Tom Fleming (Kerry South, Independent)
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I move:

“That Dáil Éireann:

calls on the Government to:

— implement a range of policies that are favourable to senior citizens to maintain independent living;

— provide the supports and services to assist people to continue to live in their own homes;

— in light of the upturn in the economy, prioritise the household benefits package including the electricity/gas allowance and the free television licence among other measures;

— continue to maintain the free travel scheme and the Christmas bonus;

— ensure that home help hours be maintained in line with demand so as older people can age in the community;

— invest in the Health Service Executive community care and community mental health services;

— ensure that:

— the living alone increase continues to reflect the cost of living; and

— the carer’s allowance and the half-rate carer’s allowance be maintained and recognise the value of the respite supports; and

— acknowledge the importance of:

— the household adaptation grant for people with a disability, housing aid for older persons scheme and home insulation and energy saving for older people living at home; and

— maintaining and enhancing rural community bus services.”

Over the past six years, changes in public services such as home help hours and community nursing units, reductions in the fuel allowance, cuts in the household benefit package, the abolition of the Christmas bonus and increases in prescription charges, as well as decreased front-line staff and services in the health care sector, have all adversely affected older people and have fallen very heavily on poorer groups without the income to compensate. In particular, the changes have affected poorer people with disabilities or illness. International experts have identified that spending on public health and on the over-65s will have fallen by approximately 32% between 2009 and 2016. Supports that enable people to live at home need to be part of a broader integrated approach that ensures appropriate access to and discharge from acute services when required. To achieve this, the specific deficits in infrastructure that exist across the country need to be addressed urgently. There should be an emphasis on replacement or refurbishment of facilities. If this is not done, the inappropriate admission of older people to acute care facilities will continue, along with the consequent negative effects on acute services and unnecessary stress on older people and their families.

A related issue is the shortage of appropriately resourced and staffed geriatric rehabilitation units. The National Clinical Programme for Older People 2012 recommends that every hospital receiving acutely ill older adults have a dedicated specialist geriatric ward and a designated multidisciplinary team as well as access to on-site and off-site rehabilitation beds delivering a structured rehabilitation programme for older people. This document recognises the fundamental right of an older person to receive an adequate period of rehabilitation before a decision on long-term care is made. Implementation of these recommendations is lacking and there continues to be a shortage of appropriately resourced and staffed geriatric rehabilitation units. The stated focus on the development of community-based services to support older people in their own homes and communities for as long as possible is welcome. However, an expert group described Ireland's under-resourced community health services as "perhaps the greatest deficiency in the current provision of health services in Ireland". A commitment to supporting people at home is only aspirational if funding is not provided for home help services, day care centres and home care packages, some of which have received serious and unwelcome cuts in recent budgets at a time when, on the contrary, they should have been the subject of investment to address population ageing.

Despite the steady growth in population, the public bed stock capacity has reduced significantly from a high of more than 10,000 beds in 2008 to a current capacity of 7,157 beds in 2014, which represents a 29% bed stock reduction since 2008. This is inclusive of a reduction in short-stay beds from a high of more than 2,000 to the current capacity of 1,868, an 11% reduction, and a reduction in long-stay beds from more than 8,000 to the current capacity of 5,289, a 35% reduction. In addition to the funding issues, HIQA requirements for the standards of long-stay accommodation have deemed certain facilities or parts of facilities to be unsuitable, and required reduced occupancy levels in others. This is a continuing issue for the sustainability of current levels of public bed provision. There has been some major and minor capital provision to address this issue, but not on a scale which would allow for the planned improvement or replacement of all facilities in need of upgrading.

Support for people to remain in their own homes is a key and appropriate policy objective, and coincides with the wish of most older people. However, this commitment does not appear to be supported in practice when we note the significant decrease in the provision of home help hours in recent years, especially at a time of population ageing. Approximately 8,300 fewer people were in receipt of home help support in 2014 than in 2008, a decrease of approximately 14.5%. There was a decrease of 2.34 million in the hours delivered, a decrease of 18.5%. In the years after 2008 there was a steady decrease in the number of hours delivered and people receiving hours, especially from 2011, and although there has been a slight increase in 2014, both the number of hours delivered and those served by the scheme are still considerably less than in 2008 or indeed in 2011. During the period between 2008 and 2014, the number of people in receipt of home care packages grew by 4,200, representing an increase of 47%, but the funding for this scheme has remained static. The 2015 Health Service Executive national service plan envisages additional spending in this area, including on home care packages for 600 people, but also acknowledges the risk that the overall amount allocated for older people is not sufficient to address the dramatically increasing demand.

The 2011 programme for Government committed to implementing the national positive ageing strategy in order that older people could be supported and enabled to live independent lives, enhancing and protecting people’s well-being and quality of life. Unfortunately, four years on, this strategy has been neglected and has not been implemented in any shape or form.

Four successive austerity budgets have greatly limited older people's ability to live full independent lives. Despite an 11% increase in the number of people aged 85 and over in the past three years, home help hours have not increased from the 2012 levels of 10.3 million hours and the present system is designed to see home help and home care as ways to meet the priority needs of supporting acute hospital discharges.

The failure to provide support to those in the community with low to medium needs has consequences in terms of demand for more intensive home care packages and long-term places for those with high dependency. More important, it denies older people the opportunity to live a full quality life. People are living longer with a growing population of people aged 80 and over and we need to plan to meet the increased demand for home help and home care services. These services give people, struggling at home, the skills to manage their daily lives, delaying the need for more intensive intervention and reducing the risk of admission to acute hospitals.

The Government should consider introducing a national re-ablement programme, a model that has proved very successful in the UK. Re-ablement or restorative care programmes improve and maintain an individual's physical strength and mental health. They enable greater independence, reducing ongoing home support needs. An evaluation of a re-able pilot programme in north Dublin and research from other countries show a reduction in the need for home care hours. Participants, the majority of whom were aged 80 or older, had a 21% reduction in their requirement for home help and a further 59% reduction in the number of hours required. Councils in Britain that are implementing this programme found a reduction in the number of people being admitted to long-stay care. For example, in central Bedfordshire, numbers admitted to long-stay care fell by more than 10% over three years. The percentage of the population entering long-stay care per year in Britain is 0.7% compared with Ireland, where the number of new clients supported by the national system in 2013 stood at 1.5%.

