives and their dignity. It should be a right to remain in one's home. Every Government party Deputy needs to take a long look at himself or herself before pressing the button tomorrow night. Voting against the motion is condemning people to death. Many of these people will die of loneliness or isolation, and it is a disgrace. Every Deputy should be fighting on behalf of the most vulnerable in our society and standing up for the home helps and carers who look after them. The Minister of State and I will be relying on some of those people eventually. It would be silly to undervalue their contribution to society and it is not fair to them.

Michael Healy-Rae (Kerry South, Independent)
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I acknowledge the Minister of State. I thank Sinn Féin for allowing me speaking time, for tabling this important Private Members' motion and for the briefing organised by Deputy Ó Caoláin. This is important because there is an agenda by the Government to introduce privatisation. In 2007, the HSE paid a private company, Home Instead, €621,000 and last year it paid the same company €6.02 million. The Government wants to privatise the care of elderly people. The only thing keeping care going is that home helps are working for nothing. Where a person is in a wheelchair, one cannot take care of personal needs in 15, 25 or 30 minutes. It takes however long it takes and these people do the work rather than looking at the clock. They do the job for however long it takes and take an amount of money that is always less than the hours allotted to them.

Last night in Kerry, I met a large group of home helps. I informed them that Sinn Féin was introducing an important Private Members' motion which would result in a vote. I told them Fianna Fáil, the Independents and other groups would support them and that it was up to them to contact Labour Party and Fine Gael Deputies to ask whether they were in favour of taking care of elderly people in their homes or having matters dictated by the troika and Government policy. One cannot be for two things on this issue. One is either with the older people in our community, who want the dignity and privacy of care in their homes, or one is for something else, but one cannot be in favour of two things. It drives me mad when Deputies go home pandering and kissing the backsides of people at home, promising they will do this, that and the devil. When they come here, Deputies do the exact opposite and that is not right. Deputies should be straight in their dealings and tell people they will not back them on this issue and that they are with the Government. Deputies try to say one thing at home and something else in the Chamber.

Privatisation is the agenda. I thank the unions for the work they have done in representing home care workers. They are doing so to the best of their ability but I want them to be tough on the point that we cannot bow down and say it is acceptable if people only have 20 minutes to look after someone. Unions must fight that type of nonsense. The majority of us adore our elderly people. Why do we adore them? They were there before us, they are older than us and it is in all of us to respect our elderly people. I compliment Older and Bolder on the great work it does and the way it stands up for old people. We may not survive long enough to be old but, if we do, we would like to think that people will take care of us, respect us and do right by us. The motion asks that we do right by the elderly people in our society.

I had the privilege of serving with the Minister of State, along with great people such as Joe Sherlock, on what was the Southern Health Board. We were passionate about the services in our communities and I know this measure does not sit well with the Minister of State. I am not being political and I know where her heart lies. I would love to see people rising up and refusing to toe the line and voting with their hearts and for what they believe in.

Being factual about it from a money point of view, we all know it is cheaper and economical to take care of people in their homes rather than putting them in private nursing homes or in long stay beds in our community hospitals. It is infinitely more expensive to take care of people in that way so our home helps provide a great service at minimal cost. They keep people where they want to be in order that neighbours and people in the community can visit them, and it keeps them out of the hospital structure. When they go to bed at night, those people are lying down in the one place everyone in the world likes to be: one's own bed. I ask the Minister of State to take on board the compassion shown by every Deputy.

I compliment every Deputy who spoke on this motion.

In particular, I compliment Deputy Micheál Martin on highlighting page 31 of the programme for Government which has been, effectively, shredded with the continuation of cuts.

Kathleen Lynch (Cork North Central, Labour)
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I move amendment No. 2:

To delete all words after “Dáil Éireann” and substitute the following:"acknowledges:

— the Health Service Executive (HSE) community based supports currently in place for older people, including vulnerable older people; and

— the imperative to maximise service delivery in all relevant respects in line with current or expected overall resource availability;

recognises the significant existing investment of, for example, in the region of €320 million this year for home help and home care packages and overall for the wide range of HSE health and personal social services generally, including mainstream home help, enhanced home care packages, meals-on-wheels and day or respite care, which meet the preferred wishes of many vulnerable older people and help reduce pressures elsewhere in the wider health system;

notes the complex and multi-disciplinary nature of such services, including the partnership by the HSE with non-statutory agencies to complement its overall funded provision;

welcomes progress by the Government so far, to consolidate and improve the planning and delivery of such services, including maximising the use of limited resources while promoting quality, safety and equity for both providers and care recipients alike;

acknowledges various quality related initiatives led by the HSE, including developing new guidelines and a new procurement framework for its home care services;

welcomes the recent publication by this Government of the National Carers’ Strategy, which reinforces the Government’s recognition of, and commitment to, all those caring in whatever capacity for vulnerable people;

welcomes progress by the Government to advance the long awaited National Positive Ageing Strategy, now being finalised, to enhance a more strategic and co-ordinated approach to the well-being of older people and the intention of the Minister for Health to bring a draft of the completed Strategy to Cabinet before the end of the year;

acknowledges that it is best practice to keep home help and other services for older people under review, so that such assistance is in keeping with their individual requirements, as assessed by the local health team, which may increase as well as diminish;

and commits to keeping the position in relation to home help and home care packages under review for the remainder of the year, and that anyone who has been assessed as needing a service will have that service provided."

