Michael McCarthy (Labour)

I support the motion and welcome that we are debating an extremely important issue. I do not believe there is anybody who cannot attest to the wonderful service provided by many people to many homes throughout the country. The service has been developed in recent years and thankfully our economy is now sufficiently buoyant to allow us to do so. It began with the helpers being paid a pittance. The service was relatively new and money was needed for other areas in the health system. Thankfully in recent times we have seen the conditions and levels of remuneration improve. Accordingly, there is a higher rate of dependence on the service on the part of those who wish to remain in their communities for as long as possible and who are not as reliant on hospital care as others are.

It is important to make sure that the person receiving the service as the single most important individual represents the cornerstone of policy in this area. We need to ensure the standards, under which those who provide the care operate, are beyond reproach. We also need to ensure that those conditions of employment are conducive to providing a very good service and encourage people to become involved in the area.

On the question of ongoing training and development, step down services are in great demand. There is a double whammy here. If we can provide the type of support that is necessary for people to remain in their communities it is equally important to have a sufficient level of expertise for those providing the service. For instance, I know many people who have completed courses and obtained certificates in dealing with patients with Alzheimer's disease. It is important to invest in such education so that people can learn the various skills although not on a full-time basis as we have sufficient medical personnel in that regard. It is also important that those providing a service in that area have some level of knowledge and expertise. We have seen an increase in the courses available, which improves the standard of service. There are immense benefits to those who can acquire such skill and knowledge. There is also a certain amount of fulfilment in terms of the commitment those providing the home help service have to the people availing of it. It is critical to ensure that the standard of excellence exists at all times. It is therefore critical to invest in training and ongoing development of those providing the service.

The support can be monitored on various levels. There is a huge element of emotional support for people. Someone calling on a daily basis provides companionship. Too often we can forget the loneliness of those living on their own, who by and large have fended for themselves throughout their lives but are now getting on in years and have become more reliant on others for various reasons. We cannot underestimate the level of emotional support given to these people in terms of companionship to provide an ear and be there for somebody. Occasionally we overlook that very important part of the service.

I refer to the conditions under which people work. A relative of mine who worked in the service in the 1990s did so for a pittance. The Department has a much bigger budget and we have more money in the economy allowing us to provide these services. I am very glad that the level of remuneration is equated to that of a care attendant in a hospital.

Approximately two years ago budgetary constraints resulted in a reduction in the number of hours some people provided. Even when overall cutbacks in services need to be made, we cannot afford to reduce the level of home help service. We are sufficiently well covered. If overall expenditure needs to be reduced, I plead with the Minister of State to consider other areas. Vulnerable people are availing of a service and people provide a service for what in real terms is not a huge amount of money. If cutbacks need to be made this particular area should not be attacked. I recall a case of a person who was provided with care in the aftermath of having been widowed. The person had a child with a disability and the task of minding the child was particularly tough and harrowing in their new circumstances. The home help hours were reduced by approximately two hours per week. While this might not seem very much, it was a large amount of time for the person concerned and caused some trauma.

I have spoken before about care attendants in hospitals. It is critical that contracts of employment and conditions of employment given in other areas of the health service are given to home-helpers. While this occupation is registered and viewed as a stand-alone role, it should be linked in terms of conditions, including rates, hours, overtime, bonuses and all the other benefits applying to hospital posts.

I am glad to support the motion. While as we approach a general election, I presume cutbacks will not be made, if cuts ever need to be made I appeal to the Minister of State that this area should not be considered for a reduction in expenditure. It is a critical area providing an enormous service to the community. It is saving the State considerable money. If many of these people needed to go to hospital the demand on the Exchequer would be far greater.