The demand for long-term care beds is influenced by the availability of resources within the community. If the Government reneges on its commitment to meet older people's preferences for care in their homes, the number of long-term care beds required to meet demand naturally has to increase. Investment in home help and home care services is a priority. If the Government does not invest in these services, the alternative scenario is a more costly investment in the nursing home support scheme. Based on the assumption that 4% of the projected population of people aged over 85 in 2016 will require long-term residential care, this means there will be a requirement for an additional 1,056 beds at an estimated cost of €43.8 million. This clearly underlines the need for a substantial increase in funding for the aforementioned home care and home help strategy.

Over the past ten years, there has been a 44.6% increase in long-stay residents categorised as low dependency and a 17.6% increase in residents with medium dependency. These figures indicate that the effect of Government policy for long-term care provision is driving up the numbers of older people in long-term care who do not need to be there. In many cases people have been prematurely put into long-term residential care totally against their will. It is affecting their mindset and outlook and is demoralising in many respects. They would be better off in the community amongst neighbours and friends where they could visit the local shop or post office or go for a sociable drink with their friends. There is need for a total change in strategy and policy.

Other countries take a home first approach. For example, in Ontario, Canada, patients are sent home with intensive case management and enhanced home care supports for several weeks. This frees up acute beds and ensures those with higher dependency care needs can get long-term care beds. This period of enhanced care supports also allows older people to see how well they manage at home, giving them the time and space to make a life altering decision about where they want to live long term, rather than making such a choice in a stressful and disorienting hospital environment. In the long term, this is a cost-neutral approach as the cost of the intensive case management approach used in Ontario is outweighed by the cost of acute hospital or nursing home beds.

For approximately 58% of people aged 65 and over, the State pension is their only source of income. Older people receiving nursing home care under the nursing home support scheme must contribute 80% of their income, even though the scheme only covers basic bed and board. This leaves those on a full State pension with a disposable income of €46 per week. This is completely insufficient to cover everyday living expenses such as clothes and toiletries, chiropody, social activities and prescription charges among many more little items.

I tabled this motion with a view to having a rational and logical debate to tease out many of the anomalies in the system. We could be much more cost effective: we have a lot of wastage and overspending. Instead, small amounts should be put into the right organisations and the State bodies which deliver community care. There are wonderful home help staff who are part of the jigsaw. Starting tonight, we should be more positive and enhance all the services. I hope we will have a fruitful discussion over the next two nights.

John Halligan (Waterford, Independent)
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Ireland currently has a ratio of six people to every older person. By 2045, that ratio will be three to one. To give just one example of life-changing conditions that affect the elderly, the number of dementia sufferers in Ireland is expected to almost triple to 140,000 in the next 25 years.

Instead of putting into practice current policy, which according to the public service reform plan, pledges to "enable people to age with confidence, security and dignity in their home and communities for as long as possible", the Government has hacked away at services for older people since the recession began, to the tune of hundreds of millions of euro. This includes cuts to staff in hospitals and health centres, cuts in medical cards and the abolition of the telephone allowance. The number of home help hours has been reduced from 11.9 million in 2009 to 10.3 million in 2015 and provision of this service remains largely based on geography and available resources. I have seen the result time and again in the cases being handled in my office and know that where a person lives is a huge deciding factor in successfully securing home help hours. There was a high profile case in Waterford some time ago of an elderly lady whose breakfast and lunch were delivered at the same time because of the distance to where she lived and the lack of available carers to come to help her out. How undignified is that?

Furthermore, spending on the housing adaptation grant, housing aid for older people and the mobility aids grant, all invaluable in helping elderly and disabled people to continue living at home, have almost halved in recent years. Behind these facts and figures are real people being deprived of their dignity. By the end of this year, Government figures provided to me by the Department estimate that the nursing home support scheme will support just under 24,000 people in public and private nursing homes. Elderly advocate groups, however, believe one third of older people living in nursing homes could live at home, with the right supports. This is what we should be doing, as Deputy Tom Fleming said in his opening statement.

At any given time it is estimated that at least 700 older people are occupying beds in hospitals while they wait to access a bed under this scheme. These patients, who are deemed "fit" for discharge, are often unhelpfully referred to as "bed blockers" in hospitals that are struggling to cope with huge backlogs. The price of a bed in an acute hospital is €850 per night. They would give anything to be able to sleep in their own beds but the supports are simply not there to allow them independently to do so.

Staff in nursing homes have told me that, after spending many weeks stuck mainly in a bed or chair in an acute hospital, elderly patients are often unable to walk by the time they get their places in nursing homes. At the root of this complete waste of public resources and unnecessary suffering by already frail elderly people is this Government's and the last Government's failure to plan for our aging population. Figures based on Department of Health records suggest that 35% of elderly people in long-term beds have "low to medium" support needs. It is the absence of proper supports in their community that is forcing many of these people into long-term nursing home care at an annual cost of €50,000 each to the State. It is estimated that nursing home care is three times more expensive than home help. Economically, the way we care for our elderly does not make sense.

Unless we change our approach and put in place statutory entitlement to home care for the elderly, as there is for nursing home support, the number of older people in nursing homes who could be supported to live at home will increase. Already, since 2003, there has been a 49% cent increase in the number of private nursing home beds. That is incredible. There is no doubt that if proper primary care supports were in place in the community, including home helps, home care packages, public health nurses, occupational therapists, day care centres and meals on wheels, many of these people would opt to return home. There is no question about that. The Government's approach is at variance with the stated policy of enabling people to "age with confidence, security and dignity in their home and communities for as long as possible". Economically, and to treat people with dignity, the policy needs to be dramatically changed over the next few years based on the statistics coming from the Government and the Health Service Executive.

Maureen O'Sullivan (Dublin Central, Independent)
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We are all making our way through the seven ages of man as described by Shakespeare. It is fair to say that each age from childhood on brings its own joys but also frustrations and challenges so that by the time we reach that older age we have experienced a great deal. The majority of older people have worked all through their lives. They have paid their taxes and reared their children and many are now rearing grandchildren also. Many of them are the carers for family members with disabilities. I acknowledge the great voluntary work that so many older people have done throughout their lives.