No one I know, no one involved in politics and no one who has direct experience of elderly people in the community underestimates the value of home helps. Everyone recognises the incredible work they do. I do not disagree with anything Deputy Jonathan O'Brien said about his father. I know the experience his family had. It was not a pleasant experience but it was made manageable by the supports the family received. A cup of tea can be as valuable in certain circumstances as intensive help would be in another. We cannot forget that.

Home helps work across a range of services. They wash, move and turn bedridden people. They care for families and do household chores. The flexibility within the service is what makes it so valuable. In other care settings there can be a rigidity and demarcation of responsibility leading to inflexibility and, in some cases, a lack of the homely atmosphere that we can only have in our own homes.

Fortunately, the majority of older people do not require dedicated intervention until absolutely necessary and, unlike some other care options, community based services for older people are intended as an individual and family support. That needs to be reiterated. In some cases it is not one person who is being helped within his or her own home, but an entire family.

I fully appreciate, through feedback from various sources, the difference quality home care can make to individuals and their families. It is estimated that there are around 100,000 people over the age of 65 who receive some form of HSE community based supports each year. The HSE Service Plan 2012 provides for various community based services such as mainstream home help, enhanced home care packages, meals-on-wheels and day or respite care.

It is widely acknowledged, both in Ireland and internationally, that the home help service is one of the key services in the community care of older people. It is a critical factor in helping to maintain older people in their own homes and communities. That is not in dispute. The service is discretionary and flexible and this allows it to be targeted at those most in need. The home help service primarily includes the provision of personal care and essential domestic support, mainly for older people. The level of service provided depends on the resources available. We all understand that perfectly.

The service is provided, depending on local arrangements, by HSE employed home help staff and-or through a partnership of private or voluntary sector organisations. In the last year, my experience in the Dublin area has been that several voluntary organisations provide home help and home care. They have done an exceptional job for many years and continue to do so. We need to bear that in mind.

In 2011, there were just over 11 million home help hours provided to about 51,000 clients nationally. Approximately 11,000 clients were in receipt of a home care package, HCP. At the end of July 2012, some 6,072 million home help hours had been provided to clients nationally in the first seven months of this year. The number of people in receipt of home help services at the end of July was 50,139. The vast majority of clients in receipt of services at that time were older persons, with smaller numbers of people with disabilities, children and families, or those with mental health problems benefiting from the service. It is sometimes forgotten that home helps provide service across a range of disabilities.

In addition to mainstream home help, the HSE also provides, either directly through HSE employees or indirectly through voluntary or private organisations, home care packages, HCPs. It is important to emphasise that such packages do not replace existing services. At the end of July 2012 there were 11,119 people in receipt of a home care package. A home care package is an enhanced level of services for those people living in the community that require additional home supports. The purpose of home care packages is to facilitate timely discharge of older clients from acute services; reduce inappropriate admissions of older people to acute care or residential care; reduce pressures on accident and emergency departments; support older people to continue to live, or return to live, in their own homes or communities; and support carers so that they might be able to continue to provide care for older people.

We are working on mechanisms to ensure that people can leave acute hospitals and return to their own homes. I was working on this issue this afternoon. I agree with Deputy Ó Caoláin that helping people to leave acute beds and return to their homes, or to a step-down facility, is something we must address as a matter of urgency. We have been working on this actively.

The HSE has a statutory responsibility to live within the budget voted to it by the Oireachtas. In this context, the HSE developed a range of proposals for discussion, which would reduce spending and yield cash between now and the end of 2012, which is not an easy task. It is a priority for the HSE to minimise the impact on patients and clients of any spending reductions. Many of the proposals, therefore, focused on areas that do not have a direct patient impact, such as furniture, education and training, office expenses, ICT, travel and subsistence or similar measures.

The target in the HSE service plan for 2012 was to deliver 10.7 million home help hours to 50,000 people with a budget of €200 million. In addition, just over 15,700 people were targeted to receive a home care package in 2012, at a budget of €138 million. That is all outside the fair deal scheme.

It is proposed that there will be a reduction of approximately €8 million in spending on home help hours between now and the end of December, and €1.2 million for home care packages. However, the HSE intends that the impact of these reductions will be minimised for individual recipients by ensuring that services are provided in the first instance for direct patient cars.

