Michael Finucane (Fine Gael)

I welcome the Minister of State to the House. I listened to the debate on the monitor and while €150 million seems a considerable allocation, it is not an amount to crow about in the context of the length of time the Minister of State has been in office. Following the passing of the budget, an advertisement on behalf of ALONE appeared in a newspaper last week, which the Minister of State might have seen, requesting people to send letters to the Minister outlining their concern about the amount of funding being allocated to the elderly.

The heading of a newspaper article was "We were proud to be young in our new republic now we are at the mercy of the rip-off state". The article referred to people in 1949 in the new Republic and their excitement at that time. That is worth bearing in mind in the context of what we are talking about in this debate, namely, the elderly, home help and carers. The level of home help service here is 3% compared with 16% in Sweden and 14% in Northern Ireland according to the statistics available. Since 2003, the home help service for the elderly has been cut by 22%. In this allocation, is the Government trying to make up for lost time?

Politicians are approached regularly on behalf of the elderly. I am saddened by the level of service in this area and I will outline a classic example. A man of 82 years of age contacted me recently. He is in reasonably good health, living in a rural location and all he wanted was a home help for one hour a day. The home help organisers said they would like to help him out but they are unable to do so, unfortunately, under the existing means testing arrangements. The circumstances of the man in question are typical of many people in the locality. Home help organisers should have the flexibility to use their discretion. The ceilings used in such instances may preclude a person with two pensions from benefitting under the home help scheme. I often wonder whether we pay lip service to the idea of looking after people in their home environments, rather than encouraging them to stay in private or State nursing homes.

There has been a surreptitious erosion of the number of beds available for elderly people in public health facilities. Tax incentives have been made available to encourage the development of more private nursing homes, which perform a useful function, on the basis that more beds are needed to deal with our aging population. When the Cathaoirleach, who is familiar with the circumstances in this regard in County Limerick, and I were young, people often used to say that they would not like to finish up in St. Ita's Hospital in Newcastle West, which was known as "the home". There has been an amazing change in that regard, however, as many people now say they would like to finish up in St. Ita's Hospital. Many people have asked me for help in trying to secure a bed for a member of their family or extended family in the hospital because they recognise that a high level of care is offered there.

The Minister of State, Deputy Seán Power, and many other Ministers have visited St. Ita's Hospital over the last seven years, since it was first suggested that an Alzheimer's disease care unit would be developed in Newcastle West. On the Order of Business this morning and again as part of this debate some moments ago, Senator Daly quite rightly highlighted the need to provide accommodation for elderly people suffering from Alzheimer's disease. Private nursing homes do not necessarily cater for such people. The development of an Alzheimer's disease care unit in Newcastle West is absolutely essential. I am optimistic that such a unit is likely to be developed in the near future, after seven years of waiting. Although a great deal of time has passed, not a block has been laid.

I acknowledge the work that is done by the staff of St. Ita's Hospital. The Minister of State has seen the hospital's facilities. We need to give positive encouragement to the staff, who work in a building that was constructed in Famine times. Newer buildings have been developed at the hospital site, but the facilities which are available in the older structures are not compatible with modern needs. If we want to do a proper job, we need to build a completely new hospital for elderly people in Newcastle West. It is probably not possible to improve the facilities in the existing structure because that building is so old. The standards which are being tolerated in public hospitals would not be accepted in private hospitals. I refer to the distances between beds, for example.

I am concerned about the elderly. All Senators agree it is preferable to keep such people in their home environments. A great deal of comfort is offered to elderly people living in rural areas, who often feel isolated, when home help staff come to their homes to perform basic functions, even for just one hour each day. We can offer elderly people a type of lifeline by allowing them to have discussions with home help personnel, for example. The efforts of such workers over short periods of time are particularly valuable when one considers the relatively small amount of money that is spent.

I recently read a breakdown of the cost of the services which are offered to elderly people in County Limerick by various bodies, such as the rural community care network. The former Mid-Western Health Board used to provide a home help service. If three people are living in a house, one of whom is handicapped, another is elderly and another has a further problem, it could be the case that three different units of the health service call to the house, each within its parameters of responsibility. It is time for us to dovetail the facilities so that we provide a proper care package to the elderly population.

We have a great deal to do. It is easy to appeal to elderly people in monetary terms by pointing out that the old age pension has been increased over recent years. It is quite right that such improvements have taken place, in light of the buoyancy of the economy during the Celtic tiger years. If we are unable to look after the people who helped to build this country in difficult times, we should shed some tears.

It is not enough to cater for elderly people financially, however; we have to do a little more than increase the pension. We have to help to look after elderly people in their home environments. I do not think the funding which has been made available —€110 million in 2006 and €40 million in 2007 — will meet the deficiencies in that regard. We need to compare that provision of €150 million with the overall level of expenditure in the health service. The almost €200 million that was spent on the PPARS project, for example, exceeded the provision in question by €50 million. The Government needs to consider what it is doing for the elderly in that context and recognise the work it has yet to do.

I would like certain aspects of the home help service, such as the means tests and the eligibility criteria, to be examined. Home help organisers should be responsible for making decisions on the basis of an analysis of medical matters, the need for care and the person's rural location, rather than on the basis of means tests. Such people have to try to dispose of the limited number of hours available to them as part of the depleted home help resource. As far as elderly people are concerned, the Minister of State and his Government have "a lot done, more to do". Action needs to be taken in respect of home help services in particular.