I do not think there is a village, town or community in Ireland, urban or rural, that has not benefited from the huge array of voluntary work done by older people in the course of their lives. The expectation is that when they get to that older age, life should get easier, not much more difficult.

It is very good that, tonight and tomorrow, thanks to Deputy Fleming's motion, we have an opportunity to talk about and highlight life for older citizens. To use the cliché, they are the unsung heroes of Irish life. However, there are glaring examples of where they are not treated appropriately. It is very sad to see senior citizens living in situations that do not afford them dignity, as I have seen in my own constituency in Dublin Central and I am sure it is the same in other constituencies. The loss of the Christmas bonus some years ago was a devastating blow, especially to those living in poorer circumstances.

Sustaining independent living is very important, and part of that is keeping people out of nursing homes when there is no need for them to be there. This comes back to home care. In the community in which I live, East Wall, excellent home help care is available, mainly provided by local women. There is a great relationship between the carer and the person for whom they are caring. In so many cases, they are giving far more than the hours for which they are being paid. There is also very good community care in East Wall, with social events and outings organised by the community for seniors, and facilities and events in the day care centre. We also have very positive intergenerational exchanges with the local school and youth club.

However, there are deficiencies in the home care area. There is no regulation of home care contracts. What we are seeing is a lot of privatisation, with agencies springing up. The agencies are good at the tendering aspect of presenting low cost care, but low cost care means lower paid care workers with poor conditions of employment. This is very particular to rural areas, where one carer may have to travel long distances from one client to another, with no travel expenses. All of that is impacting on the quality of care provided. Quality standards have to be in place to deliver quality care. Our seniors who need home care and home help deserve no less than those high standards. Therefore, one request is for home care services to be regulated. I am thinking in particular of three ladies I know who are well into their 80s and who, because they have support from home help and their families, are able to live in their communities in their own homes.

I thank Age Action for the information in regard to the budget for this area. It notes that 72% of the budget is spent on nursing home support schemes, 14% on home help and 9% on home care packages. With a decline in funding for home help services and a decline in the number of home help hours, we know more people are being admitted to nursing homes who could stay in their homes. This is not an efficient use of resources, so something is wrong. I thank ALONE for providing the information that the proportion of older people in nursing homes in Ireland is 35% higher than in other EU countries and the second highest in Europe. This brings me to my point on the need for a statutory entitlement to more care, in the same way an older person needing long-term care has a right to State financial support.

Deputy Fleming mentioned "reablement". A pilot project carried out in north Dublin by the HSE had very positive results after the six-week programme in that people were able to stay in their homes and needed less home help support and fewer hours. What is needed is a serious look at the continuum of care so that needs are met as they arrive and also at how funding is allocated. ALONE tells us that one in three of those in nursing home beds could live in their communities. Its "Home First" campaign shows that one third of older people in long-stay beds have low to medium support needs. In addition, if the housing adaptation grant could be accessed more promptly, this could mean people staying in their homes.

I mentioned my own community. The Minister of State will know it from his time teaching there that there are great facilities for older people in the Docklands area. However, I believe that loneliness is a major problem, sometimes in the cities but more particularly in isolated rural areas where there could be miles between one person and their nearest neighbour. The two venues that used to provide contact, support, friendliness and the personal touch - the pub and the post office - are under serious threat, with a number of closures, and we can add to that the closing of the rural Garda stations. All of this is contributing to feelings of insecurity, loneliness and isolation. While I am not advocating drink-driving, I doubt it was our senior citizens who were responsible for traffic and road fatalities. Nonetheless, when one social venue is removed, it needs to be replaced with another.

Older people, either couples or individuals, may reach a point in their lives when their three-bedroom or four-bedroom home is more than they need. We should have a system where they can get out of that home and transfer into supported living. I receive frequent calls from elderly people living alone who have nobody to help them. Age Action is great at doing various jobs but there are some jobs that it cannot do without further support. To have senior citizens, in particular those with disabilities and those in various stages of dementia, coming into hospital accident and emergency departments is appalling. There is a need for designated intellectual disability nurses if we do not want senior people presenting at primary health care centres.

We know the consternation that arose when free travel appeared to be under threat recently. Free travel is a contributing factor in the independence of the elderly and, for many, it is their sole means of getting around and getting to essential services and appointments. It is also a gateway to social life and visiting places and people. Of course, when older people avail of free travel, they spend money. There is discrimination against older people when it comes to car insurance. Older people, even those who have had no claims on their insurance policies all of their lives and are in very good health, can still find it next to impossible to get car insurance.

I hosted an Irish Food Writers Guild event on the health of the nation in the AV room in Leinster House today. One of the points made by the speakers concerned the relationship between food and health. Diet and nutrition are major killers in the developed world and, therefore, better eating is intrinsically linked to better health and well-being, with significant economic gains. The speakers called for the Government to revise food and health spending because better eating means improved lifelong health. They gave an example from Copenhagen of an older person's home for people with disabilities where a change in the diet, the food and the cooking meant fewer visits to doctors and hospitals, which meant savings. With increasing numbers of older people living longer, it is a challenge for the Government and succeeding governments. However, it points to the need to plan ahead. Yeats said this is no country for old men, but Ireland should be a country for old men and for old women because, at that stage - we will all get there, hopefully - we will need those supports.

Finian McGrath (Dublin North Central, Independent)
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I am grateful for the opportunity to speak on this important Private Members' motion on supporting our senior citizens. I thank and commend Deputy Tom Fleming for bringing forward the motion and I also thank all of the Independent Deputies who are supporting it.

This is a very important part of the Independent vision for our country and, in this case, for our senior citizens, who have served the State so well. We all need to ensure that we have policies that are fair to senior citizens in order to maintain their dignity and independent living. The State has a duty of care for all of our people and our elderly have to be part of our society. I want a society built on social justice, on equality and respect and, above all, I want a society that puts the care of the elderly, a quality health service for all, and also for people with physical and intellectual disabilities, top of the political agenda. Tonight, in the Dáil, the Independent Deputies have proposed a plan to support our senior citizens. I call on all Deputies to support this motion in the vote tomorrow.