Decisions in regard to the provision of home help hours will continue to be based on a review of individual needs and no current recipient of this service and who has an assessed need for this will be without a service. That is something we have insisted on. Similarly, the HSE is reducing the home care package budget by €1.2 million from an overall target of €138 million, and the same principles in regard to minimising client impact apply.

This has been a challenging year for the health services overall, including maintaining services in line with evolving resource pressures. The overall provision of home support services is therefore regularly reviewed at national and local levels, in the context of client need and resource availability. Notwithstanding the recently announced reductions for HSE home support provision over the remainder of 2012, investment in these services remains significant, with expenditure of about €320 million expected for home help and home care packages this year.

The HSE has been developing various operational initiatives to improve its approach nationally to all relevant aspects of its home care services. These include various new guidelines for home care and recently adopting a new procurement framework for approved agencies providing such services on its behalf. While ongoing developments have been designed to standardise and maximise the use of limited resources in the face of increasing demand, they are also intended to enhance quality, safety and other key aspects of planning and delivering services for both providers and care recipients alike. We are all aware of the financial circumstances in which the country finds itself, but the applications for home help and home care packages have not stopped. They are still being accepted and people are still being assessed. We are working on the assessment of need because we believe a great deal more can be done to ascertain the person's true needs, be they social or medical. We must take the social needs into account as well.

Following a national procurement process concluded earlier this year, approved external providers of home care packages must meet certain criteria, including requirements relating to staff training, elder abuse, infection control, recruitment of staff, supervision of staff and monitoring of care. Each provider must sign a service level agreement with the HSE and these incorporate quality, safety and monitoring requirements. The new procurement process will not impact on existing service providers and will only apply to any new home care packages to be assigned during the lifetime of the agreement. The fundamental motivation for this tender was the introduction of improved standards for enhanced home care services for clients nationwide. The tender is due for review in 2013.

On a broader but related front, we will progress the commitment contained in the programme for Government to develop and implement national standards for home support services. These, as envisaged, will be subject to inspection by the Health Information and Quality Authority, HIQA. Various options are currently being examined, including the complex legal issues involved. However, the strategic reality we face is a need to prioritise legislation across the wider social care area, such as that relating to widely accepted requirements in the child care and disabilities areas. As regards the latter, the Government continues to fund a broad range of services to the tune of €1.4 billioneach year. In 2012, the Health Service Executive national service plan commits to providing residential places for 9,100 people, day services for 18,600 people with intellectual disability, residential support for 6,300 people and 1.64 million hours of personal assistant or home support hours.

While this programme provides support for the full cohort of people with disabilities, older people in this category also benefit through respite and personal support services. A number of other significant developments are also underway to transfer more people with disabilities from congregated residential settings into the community and to put in place a system of registration and inspection of residential services by HIQA, which is expected to be up and running by the middle of next year. We hope to have the standards developed by HIQA published in January next.

As Minister with responsibility for older people, I am keenly aware of the importance of positive ageing, not only for each of us as individuals, but also for our communities and for Irish society as whole. The Government acknowledges the need "to better recognise the position of older people in Irish society". The programme for Government has committed to completing and implementing the national positive ageing strategy so older people are recognised, supported and enabled to live as full and independent lives as possible. The strategy will set the strategic direction for future policies, programmes and services for older people. It will set out a common framework for the development of operational plans by a number of Government Departments which will clearly set out each Department's objectives relating to older people. Mechanisms designed to monitor the implementation of measures contained in operational plans will also be included in the strategy. However, I do not envisage that the strategy will propose new service developments. Instead, it will set the strategic direction for future policies, programmes and services for older people. A considerable amount of preparatory work has already been completed. It is my intention that a draft of the strategy will be brought to the Government at the end of this year.

Carers are vital to the achievement of Government policy for older people, children and adults with an illness or a disability, which is to support them to live in dignity and independence in their own homes and communities for as long as possible. I am fully aware that every day in this country tens of thousands of family members, friends, partners, parents, children, neighbours or home helps provide care for someone who, through a variety of circumstances, is in need of that care. The Government is under no illusion about the challenges carers face on a daily basis. That is why the Taoiseach committed to developing the National Carers' Strategy, which was launched in July of this year. The strategy sets the strategic direction for future policies, services and supports provided by Government Departments and agencies for carers.

The National Carers' Strategy is the first of its kind to be developed in recognition of the invaluable role and contribution of carers. It places carers firmly on the national agenda and sets the strategic direction for future policies, services and supports provided by Departments and agencies for carers. It sets out a vision to work towards and an ambitious set of national goals and objectives to guide policy development and service delivery to ensure carers feel valued and supported to manage their caring responsibilities with confidence and are empowered to have a life of their own outside of caring.

It is very important that available resources are targeted at those most in need and that care is provided in the community and the home as much as possible. The continuing pressure on resources in the health sector generally will make it an imperative that we obtain the best targeting of resources towards those most in need. Members can rest assured that this will entail follow through on all the commitments outlined in the programme for Government, including progressing regulation of the home care sector and considering new ways to fund home care, similar to the model pertaining for long-term residential care, or the fair deal scheme as it has become known.

