Joe Cooney (Clare, Fine Gael)
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I want to raise an issue that is a real worry for people, not just in County Clare but across the country. I hear every day from older people and their families who are struggling to get home care or a place in a nursing home. Clare has the longest home-support waiting list per person in the country. Even though the Government is spending more on home support nationally, Clare is not getting its fair share. This needs to be fixed so waiting times can be brought down quickly.

Because of this, more people are going into nursing homes, unfortunately, but nursing homes in the county are also under severe pressure. Private and voluntary homes, which provide most of the beds in rural counties like Clare, face real financial problems. The fair deal rate does not match the rising cost of care, unfortunately, and smaller rural homes are struggling the most. People in Clare are stuck with a problem. There are not enough carers to let them stay at home and there are unfortunately not enough nursing home beds available for those people to go into. Families are under huge pressure. People in Clare want to grow old at home where possible and have dignified care in a nursing home when the time comes. The Government has the power and the vision to make that happen. I ask that Clare be not left behind. Will the Taoiseach commit to a plan to increase home support in counties like Clare where waiting lists are the longest and putting serious pressure on families? Will he commit to providing support for existing rural nursing homes so they can cope with the rising demand and encourage new entrants into the market to ensure there are enough beds into the future?

Micheál Martin (Cork South-Central, Fianna Fail)
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I thank the Deputy for raising this very important issue. It is fair to say that we are ageing as a society. Our lifespan has improved dramatically compared to 20 years ago. Irish lifespan has increased more than most in the European Union, which is a good thing for all of us, potentially. On the other hand, it creates more challenges in terms of care costs, health costs and so on. Every year, there are substantial increases in the budget as we try to provide for an ageing population. The budget for home support in 2026 is the largest ever at €914 million. That is an increase of over 87% on 2020. That illustrates how services are expanding to meet the needs of a population that is ageing and living longer. That investment will see additional support, and complex home support hours will increase to approximately 26.7 million. That will support about 62,000 people by year end.

In the Clare and Limerick county integrated healthcare area, in 2025, 1.38 million hours of home support were delivered. That exceeded the target of 1.35 million hours and represented an increase of over 500,000 since 2024, just two years ago. That is a massive increase in the number of hours we are providing. The Deputy is correct, however, that there are still challenges. There are about 694 people on the waiting list for home support services in the Clare and Limerick county integrated area, down from 748.

The service has expanded so much that there has been a challenge in recruiting home carers. The HSE, private providers and others have undertaken a lot of external overseas recruitment initiatives endeavouring to get more in. That is an international challenge. A strategic workforce advisory group on home carers is working with the Department of Health on exploring options. We are also using assistive technology in home support initiatives to directly address rural home support provision. The Health (Amendment) (Home Support Providers) Bill 2025 has passed Second Stage. That will improve the regulation of the sector. More importantly, it is the first step in ensuring that home care will be provided in the context of a statutory home care scheme. We are also providing additional funding to meals on wheels, with about 3.3 million meals a year being provided. A total of 313 day centres will be resourced to support nearly 16,000 people in 2026.

I might respond to the Deputy's comment on the fair deal scheme after the supplementary question.

Joe Cooney (Clare, Fine Gael)
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I thank the Taoiseach. Clare is a county with one of the fastest growing older populations and avoiding serious challenges for those elderly people is very important. Its rural nature and the remoteness of many of its areas are especially challenging to provide home help to older people, given the travelling distance. In addition, support for more home help and nursing homes in Clare would help in a big way to alleviate the overcrowding in UHL. I am aware of families who have been told patients in the hospital could have to travel, 30, 40 or 50 miles to get a nursing home bed, which is not good enough for those families and those people. It is a serious concern and a serious issue in our county and it needs to be addressed. We have a rural county and we have serious problems as regards the elderly, nursing homes and home help.

Micheál Martin (Cork South-Central, Fianna Fail)
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I fully appreciate the Deputy's advocacy for his home county. In terms of home care, day care and meals on wheels, there are very significant extended resources all working together and they are particularly effective in rural areas. I am sure the Deputy will agree what is needed is additional resources, particularly in County Clare. That is what he is advocating for.

The fair deal scheme supports people to access nursing home care. The more people have, the more they pay in terms of income levels. It is structured that way. The less they have, the less they pay. Again, there are huge costs involved here. There are about 24,000 people on that scheme, with 80% supported in private nursing homes and the remainder in HSE-run facilities. The cost has gone from €968 million to €1.2 billion in 2025. That will continue to rise. I take the Deputy's point about the need to try to improve that to give people access closer to home. That is accepted. People generally want to stay at home for as long as they possibly can. There comes a stage, I accept, when a nursing home is required. Obviously, the closer to the family home for the family the better in those situations.