There are many excellent groups in this country which work with our senior citizens, including many in Dublin Bay north and across my own constituency that do magnificent work. However, the reality is they need and deserve our support. We also have to deal with the reality of what is happening in the country at the moment. Our population is aging rapidly and we are witnessing the most dramatic increase in population age in recent history. The current models are struggling to provide care for the older population and unless immediate action is taken to put in place long-term sustainable solutions, we are facing a major crisis.

It is envisaged that by 2026, there will be approximately 908,000 people aged 65 years and older, which accounts for 16% of the population. These are Central Statistics Office, CSO, figures. Currently, there are six working people to every one older person. By 2045, this will have changed to a ratio of 3:1. The cost of older persons' care is set to double to 1.8% of GDP by 2050. Every day over the next ten years, an additional seven older people in Ireland will require long-term residential care or home help. We need to plan and deal with the reality of what is happening at the moment.

We also need to be brave and sensible when it comes to funding these projects. People ask where we will get the money from. They should just look at the Revenue report over recent days. An extra €44 million was taken in by Revenue following a trawl of wealthy individuals in recent weeks. This was ahead of the June deadline. There were only 137 cases but the average settlement was in the region of €320,000. Since they started this trawling a number of years ago, the Revenue Commissioners have raked in around €2.7 billion on 35,000 cases. That is a figure we will not hear in the broader society and I bring it up tonight in respect of funding for services. One in three people in nursing home beds could be supported to live in our community. We have the second highest number of over-65s living in nursing home care in the European Union. We have a dramatically ageing population. As I said before, 16% of the population will be over 65 by 2026. That is the reality of what is going on.

We have two Ministers in the Chamber tonight. I call on the Government to implement a range of policies that are favourable to senior citizens to maintain independent living. I call on the Tánaiste and the Minister of State, Deputy Ó Ríordáin, to provide the supports and services to assist people to continue to live in their own homes. In light of the upturn in the economy, we should prioritise the household benefits package, including the electricity and gas allowance and the free television licence among other measures. We should continue to maintain the free travel scheme and the Christmas bonus. We should also ensure home help hours are maintained in line with demand in order that older people can age in their own communities. We should also invest in the Health Service Executive community care and community mental health services.

These are the proposals we are putting on the table tonight. I also want the Government to commit to supporting older people to live a better life and in their own communities. We need to develop our primary and community care systems. We need to extend the fair deal scheme to include home supports. We need to increase home help hours and home care packages, which will also reduce costs. We need to support older people to move home from acute hospital and nursing home beds after respite.

Recently, I spent a couple of hours in the accident and emergency department in Beaumont Hospital, in my own constituency. For the front-line staff there, the solution to their problem is 90 to 100 beds. Any Minister for Health who comes in here and says he can reform the health service without dealing with the reality is in error. Beaumont Hospital needs 90 to 100 beds, which would make a huge dent in many of the problems we see. We have to look at ourselves and face the reality. We must ask if it is acceptable in 2015 to have a 102 year old woman lying on a trolley in any hospital. For me, that is not acceptable and is criminal. We need to focus on the issues and on people's lives. We need to restore the grants to 2011 levels to allow older people to adapt their homes when they need change. We also need to restore the benefits to 2011 levels.

Approximately 35.4% of people in long-stay beds have low to medium support needs. Low dependency beds have seen a 44.6% increase from 2004. Medium dependency beds have increased 17.6% from 2004. Figures of low to medium dependency people in long-stay beds are increasing, while those for high to maximum are decreasing. There has been a 44.6% increase in the number of people with low support needs in nursing home beds from 2004 to 2013. There has been a 17.6% increase in the number of people with medium support needs in nursing home beds up to 2013. Research has shown there is a significantly higher number of older people going into nursing home care in Ireland than any of the other European countries. Approximately 7% of people aged 65 and over in Ireland live in nursing homes, whereas the figure is 4% for the same age group in the North. Those are the figures and statistics. To deal with the solutions, we have to deal with the facts. Ireland has 35% more people in nursing homes than the EU average as of 2013. The average length of stay in an Irish nursing home is 3.7 years while the average length of stay in UK nursing homes is 2.1 years.

We need to deal with the lack of community care. The lack of finance for home help hours and home care packages, mobility aid cuts and the lack of supportive housing have led to older people being forced away from their homes and communities. From 2011 to 2015, 1.6 million hours were taken away from the home help allocations. There is no legal obligation on the Government to provide home care services. Home care services throughout Ireland are unregulated and unevenly distributed. The housing adaptation grant, which would allow homes to be modified, should be supported.

These are the proposals we have put on the table. We also need to ensure the living alone allowance continues to reflect the cost of living and that the carer's allowance and half-rate carer's allowance are maintained. We need to recognise the value of respite supports and acknowledge the importance of the household adaptation grant for people with a disability, the housing aid for older persons scheme and home installation and energy saving for older people living at home. These will enhance the services for senior citizens.

I commend my colleague, Deputy Tom Fleming, on bringing this motion before the House. I thank and commend the Independent Deputies who have worked very hard on these issues and who also work very hard in their own constituencies every day. I want to build a country and society that has respect for our senior citizens. Many of these people have worked hard for many years and paid their taxes. It is the least they deserve now. I urge all Deputies to support our motion when it comes up for a vote tomorrow.

Bernard Durkan (Kildare North, Fine Gael)
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I call the Tánaiste, Deputy Joan Burton, who is sharing time with the Minister of State, Deputy Aodhán Ó Ríordáin.

Joan Burton (Dublin West, Labour)
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I thank the Deputies for the opportunity to contribute to the motion and to highlight the Government's steadfast commitment to our older citizens. When I became Minister for Social Protection, even though the public finances were practically bust, I was determined to ensure we protected older people given their massive contribution to the State. They helped sustain this country through bad times and bring the country to better times. Now, as Tánaiste, my goal is to ensure our older citizens share in the recovery that is under way, a process which began in the previous budget.