The Government will make every effort to protect front-line home support services for vulnerable older people. The position next year will be considered in the context of concluding the Estimates and budget process for 2013. I have been listening to the contributions from Deputies and will take their comments on board.

Michael McCarthy (Cork South West, Labour)
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Much has been said in recent weeks and months about the HSE budget. It is obvious there is a huge task in that regard, not just in respect of home care services but in a variety of areas. Let us look at the context in which this debate is framed. We are now a number of years into the EU-IMF deal. Some people might reasonably argue that they have heard enough about that, but that is the blank canvas with which we must start. It is the basis for all of our spending. The State has borrowed €11 billion so far this year, or it has spent €11 billion more than its income. One need not be a chartered accountant to know that such a situation is utterly unsustainable. As Ministers head into the pre-budget process, each of them will do their best to protect their budgets. There is huge pressure, particularly in the case of big spending Departments such as the Department of Education and Skills, the Department of Social Protection and the Department of Health.

The Leas-Cheann Comhairle will recall that early in the last decade a cross-party report was produced by the joint committee on social affairs, as it was known then. People from all parties and none subscribed to the report. It proposed the abolition of the carer's allowance because at the time the State could afford to do that. Sadly, and regrettably, we are no longer in that position. This is a very sensitive issue and Deputy O'Brien spoke passionately and sincerely about his own experience of the home help service.

We can all relate to that. No one on this side of the House disagrees with the genuine sentiments expressed in the motion.

We must, however, place the person being cared for at the heart of this debate. Home helps are important and Ministers are essential in the process, but once we investigate the issue, the most significant person is the person being cared for. Based in west Cork, I know the importance of this service. It is critical to allowing a person to stay at home. All people wish to remain in their own home when they are older, and whatever assistance necessary to allow that is justifiable. There is also the added benefit of keeping people out of private nursing homes and community hospitals. When looking at budget decisions, the Minister of State, Deputy Kathleen Lynch, has ring-fenced €30 million for adults with disabilities. That is an achievement given the economic nightmare the country faces. There are times when we must consider the nuances of a story.

The national carers strategy referred to by the Minister of State, Deputy Lynch, and launched by the Taoiseach is an essential part of the programme for Government. This Government values the work being done and there is no question of its commitment to it. That work must be balanced with the needs of the person being cared for in order that he or she can remain at home for as long as possible.

I support the Minister of State's view that maximising HSE supports in communities must be balanced against evolving service and resource pressures. I do not say that lightly because I can only assume the resource pressures are mammoth.

The continuing pressure on resources in the health sector will make it imperative that we target resources towards those most in need. The HSE has assured us the impact of the reductions will be minimised for patients. Decisions on the provision of home help hours will, as always, be based on a review of individual needs. The HSE has said no current recipient of the service who has had his or her need identified will be without a service. That is critical. Annually, 11 million home help hours are provided, with a budget of €195 million. It is a priority for the HSE to minimise the impact on patients and clients of any spending reductions. Many of the proposals, therefore, focus on areas that do not have a direct patient impact, such as furniture, education and training, office expenses, laptops, PCs and so on.

We must ensure, and there is a strong prioritisation of this within Government, that there is better co-ordination of services for older people in future. This is borne out by the recently published national carers strategy and the planned national positive ageing strategy. Further progress is to be made in the regulation of the home care sector and consideration of new ways to fund home care.

The programme for Government commits to the fair deal system of financing nursing home care, to the developing of a national Alzheimer's and other dementia strategy by 2013, and to a review of the fair deal system of financing nursing home care. The issue of older people, their care and the services they need is cross-departmental and does not specifically pertain to the Department of Health. In the most recent budget, when many commentators, in this House and outside of it said it was not possible, the Minister for Social Protection retained basic rates of social welfare for carers and pensioners and maintained the household benefits package. I hope that, in this debate, we will understand the genuine care this Government has for older people in society.

Catherine Byrne (Dublin South Central, Fine Gael)
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I thank Sinn Féin for bringing this issue to the House. It is an important one and I welcome the few minutes I have to speak on it. I was reared in a family where respect for parents, grandparents, aunts and uncles was very important and where everyone played a part. I know and understand only too well the needs of older people in my own family and in the community, and I recognise the value that has been given through the years by those in the health service and home carers. In early 2009, my family received the devastating news that my mother had been diagnosed with Alzheimer's and dementia. With a family of eight children, my mother had the best of care at home, with all of us giving a hand, especially my two brothers, who looked after her 24-7. The only words to describe their attention to her are unconditional love. They practically did everything for her. There were, however, many difficult times, and I remember on many occasions arguing with the Minister for Health and Children that we could not get incontinence pads or proper sheets for my mother's bed. The care she received at home from her family and friends, however, was second to none. At the end of her days, when she finally passed away, it made her passing more bearable for all of us.

