James Bannon (Fine Gael)

I move:

"That Seanad Éireann, conscious of the valuable and mainly unrecognised work carried out by home helps, calls on the Minister for Health and Children to:

—regulate their contracts of employment;

—recognise the need for the regulation of their working hours and pay scales, under partnership agreements;

—provide home helps with adequate training;

—rectify the position of home helps in relation to the failure of the Health Service Executive to honour an agreement, stipulating that where hours have to be reduced, wages would only be reduced after two weeks or four weeks, depending on length of service; and

—substantiate her claim that there were no cutbacks in the home help service in 2004 and in 2005."

I have tabled the motion to highlight the thousands of workers employed in the home help service who have been invisible for too long. In view of the valuable contribution these unsung workers have made over many years to their local communities and the long hours they have put in on behalf of the ill, the elderly and people with disabilities whose quality of life would be bleak without their care and, conscious of the valuable and mainly unrecognised work carried out by home helps, they must be given their proper entitlements. Their contribution is a one way ticket and I intend to do everything in my power to ensure those who give so generously are rewarded and not taken for granted, as they have been by the Government over the past eight years.

It is a scandal in this post-Celtic tiger era that these essential workers remain underpaid and must work in untenable conditions. The imbalances that remain in certain sectors are a sad reflection on our society. The Minister must recognise the need for regulation of the working hours and pay scales of home helps under partnership agreements and she must also ensure the regulation of their terms of employment under the Health Service Executive. Despite continual requests to do so, the HSE has consistently failed to give home helps proper contracts of employment specifying their working hours and specialist work or provide the necessary training facilities for them.

I call on the Minister to rectify the position of home helps by addressing the failure of the HSE to honour an agreement stipulating that where hours have been reduced, wages would only be reduced after two or four weeks depending on length of service. Most important, will the Minister of State clarify the position regarding the 2 million home help hours cut in 2004? Parliamentary questions on this issue were tabled by my colleague, Deputy Twomey, in the Dáil, and followed up by my party leader, Deputy Kenny, as recently as 13 October, but the Minister has not produced data, despite her contention that the figures are incorrect. A comparison between the HSE's 2005 national service plan and a parliamentary reply on home help hours in 2004 revealed a discrepancy of 2 million hours service for the elderly. The Minister of State, Deputy Tim O'Malley, promised to supply accurate figures last July and we are still waiting. If there is no cover up, he should stop hiding and release the figures. He obviously has no grounds on which to dispute our figures. In my constituency in the midlands the figure for employed home help in 2002 was 312. This decreased to 286 in 2003 and decreased further to 261 in 2001. Nationally, the figure for 2002 was 2,534 and this was dropped to 2,304 in 2004. Last year the home help hours were reduced by 254,000 over four counties in the midlands area.

In every constituency throughout the country, evidence supports the contention that home help hours have been slashed. The Minister of State has tried to cover up Government inaction on services for the elderly over the past eight years by spinning old Government promises as new initiatives. I urge him to forget the empty promises, whichever way they are spun, and to release the figures if he feels our estimates are incorrect. That a simple question on figures should cause the Minister to go to ground is self-explanatory.

It is hardly reassuring that the HSE's 2005 national service plan is not clear on the difference between the 2004 figures and those for 2005. If the difference of 2 million is because home help services for people with disabilities are not included with those over 65 years, it should not be a problem to provide accurate figures.

The Minister should clarify the HSE's figures if this is the case. This should be easy but not if there is another explanation, namely, another botch-up by this lame duck Government. If home help services are undermined, the repercussions will be felt in our hospitals and accident and emergency units. Elderly patients who are no longer able to remain at home or to receive the specialised assistance from home helps will end up on trolleys in our already overworked and under-funded national health service.

The Years Ahead, A Policy for the Elderly, was published in 1988 and advocated that older people should be maintained with dignity and independence in their own homes and also that the care of older persons in their own community by family, neighbours and voluntary bodies should be encouraged and supported. However, the health strategy, Quality and Fairness — A Health System for You, published in 2001, acknowledges the "need to develop a comprehensive approach to meeting the needs of ageing and older people, if the problems in the care and quality of life of older people are to be addressed and increased demands over the next 20 to 30 years are to be met". At that time it recognised the need to develop a range of community support services, including the home help service.