Over the past ten years, there have been significant improvements with regard to the level of pensioner poverty in Ireland which, I am happy to say, has been steadily reduced. In 2004, the at risk of poverty rate for people aged 65 and older was very high, at 27.1%. According to the CSO survey on income and living conditions, SILC, data, by 2013 this rate had dropped below 10%. The consistent poverty rate for those age 65 in 2004 was 3.3%. By 2013, this had fallen to 1.9%.

It is a tribute to everybody involved in politics in this country that, notwithstanding our terrible economic experience, we have prioritised the protection of older people. Their relative position has improved compared with the boom days of 2004. The figures demonstrate that progress has been made in protecting older people against poverty, something which has been, and will remain, a key priority for the Government. Central to safeguarding older people against poverty is the State pension. It is a very valuable benefit and the bedrock of the pension system. A little known fact about our welfare system is that State pensions, including the contributory and non-contributory pensions, account for the single, largest block of social welfare expenditure.

As we heard from previous speakers, while expenditure on pensions is increasing because of the growth in population and demographic pressures, this is being successfully managed within the overall welfare budget. Last year, in 2014, overall expenditure by the Department was €19.8 billion but expenditure on the pensions programme accounted for almost one third of this figure at more than €6.6 billion. In 2015, expenditure on the pensions programme is estimated to reach €6.7 billion, or 34% of total expenditure by the Department of Social Protection.

I thank Deputies for the reference to last year's budget, in which I increased the living alone allowance, a payment made to pensioners and people with disabilities who live alone and which was last increased in 1996. I made the decision in recognition of the fact that people living alone can be more vulnerable to economic deprivation than a two person household where resources can be pooled. We are all familiar with houses where at one point there were five people, and at a certain stage even five adults, and now one individual remains and he or she must still carry the costs of the household.

A second factor was that a very wide range of pensioner representative groups, whom I meet regularly, had identified such an increase as a key budget priority for a number of years. I will get technical for a moment. The real value of the State pension can be seen when viewing the market cost of an inflation-linked annuity of €12,000 a year, which is the current annual value of a State contributory pension. If one were to buy that on the market, the cost would be in excess of €300,000. The value does not include associated benefits available with the State pension such as increases for a spouse or another adult living with the person who qualifies.

Core pension rates have not been reduced in the period since 2009, despite the significant pressures of which people are aware following the crash. In dealing with the inherited economic crisis, it was a Government priority to protect the primary weekly social welfare rates such as the State pension. This was because maintaining the rate of the State pension and other core payments is critical in protecting people from poverty and gives people assurance and certainty about what they have to spend. When one is aged 70 or more, one does not have the option of earning extra income, as younger people might have. CSO figures show that people over the age of 65 are significantly less likely to be at risk of poverty or deprivation than those aged under 65.

Protecting the State pension has not been as easy as it sounds because when the Government came into office in 2011, the Social Insurance Fund deficit for 2010 was an enormous €2.8 billion. To put it more plainly, there was a huge hole of €2.8 billion in the fund. By building a jobs-led recovery, the Government has ensured that the Social Insurance Fund has been topped up by PRSI contributions from people going back to work and, therefore, we have been able to maintain the contributory principle. As a result, income from PRSI receipts this year is targeted to be just over €8.24 billion, with expenditure at almost €8.42 billion. The €2.8 billion hole in the Social Insurance Fund that put social protection at terrible risk has reduced to less than €200 million. In fact, we will shortly eliminate it altogether if we can continue the recovery. That is something about which we can be very pleased. It is a fifteenfold improvement on the funding position I inherited. The figures indicate a very healthy improvement in the income and expenditure position of the Social Insurance Fund. That allows me, as Minister for Social Protection, to ensure that the funding position for State pensioners is more than adequately protected. Pensioners do not have to worry that their pensions are at risk because as a country we have recovered to the point where people are going back to work and the income from PRSI, to which we all contribute, is available, in particular for contributory pensioners. That is a very important social insurance that protects everybody in society, but especially people of pension age.

Our country's population and demography is slowly but surely changing, with an increasing number of people entitled to a State pension. As a result, every year since I became Minister I have had to put aside approximately €200 million per year for the additional pensions required. That means that even if nothing else changes in the next five years, social welfare spending must increase by €1 billion to pay for all the contributory and non-contributory pensions required. We are able to do that as a society by careful management of our economic situation. It is so distressing for people in this country to see unfortunate people in Greece going to ATMs without being sure they can take out their money even after they have waited for hours to access their pensions.

Members also referred to the household benefits package. It is a very valuable support for older people and includes electricity and gas allowances worth €35 per month. The free television licence is worth €160 per year. The Department will spend €227 million this year on the package for approximately 415,000 customers. The package is generally available to people living in the State, aged 66 years or over, who are in receipt of a social welfare-type payment. Importantly, the package is also available to carers and people with disabilities under the age of 66 who are in receipt of certain welfare-type payments. Widows and widowers aged from 60 to 65, whose late spouses had been in receipt of the package, retain the entitlement. The annual value of the package to each social welfare recipient is currently €580. I mentioned that free television licences form part of the package. That is important as television is an essential social good whereby people who might otherwise be a bit isolated can use it for entertainment, politics, sport or to keep them informed.

The Christmas bonus was abolished by the previous Government in 2009. I remember the gasps of horror that went right through the Dáil on the day that was announced because people were shocked. The bonus was something everybody in the country valued for those who were retired or on pensions. I am pleased to say that because of the fledgling recovery I was able to partially restore it last year. A bonus of 25% was paid in early December to all long-term welfare recipients, including all pensioners, carers and people with a disability, at a cost of more than €65 million.

This benefitted over 575,000 pensioners and 1.23 million welfare recipients in total.

People mentioned free travel. I am happy to say that when I sat down with the Taoiseach, after I became leader of the Labour Party and was taking on the job of Tánaiste, the Taoiseach and I agreed, in the statement of priorities, that the Government commits itself to the full retention of the free travel scheme. It is available here and in the North and more than 828,000 people are in receipt of it. Including the companions and spouses, 1.3 million avail of free travel, and it costs the State €77 million, which is money well spent. When groups of pensioners take the train to Killarney for a nice day or a midweek break it is good for tourism and Killarney, and it is great for retired people to be able to do it in some comfort.