For many older people it was not in their DNA to ask anything of the State but, sadly, many of them now need and deserve a little help to live with dignity in their last few months or years. The Minister of State spoke about numbers, the 9,300 home helps in Ireland, the 11 million hours of home help care, the 50,000 people who receive that care, and the millions being spent on home care packages from a total of €320 million. It sounds an enormous amount and we all know it would be even greater if we had it, but that is not possible at present.

Some home help services are unregulated and that cannot continue. It is important to have proper standards in place. I agree with the points made by Older and Bolder on the need to reform home help services and adequately monitor standards of care. Regulation of services is vital and there is a need for inspections of home help provision, as well as registration of those engaged in home help. The system must be more patient focused and patient friendly.

The Government is aware of the needs of older people. I commend the Minister of State, Deputy Kathleen Lynch, on her work with older people. The HSE is carrying out a review, as we all know, and will continue to do so, and that is an important step. I also welcome the HSE approach to access and to identify those who are most dependent and require personal care services. These are the people we must ensure have access to the vital services.

What is home help? It is about those older people and people with disabilities who cannot look after themselves and who need someone to help them with their daily washing, dressing, eating and, in some cases, medical needs. It is not simply about companionship, although I recognise its importance. To me home help is about much more than a cup of tea and a slice of toast. The focus of home help services is and must be about people's health care needs at home. We cannot always depend on the State to take on the responsibilities of families, and families must be there to support older people in their homes. There are many volunteer organisations that do wonderful work and many neighbours in communities who continue to support elderly people. We must support them and provide them with the companionship that is needed.

I am, of course, concerned about the planned reduction in the funding of home help services. The Department of Health, however, has stated clearly that no one will be left without a service and, where individuals are identified as in need of direct patient care, they will be looked after directly by the HSE. I welcome that. As a member of the Oireachtas Committee on Health and Children, I support the call we made two weeks for the Minister for Health to review the proposed cuts to the home help service. We all agreed the letter calling on him to look at the service and not just at its cost.

When I grew up, "The Wizard of Oz" and many other Disney programmes were on television. This evening I heard some people in the Opposition saying that Government party Members do not have a heart. I have a heart and want to make it clear to everyone. I do not think any Deputy or Minister in this Chamber does not have a heart. We were not elected because we do not care for people. We were elected because we care for them. As far as I am concerned, I am not an alien who just flew down from space this evening. I am a human being who walks the streets at weekends and deals with my constituency, listening to the trials and tribulations of everyone. I want a health service in the future of which we can all be proud. I want us to be able to care for those who want to remain at home. All aspects of the health service must be reviewed now.

There is not a person knocking on doors for the children's referendum who will not approach any of the issues being raised in the Chamber. They are willing to speak up. It is time for change and review. That does not mean everything has to be slashed and cut but certainly some of the services need to be reformed and the motion is about examining those reforms.

Michael Kitt (Galway East, Fianna Fail)
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I call Deputy Billy Kelleher who, I understand, is sharing time with Deputies John Browne and Michael Moynihan.

Billy Kelleher (Cork North Central, Fianna Fail)
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As we will share time in equal proportion, perhaps the Chair would interrupt me after five minutes.

I thank Deputy Caoimhghín Ó Caoláin for tabling the motion. We tabled an amendment stating that we are in accord with everything stated in the motion but we also want to get on the record the issue of publishing the national positive ageing strategy.

Let us be clear - €8 million has been cut from home helps and services will be withdrawn. The chief executive of Health Service Executive and others have said nobody will be without a service. They will have a lesser service and home help hours will be cut. People who had three and four hours home help previously will have a reduced service. We all accept they will have a service but the service will not be adequate to deal with the complexity of issues facing those being cared for in the home.

I suggest the Minister of State return to her office, take out page 31 of the programme for Government, photocopy it, give it to the Minister for Health and ask him to read it one more time. Everything that is being done in regard to home care package cuts is against the grain of the programme for Government. It states explicitly that year on year there will be increased funding for people in home care packages, home help and other services to older people. Clearly what is happening is the exact opposite. The Government is withdrawing services on a daily basis from those who need home help support. Basic economics shows that it makes no sense to withdraw home care services and home help hours and force people into institutions, residential care or acute hospital settings. That is exactly what is happening. We know the results of a reduction in services and supports for people who want to remain in the home.

This is not about the troika or the difficulties the country faces, but about choices made by the Minister for Health, Deputy James Reilly, in dealing with the substantive issues that underpinned the budget presented to the House last year. Great fanfare was made of the consultant contracts but not one euro has been saved since. There was an explicit commitment in the programme for Government that the Government would reduce the numerous packages of consultants. We were told the generic price referencing would come through and that €124 million would be saved. To date, not one euro has been saved. Those are two areas I can identify, and we can go through some more. It was stated there would be a reduction in agency staff that would deal with the issue of over-runs in the budget. Clearly none of this has happened, hence the reason we are debating the issue of a cut of €8 million to home help services. What has happened is that there has been a budget over-run. The budget projections and figures of last year were built on a foundation of sand.