The Government places great emphasis on community care, including home help services. It is now recognised that this service is an essential support to family and informal carers. The duties of home helps fall predominately into two categories, personal care and domestic tasks. The home help assists the elderly person in bathing and showering, dressing, feeding, assistance with toileting, personal hygiene and administration of medication, under personal care provisions. With regard to domestic tasks, the home help may assist the client in preparing and serving food, assistance with meals-on-wheels service, lighting fires, bed-making, room tidying, and essential cleaning, including hoovering. The remuneration for this service is an unbelievable sum of €8 per hour, sometimes inclusive of night time work. Home helps are the unrecognised and hidden workers, who perform an invaluable job, without adequate salary, training or security of employment.

The majority of these workers are female. Their work has been erroneously described as menial by the more belittling among us. Perhaps this is why they can be paid the minimum rate and the Government can cut their hours. Categorising their work as menial is an appalling description of the valuable contribution they make to our society. In reply to a parliamentary question on the impact of cuts in allocation to health boards the then Minister of State at the Department of Health and Children with special responsibility for services for older people, Deputy Callely, stated "the policy of the Department of Health and Children on services for older people is to maintain them in dignity and independence at home in accordance with their wishes, as expressed in many research studies; to restore to independence at home those older people who become ill or dependent; to encourage and support the care of older people in their own community by family neighbours and voluntary bodies".

This sounds familiar and, in fact, he was quoting directly from the 1988 reports, to which I referred earlier. The aims are the same but not the provisions. Despite Deputy Callely's contention that there has been a major step forward in the implementation of the home help scheme since 1999, the picture is bleak and the repercussions will resonate in every area of our already overstretched health service. It is claimed funding for the home health service has increased, from €12 million in 1997, which is the year the world began, according to Fianna Fáil. The current figure is inadequate so the increase is meaningless. It is a blatant lie to contend that services in this area have improved in the past few years. It is my contention that services for our elderly, disabled and handicapped and the treatment of home helps, both financially and in terms of security of employment and training for their role, have deteriorated drastically over the past couple of years. The losers are the most vulnerable in our country and those who seek to help them.

The bottom line is that the cost of keeping people in a nursing home, whether private or public, far exceeds the cost of supporting them in their own homes, which is the preferred option of the majority of our elderly citizens. Any cutback on hours or pay and facilities for home helps is a false economy and will come back to haunt this Government in its financial mismanagement.

The Health Service Executive has revealed that patients well enough to be cared for in their own homes are tying up hundreds of hospital beds. The shortage of home helps, nursing home care and other support services is responsible for seriously ill patients being denied life-saving hospital beds. Recently 450 patients in the eastern area alone had finished the acute phase of their treatment but were forced to remain in hospital, due to the lack of essential support services. With up to 200 patients a day waiting for hospital beds, this is farcical. Most health professionals agree that unnecessary admissions to nursing homes could be avoided or delayed by proper investment in community-based services. Some studies suggest that 16% of admissions to nursing homes are social admissions.

Elderly patients are at the mercy of a nursing home system that leaves a lot to be desired, as evidenced by the scandal at Leas Cross nursing home. This revelation, along with other investigations that have so far only scratched the surface, makes it imperative the Minister faces up to the facts and figures of the home help sector and accepts the points raised in this motion. Home helps must see a regulation of their contracts of employment. They must have recognition of their working hours and pay scale, under partnership agreements. Home helps must be provided with adequate and appropriate training. The Minister must also rectify the position of home helps in regard to the failure of the Health Service Executive to honour an agreement stipulating that where hours have to be reduced, wages would only be reduced after two or four weeks, depending on the length of service.

There is no escape for the Minister. There can be no more delay. Figures must be produced to sustain the Minister's contention that there have not been any cutbacks in the home help service in 2004 and 2005. If our claims are substantiated, another nail will be hammered into the coffin of this lame duck Government and the victims of the Minister's ineptitude will once again be the ill, the infirm and those who work quietly on their behalf. We want regulation and we want a statement on that from the Minister this evening.