Tom Fleming (Kerry South, Independent)
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They are very welcome.

Joan Burton (Dublin West, Labour)
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Deputy Tom Fleming is always there to welcome them. Just 50% of people in employment have an occupational or supplementary pension, and only 41% in the private sector, despite all the efforts over the years to promote the importance of retirement savings to make life more comfortable in retirement. Given that the voluntary approach has not worked, in the statement of priorities after I became Tánaiste, the Taoiseach and I confirmed that the Government will agree a road-map and time-line for the introduction of a new, universal supplementary pension savings scheme. We have established a high-level, universal retirement savings group, chaired by my Department, which includes international expertise. Countries such as Australia, New Zealand and the UK have introduced supplementary pension saving schemes. We are doing the work to set out how the scheme would work.

Deputies mentioned carers of older people, children and adults with an illness or disability. Carers do an unbelievable amount of work and help people live in dignity and independence in their own homes and communities for as long as possible, which is what everybody wants for themselves and for as many people as possible. Carers are vital to the achievement of this objective. Every day, parents, partners, children, friends and neighbours provide care for people who, through a variety of circumstances, need it. Their work makes a profound difference to the health, well-being and quality of life of the people for whom they care. It also makes an important, often unacknowledged contribution to the economy.

We published the National Carers’ Strategy in 2012 and, in acknowledging the contribution that carers make, the Government provides a range of income supports including carer's allowance, carer's benefit, domiciliary care allowance for children who need care and the respite care grant. This year, it will cost us more than €822 million in social welfare payments. In 2004, only 23,000 people were in receipt of the carer's allowance. By last May, it had grown to 57,200 people. There has been a major increase in the number of people in receipt of the carer’s allowance or the half rate carer’s allowance. Nearly 25,000 of the people in receipt of carer’s allowance are at a half rate because they are in receipt of another social welfare payment. For example, a lone parent who is caring for one child on a full-time basis would receive €219.80 in one parent family payment and an extra €102 per week in a half rate carer’s allowance payment if he or she were caring for somebody.

Recipients of carer's allowance also qualify for free travel and, if they are living with the person they are caring for, the household benefits package. The respite care grant is an annual non-means-tested payment made to carers by the Department. Full-time carers who are not in receipt of a carer’s payment from the Department are also entitled to the respite care grant.

Approximately 24,000 people over the age of 60 are in receipt of the invalidity pension. These are people who typically worked all their lives but are now unable to do so due to a long-term illness or disability, and who have been medically certified as being permanently incapable of taking up employment again. The invalidity pension is an important safety net, acting as a support if people find themselves in the unfortunate position of not being able to continue in employment for health reasons, up to the age State pension is payable. In addition to the pension, recipients of invalidity pensions are also entitled to free travel and may qualify for gas, electricity and fuel allowances.

Staff in my Department and the Intreo offices are ready to help, as are the information services we fund through the Citizens Information Board. The staff of my Department are committed to providing the best quality service we can to older people. We fund all the community employment schemes and community services programmes around the country. The Deputies here from the north inner city of Dublin and from Kerry know that every area of the State has community centres with community employment schemes funded by the Department which provide day services. People might meet friends, play a few games of 25 or such like and have lunch or other meals. This cuts across the social isolation whereby people, particularly in rural areas, but also in cities, can lose contact with their network of friends as they become older.

I am very happy to support the motion and take it as a mark of the common concern everybody in Irish politics has to ensure that as far as possible we try to make life better all the time for older people, and that as we build an economic recovery, they share very importantly in a social recovery and in security, so that they have a solid future to which they can look forward, particularly living independently for as long as possible.

Aodhán Ó Ríordáin (Dublin North Central, Labour)
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I welcome the motion. It is timely and well constructed. The contributions from both sides of the House serve us well as a Department when we deal with the issues around older people. As the Tánaiste outlined, there have been major challenges in recent years and it is a good time to take stock as to where we are and where we intend to go. One of my responsibilities relates to the 2016 commemorations and as part of the consultation process we have organised a number of meetings around the country to get feedback from people. The number of people of an older generation who were still fascinated and determined to make their contribution and still have the ethic of citizenship that may have diminished or been lost somewhat over the years was remarkable. When one engages with people of a certain generation who understand the citizenship ethic, who understand what it means to be a citizen of a country and who want to play their part in commemorating what has happened in the country over the past 100 years, and when they tell stories of their families, communities and where they come from, it is inspiring. It is only when we listen to them and learn from them that we can hope to build something brighter for the future.

I want to ensure people play their full role and feel part of next year's commemorations. We are in a period of reflection on Irish history, not least because we are coming out of a particularly difficult and painful economic turbulent time. We are also in a period of reflection of the past 100 years and building for the next 100 years. We do have to discuss our values, the ones about which we feel strongly and, as Deputy Maureen O'Sullivan rightly said, about making this a country for old people. That is one of the aspirations to which we have to cling rigidly.

Our population is aging rapidly with advances in health care leading to a dramatic rise in our older population. This is a positive development. It should never be construed otherwise or suggested these are resources that could be spent elsewhere. Each year, the total number of persons over the age of 65 is growing by around 20,000. Projections indicate this will continue to increase with the impact being more significant in the over 85 age group. We should celebrate this as the success story that it is. The Government is strongly committed to protecting and advancing the policies and services necessary to promote all aspects of growing older.

Maintaining good health is the key to living well for longer. Older people are now staying healthy for longer than was previously the case. It is important society supports us all as we age, as well as providing access to high quality health and care services along with supports from primary care through to acute care, community, residential and end-of-life care. The Government’s policy is to support older people to live in dignity and independence in their own homes and communities for as long as possible. This is where people have consistently said they want to be supported. We must consider how we can best respond to this clear preference. There is now a stronger emphasis on home care and other community services which provide a greater range of options to avoid admission to acute hospitals, support early discharges and, where appropriate, to rehabilitate and re-enable patients after periods of particular difficulty. The Health Service Executive provides a range of community-based services aimed at ensuring older people receive safe, timely and appropriate care and treatment at the lowest level of complexity and as close to home as possible.