A member of the Committee of Public Accounts, Deputy Simon Harris, from the Fine Gael Party, said clearly that it is obvious last year's budget was built on sand. It unravelled very quickly. The difficulty is that in unravelling the budget, many thousands of people live in fear of receiving another letter from the Health Service Executive stating that an assessment of home help hours is taking place and, accordingly, there will be a reduction. I have yet to meet a person in recent weeks who has had a home help service increase; everybody's home help service is being decreased. Some of the private agencies say we offer 15 minutes for home helps. Is there anything most people could do in 15 minutes? We are talking about caring for people who want to remain in their home setting, yet we are offering them a 15 minute package where the home help comes in, does something in 15 minutes and heads off down the driveway. This is an attack on the basic principle of trying to care for people in the home in the lowest cost setting. All the analysis, matrics and indices the Department of Health has show clearly that this is the most cost-effective way of treating people and keeping them out of acute settings and long-term stay. This is a false policy in economics terms. I am not directing this at the Minister of State but the Minister - this is an attack on the most vulnerable who have given a life of service to the country and all we ask is that the €8 million cut in the budget be reversed and found elsewhere. I can identify three or four places immediately where that could be done. The Minister identified them last year and has yet to do anything about them.

I thank Deputy Caoimhghín Ó Caoláin, Older and Bolder and the many voluntary organisations who, day and night, are advocating on behalf of the elderly who need home help hours and home care packages and support to remain in their homes and, more important, for Government support in reversing the nasty cuts.

John Browne (Wexford, Fianna Fail)
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I compliment Deputy Caoimhghín Ó Caoláin on tabling the motion. It gives us an opportunity to raise some of the issues affecting older people in our communities. Today, I received a large number of letters from the Older and Bolder organisation. The first few words of each letter sums up what older people want. They state that they want to grow old at home. They outline the cuts in home care services and ask if they make human or economic sense. The cuts will result in earlier admission to nursing homes, longer stays in acute hospitals and anguish for families who need support in caring at home for relatives suffering from illness, frailty or disability.

As public representatives, particularly in rural areas, we are aware of the importance of the home help service to older people. It enables people to live at home and remain in the community. This is the annual magician story from the Health Service Executive that it will cut €8 million from the home help service budget and remove 450,000 home help hours, but it will not affect the home help service. It also talks about efficiencies. Perhaps the Minister of State would ascertain from the Health Service Executive what it means by efficiency. I meet the Health Service Executive every three or four months with my Oireachtas colleagues in Wexford and it continues to tell us that home help and hospital services are good and the community service is good, yet we get hundreds of complaints monthly from older people owing to the lack of services.

At any given time in Wexford General Hospital, up to ten people occupy beds when they would much prefer to go home. However, they cannot go home because no home help service is available. Community nurses in Wexford have told me there is no hope of getting home help between now and Christmas unless the person who has it currently passes away. That is disgraceful. Perhaps the Minister of State would explain tomorrow night the reason home help service in some areas in inadequate while in other areas it is not too bad. It appears there is an allocation of moneys on a county per county basis but some are faring much better than others. Given the Minister's cutbacks in the home help area, there will be no moneys available for home help between now and Christmas. It is not good enough for the Health Service Executive to say it will work on efficiencies and save money elsewhere, yet it does not spell out how it will do it.

Home help is a very important service for older people. Older people want to remain in the community and live at home. Perhaps in urban areas the next door neighbour will look in occasionally to check if an older person is well. Out in the rural heartland, however, there could be a distance of five to ten miles between where people reside. In such instances, it is important that home help is available to people.

We all accept there is a financial difficulty in the country. There is also a financial difficulty owing to the Minister not fighting his cause at the budget table last year, resulting in the inadequate moneys being available to the HSE.

To start making cutbacks affecting the most vulnerable people in our society is completely unacceptable. As Deputy Catherine Byrne said, this decision should be revisited. There is no chance of the HSE carrying out an assessment of the number of people at present in receipt of home help between now and Christmas to ascertain who is entitled to it - that is not good enough. The money needs to be restored as quickly as possible to provide adequate home help to the people who need it. I support the Sinn Féin motion and hope some common sense will prevail within the HSE and with the Minister, Deputy Reilly.

