John Minihan (Progressive Democrats)

I welcome the Minister of State and am grateful for the opportunity to contribute to this debate. The Opposition's claim, in the introductory sentence of this motion, that a contribution to society such as that made by home help services could go "unrecognised" is beyond comprehension. Home help provides aid to older people, families in stress and difficulty, those with disabilities, other carers and hepatitis C clients who need assistance. To paraphrase a famous quote, people who do this work are a light to others, doing well and willingly the tasks at hand, namely, being aware of another's needs and doing something about it.

When home help services assist a person to remain in his or her own home and avoid the necessity of entering institutional care, they do both the individual and society a tremendous service. As already mentioned, international research suggests that the life of a person can be extended by up to two years if care is delivered in the home. I, along with he Tánaiste and the Progressive Democrats Party, not only recognise the work of home helps but salute and applaud it.

The substance of the motion deals with the nature of home help contracts, including regulation of hours, training and wages. Following the necessary abolition of the health boards at the start of this year and their replacement by the HSE, responsibility for delivering all former health board services now lies with that body. All HSE service areas, as I am aware from my dealings with the staff in the Cork region, either provide the home help service directly or make arrangements with voluntary organisations to do so. The HSE is not limited in the categories of persons it may assist at home.

The executive is dealing with a challenging and changing scenario. In terms of home help for older people, it is estimated that between 1991 and 2026, there will be a 75% increase in the number of people aged 75 and over. Such demographics provide a challenge for the HSE and home help services. Moreover, people no longer die from the same diseases as in previous generations. Chronic conditions are key causes of illness, disability and death in modern societies. Given medical advances in surgical interventions and pharmaceuticals, Irish people now live longer. However, we often live longer with disabling, chronic conditions. In addition to demographic change, therefore, the HSE and home help services must also take account of the changing nature of illness and, as a result, the nature of care.

The Opposition motion also raises the issue of training. Medical staff and care professionals must work with and care for an 85 year old in different ways than they would a person of 55 years. There are remarkable differences, in needs and responses, just as there are between children and middle aged adults.

This is a composite issue, one that will not be simplified even by the €120 million spent on home help this year. As the Tánaiste sets out, the Government commitment in this area is evident, involving a tenfold increase in funding since 1997. I will not dwell too long on the funding element, except to say that, unsurprisingly, the tenor of the Fine Gael motion is that the Government's commitment to funding and resources is the problem. That is not the reality. There has been a 200% growth in spending on health since 1997. Furthermore, spending by the Department of Social and Family Affairs has increased by 110% in the same period.