In its national service plan, NSP, for 2015 the HSE stated it will continue to progress the strategic realignment of services to provide home care and community support services to maximise the potential of older people in their own homes and communities. The levels of home supports planned for in the NSP are 10.3 million hours of home help service supporting 50,000 people. This is the same level of service as 2014. Up to 13,800 people will be in receipt of a home care package at any one time. This includes an additional 600 people supported under the delayed discharges initiative. Up to 190 people will be in receipt of an intensive home care package at any one time. These packages were introduced for the first time in 2014 for people with more complex care needs. An additional €2 million has been allocated in 2015 to expand the coverage of community intervention teams with a particular focus on hospital avoidance and earlier discharge from acute hospitals in the greater Dublin area.

In line with programme for Government commitments, our priority has been to modernise mental health services and to resource implementation of the widely agreed policy, A Vision for Change. Since 2012, the Government has provided additional ring-fenced funding of €125 million, resulting in around 1,150 posts of the type required to re-balance services towards greater community-based provision. The funding includes, among other measures, provision of enhanced specialist community mental health services for older people with a mental illness.

It reflects well on this Parliament when we can come together to agree a value statement for what we collectively believe in and try to deliver. This Chamber can often be a place of theatre, grandstanding and political point scoring. However, sometimes we do not give enough credit to ourselves for the level of collective understanding we have of what our people need. Older people living longer is to be celebrated. In this time of national reflection as we challenge ourselves to think of the values that underpin this Republic, this House has always striven to protect our older citizens, particularly those who may not have a family network to support them.

The State has done well in this regard in its history. Over the past eight years we have done the best we could despite budgetary constraints. We are in a position to improve now. The test for our value system will be how much we invest in this area. We can never suggest that someone’s dignity, wisdom and experience are too expensive to invest in. Many of the contributions tonight were very worthy of this House. I appreciate the opportunity to contribute to this debate.

Robert Troy (Longford-Westmeath, Fianna Fail)
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I welcome the opportunity to contribute to this debate. I salute the Technical Group for bringing forward this timely motion. It is only right and proper that we have this debate. We have had similar debates over the past several years because, unfortunately despite the Minister’s rhetoric, the elderly have not been protected in this Government’s lifetime. Pope Francis, a man whom I admire and who has won great admiration across the world for his directness, humility and how he has always spoken out for the marginalised in society, said:

We live in a time when the elderly do not count. It's awful to say, but they are discarded. Because they are a nuisance to us. The elderly are those who carry history, that carry doctrine.

How right he is. I have huge admiration for our senior citizens. They played a pivotal role in building our State to what it is today. They worked long and hard and paid their taxes. One need only think back to the hardships they endured. When one talks to one’s grandparents, even parents in some cases, one hears of how they went to school barefoot and brought turf to ensure the school was adequately heated. There were those who worked on building sites without the support of the machinery we have today. Now, when they come to live out their twilight years, they wish to do so in a degree of comfort, security and decency which they deserve.

The manner in which this Government has targeted our senior citizens over the past several years has been nothing short of disgraceful. It flies in the face of its commitment in the programme for Government and the national positive aging strategy which aims to “enable people to age with confidence, security and dignity in their own homes and communities for as long as possible.”

Unfortunately, senior citizens' confidence has been eroded and their security, snatched. They have been robbed of their dignity.

It does not do the Government any good to state it has maintained the level of the statutory old age pension. That is true; there is no disputing it and it is a factual statement, but senior citizens are enraged when they hear it. What the Government fails to state is that, despite a promise made in the run-up to the general election and subsequently by the then Opposition spokesperson for health, the Minister for Children and Youth Affairs, Deputy James Reilly, that he would abolish prescription charges, not alone did he not abolish them but he also increased them fivefold, with a maximum figure of €25 a month for a single person or €50 a month for a couple. Eligibility for items under the medical card were removed. There was also a reduction in the income threshold under the over-70s medical card. The telephone allowance was abolished, even though it not only provided security for the elderly and kept them in contact with their families but also was a lifeline in terms of the emergency pendant worn around the neck. There was a reduction in the number of weeks for which the fuel allowance was paid. There was also a reduction in the number of the ESB units availed of by senior citizens. There was the introduction of the property tax and water charges. From where does the Minister of State think all of these charges were met? They were met from the old age pension.

Seven out of ten senior citizens live exclusively on the State pension. The contributory old age pension is €230.30 a week, while the contributory pension is €219. A senior citizen in my constituency is paying €36 a week in rent on her local authority house, full prescription charges for her medication, has to have a telephone in order to have the pendent around her neck, has to heat her house and eat. She is left with nothing at the end of the week. Recently I visited her on 80th birthday and asked if she was doing anything to mark it. She replied that, apart from some of her children bringing her out, she could not afford to do anything. Is that letting someone live with decency?

I have stated 70% of pensioners live exclusively on the State pension. As for the other 30%, most live on a small private pension. Even at that, the Government did not leave it alone. It chose to rob them and reduce their income.

It has often been said that in good times money is wasted. In the period 2001 to 2009 in actual terms the old age pension was increased by 65%. If one takes into account the rate of inflation, at 25%, there was a net increase of 40%. It was the right thing to do. It was right to give senior citizens something back because they had given so much to the foundation and development of the State.

When one looks at the recent media coverage of the wage increase granted to retired and retiring politicians and notes that the Government has chosen to give an increase to persons on salaries or pensions a multiple of what senior citizens have to live on, it shows what its priorities are in increasing the economic well-being of the population. There is the ludicrous situation where the Taoiseach has said the Government would like the people concerned to give it back. Why was it given in the first instance? It sends all the wrong signals and is morally wrong at a time when so many are living on a basic income of €230 a week or less than €12,000 a year.

It was stated in the programme for Government in 2011, "Investment in the supply of more and better care for older people in the community and in residential settings will be a priority of this Government." Despite the fact that we have an ageing population, why was there a reduction of over 1 million in the number of home help hours, from 11.7 million in 2010 to 10.3 million in 2014? In my constituency of Longford-Westmeath, there was a reduction of 60% between 2012 and 2013. I do not have the figure for 2014.