Michael Moynihan (Cork North West, Fianna Fail)
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I thank Deputy Ó Caoláin for tabling the motion and I appreciate the opportunity to contribute to the debate. In any discussion on home help the constant line we get back from the public is that the home help service is value for money. The home help service saves the State by allowing people to stay in their own communities for longer. Of all the schemes the State has introduced, this one probably represents the best value for money. In recent weeks we have been inundated with calls and letters regarding people who have suffered. I received a letter this morning in respect of an elderly woman living at home who is without the use of both her legs, is wheelchair bound and has the use of only one arm. I will read one paragraph into the record of the House:

A few weeks ago the H.S.E. in its wisdom ... decided to cut those few hours a week so now we have a situation where the home help are supposed to get [the person's relative] up out of her bed, dress her, look after her toilet needs, get breakfast, prepare her lunch, look after the fire and heating needs for the day, from 11.45 a.m. to 1.00 p.m. with an extra 15 minutes [on] Tuesday and Friday to facilitate a shower. Now how in the name of God can you or the H.S.E. explain to me or any other person [how] it is possible to get a totally invalided person up out of the bed, undress her, get into the shower, wash, dry and dress her again, do her hair and leave her in any sort of comfort for the rest of the day. If you or the H.S.E. can do that then I think you should enter that home help person into the Guinness Book Of Records.

Elderly people are concerned at newspaper reports about home help hours. They constantly worry whether this might be the last month, or the last Christmas in their own home because they might no longer have the service to keep them at home. The Government and the people making the decisions must accept that as a given. Throughout the Western world every other avenue has been tried in dealing with elderly people, but this is a system that is working. Whenever there is a need for cutbacks in the HSE the first to be affected are home help hours. Across the board they have been taking away a quarter of an hour here or half an hour there. Some 99% of people will say that those on the front line providing home help services are excellent people, who take the job very seriously and take great pride in the ability to keep an elderly person in his or her own home. Whatever about other aspects of the health budget, the home help service must be sacrosanct and must be protected at all costs.

Michael Kitt (Galway East, Fianna Fail)
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Deputies Catherine Murphy and Mattie McGrath have five minutes to share, two and a half minutes each.

Catherine Murphy (Kildare North, Independent)
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An issue that crops up repeatedly is whether cutting home help services would save money. Every time a person ends up in an acute hospital instead of at home, it costs multiples of what the home help service would cost. We are getting approximately 11 million hours for slightly more than €200 million. In no other section of the budget is it possible to point to that kind of value for money. The philosophy behind this seems to be changing and I am concerned that we are moving towards a privatised system for many people. Let us consider the taxation benefit. A person on the 20% tax rate spending €100 per week looking after an elderly person at home may claim back €833. However, a person on the 41% tax rate may claim back almost double that - €1,453. Yet, somebody outside the tax net struggling to pay will get nothing back. That exposes something that is very wrong about the priorities.

Government subsidies are paid to private companies including, for example, Comfort Keepers Home Care. In 2007 and 2008, approximately €1 million was paid. That amount was €3.75 million in 2011, which indicates a change in the way we are handling this system and this budget. We used to get extraordinarily good value. Last week I had an opportunity to speak on this in another forum. I referred to an elderly gentleman who had fallen and the home help person found him behind the door two days later. He is still in hospital and one must question the sense in this.

Mattie McGrath (Tipperary South, Independent)
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I am pleased to have the opportunity to speak on this motion tonight. However, I am not pleased - I am hurt and annoyed - by the trauma that is being visited upon ordinary decent people. I compliment Deputy Ó Caoláin on tabling the motion. I am shocked and taken aback. I sat on a social welfare committee with the Minister of State, Deputy Kathleen Lynch, and Deputy Catherine Byrne during the previous Dáil. I know that they were genuine, honest and caring. The Minister of State, in particular is poacher turned gamekeeper. It is an appalling vista.

Michael McCarthy (Cork South West, Labour)
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Which committee?

Mattie McGrath (Tipperary South, Independent)
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She should hang her head in shame.

Kathleen Lynch (Cork North Central, Labour)
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I was never on that committee.

Mattie McGrath (Tipperary South, Independent)
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Social welfare.

Kathleen Lynch (Cork North Central, Labour)
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I was never on that committee.

Michael Kitt (Galway East, Fianna Fail)
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She was not on that committee.

Mattie McGrath (Tipperary South, Independent)
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Gabh mo leithscéil. I ask the Minister of State which committee she was on with me.

Kathleen Lynch (Cork North Central, Labour)
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I-----

Mattie McGrath (Tipperary South, Independent)
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It does not matter. She spoke about social inclusion, and caring and sharing, but now she comes in here and-----

Michael McCarthy (Cork South West, Labour)
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The Deputy is misleading the House.

Mattie McGrath (Tipperary South, Independent)
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I will correct the record - that is fine. She was on an Oireachtas committee with me - the name eludes me, but it does not matter. The Minister of State has a much longer record in politics than I have. However, she should be ashamed about what she said to the Disability Federation of Ireland - Deputy Kelleher was there also. When she was asked about the appalling cuts in August to the most vulnerable and needy in our community she said she was not aware of them. Her colleague, Deputy Shortall, resigned because she could not get on with the bullyboy, the Minister, Deputy Reilly.

