Camillus Glynn (Fianna Fail)

Cuirim fáilte roimh an Aire go dtí an Teach. I move:

That Seanad Éireann,

—commends the Government on the wide-ranging new services being funded with the €150 million package announced by the Minister for Finance in budget 2006;

—recognises that this package will mean a major improvement in home and community-based support for older people;

—welcomes the fact that thousands of older people needing care will receive new services and support next year as a result of this initiative; and

—congratulates the Government on the largest ever increase in funding for services for older people and affirms that this initiative underlines the Government's commitment to older people.

It is important in the lifetime of this, or any, Government that due recognition be given to the people who have been the pillars of this State, those who have put the State where it is today. The measures announced in the budget give that recognition. The additional funding will have a number of effects. Coming on top of the additional funding for disability, mental health and primary care in the Estimates for 2006, this is part of a Government policy to develop the general community and primary care programme so that acute hospitals and residential care will not dominate extra health care investment as they have previously.

Most old people like to live in their own communities and homes where they have friends and neighbours. As a person with over 30 years experience in long care institutions I have raised the fact that many people in nursing homes are never visited. This was brought up by the recent nursing home charges controversy. It is imperative that people remain in their own homes and environments for as long as possible.

The home care support packages deliver a wide range of services and have been piloted successfully in several regions in recent years. These include the services of nurses, home care attendants, home helps, etc., and in some cases therapists including physiotherapists and occupational therapists. Home care packages vary with the needs of the person, for example, one package might emphasise home care assistance while other packages might have a greater level of home care and nursing. It is not possible to have a text book example of the care levels required for each person so this varying package is important and the flexibility necessary to give a broad based service has been incorporated by the Tánaiste and Minister for Health and Children, Deputy Harney.

The priority will be for older people living in the community or who are in-patients in acute hospitals and who are at risk of admission to long-term care. The home care packages will also be available to older people who are in long-term care and who wish to return to the community. In addition, these packages will be offered to people who are already using existing services such as home helps but need more assistance to continue to live in their communities.

I need not tell anybody in this House what happened when we did not have properly developed community care services. We saw what happened in the psychiatric services 30 years ago. St. Loman's Hospital had 1,200 to 1,300 patients but today has fewer than 300. While many of those people have gone to their eternal reward, a number of people who were in the care of the psychiatric or geriatric services are now in the community and successfully living their lives as they were meant to, in their own homes and environments.

The packages are delivered to the HSE by a range of providers including the HSE, voluntary groups and the private sector. It would be remiss of me not to say a special word about the voluntary sector, which provides a tremendous level of backup service. Often the only face a long-term psychiatric patient sees, except for the ward staff, is that of the Society of St. Vincent de Paul volunteer who has taken responsibility for visiting him or her. It would be remiss of us not to underline that.

The scheme will be as flexible as possible and highly responsive to the real needs of the individual so that if family or friends wish to provide these services they will be encouraged to do so with support and linking with the HSE, voluntary and private sectors. Approximately 1,100 care packages are now being provided to people and by the end of 2006 a total of 2,000 additional home care packages will have been provided. This will constitute a trebling of the current services provision. These 2,000 packages will support more than 2,000 persons, for example, some people need a care package temporarily. The major thrust of this initiative will be directed at older people but there will be flexibility so that a person under 65 years will not be rejected automatically but may receive home care as appropriate. That is to be welcomed.

Home helps have provided pivotal support and are an essential part of supporting old people at home thus delaying or preventing admissions to long-stay residential care. They also help keep people out of acute hospitals or help their early discharge. Given the increased number of older people there is an increasing demand for home helps. We live longer and as a consequence the age profile of the general population is on the increase. That can be explained by better lifestyles and people taking greater responsibility for their own health. Females in particular have a greater inclination to seek medical advice and assistance when it is required.

An additional €33 million has been allocated for this programme, €30 million of which will be for 2006, a significant increase over the Estimates provision for 2005. The additional funding will provide 1.75 million additional home help hours. If we are concentrating on community services and the pivotal role home helps play, it is axiomatic that additional home help hours of the scale suggested and proposed here would be the case. As with home care packages, it is expected that these additional resources will be implemented in a flexible way by the HSE, particularly for those vulnerable individuals who need a home help but who are under 65 years of age. They can now access the service.

The day care respite service is important. It may include a midday meal, a bath, occupational therapy and physiotherapy, chiropody, laundry and hair dressing, social contact for older people, respite for family members and/or carers and social stimulation in a safe environment for older people with mild forms of dementia. The provision of €9 million in a full year will allow for an additional 1,325 places per week in such centres. The number of older people who will benefit from these new places will be substantially more than 1,325 since, over the whole year, one place can provide a service for more than one person.

The investment of €9 million will allow for additional programmes for specific needs such as activity therapy. It will also mean that many day care centres will be able to open five or seven days a week, rather than just two or three days as is often the case at present. I have often argued this point, it is not rocket science, it is common sense; the needs of our elder citizens and the care needs of any person do not end on a Friday evening and begin on a Monday morning. Someone who needs care needs it seven days a week. There will be an investment of €7 million in 2006, with the balance of €2 million to be provided in the following year.

There is also a proposal for specialist palliative care, with €9 million being provided, including home care and community initiatives in 2006. A further €4 million is being provided in 2007 to develop the service, giving a full year cost of €13 million. This funding will provide €1.9 million to open six palliative care services at Blackrock Hospice under the management of Our Lady's Hospice in Harold's Cross. Some 24 extended beds will also be provided at Our Lady's Hospice. That is tremendous news for those who have people in need of palliative care. There will be ten new palliative care beds in Milford Hospice at a cost of €1.9 million, St. Francis's Hospice in Raheny will receive €1 million in increased funding and €2 million is being made available for the development of palliative home care services. Development of palliative care services in the midlands, western and south-east areas will continue, thus building capacity.

Meals on wheels has played a pivotal role in community care. There will be a significant increase in the resources available to the service. An estimated €10 million was spent on the service in 2004 and an additional €2.5 will be provided next year, together with a further €2.5 million the following year, a total increase of 50%. Sheltered housing and action on elderly abuse are also being addressed.