There is talk about the provision of housing grants that were introduced to ensure houses could be adapted for those with a disability to enable them to stay in their own homes, to ensure housing for the elderly could be insulated and that they could have their windows and doors replaced to ensure they would be comfortable. What did the Government do? It changed the eligibility criteria. The limit was increased from 60 to 66 years, while the amount paid out was slashed. In 2010, at the height of the recession, €1.6 million was spent on grants for the elderly in County Westmeath. In 2013 a figure of €561,000 was spent. I know an elderly couple in their 80s who cannot obtain a housing adaptation grant. For the first time since I became involved in public life in 2014, there is a waiting list to have necessary housing adaptations carried out. I know a constituent who recently received a grant - for some reason or other, this year's grants were announced late - and although the rain was leaking through her back kitchen, she could only receive 50% of what she needed to repair the roof. She cannot afford to pay the other 50% and has asked what is she to do. We are trying to get value for her from different builders to see if they can do the work at a reduced rate. That should not be happening, given that the Government is talking about people having a sense of decency and respect and about ensuring they can live independently in their own homes.

I have received a telephone call this evening from a lady who is looking after her sister who is blind. She is in receipt of carer's allowance, while her sister is receiving blind person's allowance. She received her bill for water charges today and has left a message on my telephone tonight that she simply cannot afford to pay them.

There was an 83 year old lady in my clinic the other day whose daughter had applied for carer's allowance, but lo and behold, it had been refused. That is a symptom of what is happening time and again. Frankly, it is a delaying tactic on the part of the Department of Social Protection which is seeking to put every obstacle in people's way. It refuses people on the first occasion in the hope they may go away and not come back a second time. That is not good enough. It is disgraceful.

The Minister for Social Protection should instruct her officials to ensure that when a comprehensive application is submitted it is dealt with in a timely manner and obstacles are not put in the way of people who are saving the State money. Those in receipt of a carers allowance are the only people actually working for their social welfare payment.

I will talk about the unbelievable manner in which we are treating our elderly when it comes to hospital waiting lists. I could have spent my 15 minutes giving examples of people who are waiting in excess of two years for procedures such as hip replacements, knee replacements or the removal of cataracts. I know a man aged 80 who lives in rural Ireland and whose only means of independence is his car. He was told he cannot drive until his cataracts are removed and that he could be waiting two years for the operation. This Government is making him a prisoner in his own home. If the Minister wants to talk about ensuring decency and respecting the people who were the founders of our State, who helped to build our State and worked so hard, he should live up to the commitments in the programme for Government. Let us prioritise the most vulnerable and most marginalised, who do not seem to have a voice at the Cabinet table where so many disastrous decisions on cuts have been made in the past four and a half years. The Government should show its commitment to our senior citizens and restore many of the schemes it has cut in the past number of years. It should live up to its commitments to ensure our senior citizens can live in the independence of their own home, in security and decency. As the Minister said, how we treat our senior citizens says a lot about who we are as a society.

Acting Chairman (Deputy Bernard Durkan):

Deputy Colreavy has five minutes.

Michael Colreavy (Sligo-North Leitrim, Sinn Fein)
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Only five minutes?

Acting Chairman (Deputy Bernard Durkan):

That is what it states here.

Michael Colreavy (Sligo-North Leitrim, Sinn Fein)
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I take it the Government will not oppose this motion and I am delighted to hear that. There can be no denying that we are an ageing population. When I look into a mirror I see it, as I normally do when I look around this Chamber. I do not see it so much tonight but it is evident on other occasions, and certainly during votes. One sees a lot of grey hairs here and this institution reflects what is happening in the country as a whole. By 2026 there will be approximately 908,000 people aged 65 years and older, accounting for 16% of the population. I do not count those over 65 as old but that is the statistic. By 2045 there will be three working people to every one older person, which will be down from the ratio of six to one that currently exists. This is a sobering thought and a fundamental change which, unless it is planned for, will cause chaos and harm, particularly for our senior citizens.

Older people could be forgiven for thinking this Government does not have a good record when it comes to making decisions that affect their future. We have witnessed cuts to the housing benefits package, living alone allowance, carers allowance and home help service cuts. We have seen a reduction or the withdrawal of financial supports for house conversions to enable senior citizens to stay in their own homes. Every rural transport cut, every post office closed, every health service delay impacts directly and most severely on our senior citizens.

Cuts to fuel allowance are a particular cut that can have a major impact on the lives of the elderly. Fuel poverty is in my brief and is in many respects a matter of distributive injustice as it is the poorest in society who are often those who suffer greatest from the lack of adequate heat. Not only does a lack of adequate heating make conditions more uncomfortable for those households, it can have a direct impact on their physical and mental health. Sinn Féin believes the fuel allowance should be extended by three weeks per annum as a small help in eliminating fuel poverty.

Local authority and housing association tenants frequently tell me that storage heating in their homes is very expensive, particularly in rural areas. Local authority and housing association tenants would much prefer solid fuel cookers because there is a ready availability of supply, even when funding is low. Energy affordability is a factor for senior citizens, as are convenience and safety but if we are to continue to use storage heating in local authority and housing association homes we need to get the costs down dramatically.

If we wish to see an Ireland where our senior citizens can continue living independent, dignified lives we must as a nation, rethink how we design and implement services. We must ensure the organisational bunker thinking of Government, State, semi-State and local government departments changes because there is an attitude which says, "Protect my budget at all costs and forget about the person in respect of whom the decision has been made." Organisational lines are high walls.

We must provide greater support to families who are prepared to care for disabled or elderly people at home. Too often, those who selflessly care for aged relatives feel as if the State views them as unworthy of seeking help. They are made to feel bad for seeking help to do the right thing by ageing relatives. We must also look at minimising dependence on community nursing units by providing independent living apartments supported by central catering and care units for people who would not be capable of independent living at home. An excellent example is Aras Bhride in Drumkeerin in my constituency. People love it there and are safe. They are not quite independent enough to live at home but they can live in their own community. It is an excellent model. It is not under the HSE nor a council but is a service which maintains the independence of those who avail of it.

I commend the Deputies who tabled this most important motion and thank them for doing so.