Kathleen Lynch (Cork North Central, Labour)
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Sorry-----

Mattie McGrath (Tipperary South, Independent)
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However, the Minister of State, Deputy Kathleen Lynch, gets on with the bullyboy, the Minister, Deputy Reilly and she is leaning down to lick his coat-tails and to support privatisation.

Kathleen Lynch (Cork North Central, Labour)
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A Leas-Cheann Comhairle-----

Mattie McGrath (Tipperary South, Independent)
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There is no agenda except to-----

Michael Kitt (Galway East, Fianna Fail)
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Will the Deputy accept a question from the Minister of State?

Mattie McGrath (Tipperary South, Independent)
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I will not. I allowed too many questions from her and her colleagues during the previous Dáil. What we now have from the Minister of State is crocodile tears and a statement that she was not aware the cuts were being introduced.

Kathleen Lynch (Cork North Central, Labour)
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That is not-----

Mattie McGrath (Tipperary South, Independent)
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Deputy Lynch is a Minister of State.

Michael Kitt (Galway East, Fianna Fail)
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The Minister of State does not agree.

Mattie McGrath (Tipperary South, Independent)
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That is fine. However, I am putting it on the record. The Minister of State can agree or not. I have the floor. I do not interrupt the Minister of State.

Kathleen Lynch (Cork North Central, Labour)
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I have no difficulty-----

Mattie McGrath (Tipperary South, Independent)
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A Leas-Cheann Comhairle, I have the floor. Are you chairing the proceedings or not?

Michael Kitt (Galway East, Fianna Fail)
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I am.

Mattie McGrath (Tipperary South, Independent)
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Then do so. I have the floor.

Kathleen Lynch (Cork North Central, Labour)
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I have no difficulty with any Deputy having an opinion. Telling lies is entirely different.

Michael McCarthy (Cork South West, Labour)
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Hear, hear.

Mattie McGrath (Tipperary South, Independent)
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There are no lies. Excuse me, there are no lies. The Minister of State knows all about lies. There are no lies in what I am saying. The Minister of State was a member of the committee. She should be ashamed of herself. She comes from a Cork constituency and demanded so much.

Michael Kitt (Galway East, Fianna Fail)
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The Deputy has one minute remaining.

Mattie McGrath (Tipperary South, Independent)
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No, I was interrupted. The heat is too much for the Minister of State, Deputy Lynch. The former Minister of State, Deputy Róisín Shortall, at least had the courage of her convictions and pulled out. The Minister for Health wants to let elderly people die on the roads and, as I stated previously in Clonmel, to humiliate them.

Michael McCarthy (Cork South West, Labour)
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That is an outrageous charge.

Mattie McGrath (Tipperary South, Independent)
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The Minister has a big house in Offaly and is part owner of a private nursing home in Carrick-on-Suir. The Health Information and Quality Authority, HIQA, is seeking the closure of the public nursing home in Tipperary. The Minister is also involved in a private development in Dublin. He is too busy to look after ordinary people.

Michael McCarthy (Cork South West, Labour)
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On a point of order-----

Mattie McGrath (Tipperary South, Independent)
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He is not interested in rural or ordinary people.

Michael McCarthy (Cork South West, Labour)
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On a point of order-----

Mattie McGrath (Tipperary South, Independent)
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The Minister promised so much. He came in here and promised the troika would be burned and attacked but what have we got? What we have is a humiliation of-----

Michael Kitt (Galway East, Fianna Fail)
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Deputy McGrath, please. I call Deputy McCarthy on a point of order. I will come back to Deputy McGrath.

Mattie McGrath (Tipperary South, Independent)
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No, the Government should be ashamed of itself. Its members are poachers turned gamekeepers, and they should be ashamed of themselves.

Michael McCarthy (Cork South West, Labour)
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Deputy McGrath has made serious allegations about the Minister for Health. He needs to prove them or withdraw the charge.

Mattie McGrath (Tipperary South, Independent)
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I have no notion of withdrawing them.

Michael McCarthy (Cork South West, Labour)
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The Deputy has made serious allegations.

Mattie McGrath (Tipperary South, Independent)
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They are the facts. The Minister is involved in a private nursing home in Carrick-on-Suir. HIQA is proposing closure of the public home.

Michael Kitt (Galway East, Fianna Fail)
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Deputy McGrath has moved away from the topic under discussion.

Mattie McGrath (Tipperary South, Independent)
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The Minister has a mansion in County Offaly and other private interests.

Michael Kitt (Galway East, Fianna Fail)
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I ask the Deputy to move the adjournment of the debate.

Mattie McGrath (Tipperary South, Independent)
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No. I want to finish my contribution first.

Michael Kitt (Galway East, Fianna Fail)
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We have gone over time.

Mattie McGrath (Tipperary South, Independent)
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No. I would like another half a minute. I was interrupted.

Michael Kitt (Galway East, Fianna Fail)
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I am adjourning the House.

Mattie McGrath (Tipperary South, Independent)
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I was continuously interrupted. They cannot take the situation.