Phil Prendergast (Labour)

I welcome the Minister of State, Deputy Hoctor, and thank her for returning to the House today for the conclusion of statements on older persons. I wish to highlight once again a number of issues which are of grave importance to our ageing population. In a fast-paced society such as we have today in Ireland, it often seems that the needs of older persons can be all too easily forgotten. I have raised some of these matters on previous occasions but as was expected, progress has been dreadfully slow.

Health will continue to be the single most important issue to older people and their families. As we get older there will be an increased need for involvement with the health services, either in the acute hospital setting or in long-term nursing care. The present state of the health service does nothing to reduce the anxiety of the older person when we hear constantly of the lack of hospital beds and the hours spent on hospital trolleys in draughty accident and emergency departments with the accompanying lack of privacy and dignity. This is the service we provide to the people who built the prosperous Ireland in which we live today and yet all we can offer them is uncertainty and a second-class health service. Waiting times and the delay in gaining access to mainstream health care continue to be a problem. While the Department of Health and Children prides itself on the fact that waiting times are reduced, in my experience I find this is not really the case. Now, instead of a long delay in the hospital setting, there are extended delays between the initial referral from the general practitioner and that first appointment within the hospital.

I know of one lady who was in urgent need of a hip replacement. Her mobility was severely affected and she was in constant pain. Her GP referred her to Waterford Regional Hospital in July 2006 and by the time she contacted me in April 2007, she had heard nothing with regard to an appointment. When I contacted the patient services manager, whom I have always found to be very efficient, I was informed this lady was categorised as a routine patient and that she could be waiting up to four years for an initial appointment with the consultant. This is simply not good enough and it is an insult to people to refer to this inadequate response as a service. Service implies that a level of care and standard is being upheld. This was not the case in this situation which is mirrored throughout the country.

I recently had a call from a lady who, having been seen in South Tipperary General Hospital, was referred to the Coombe Women's Hospital for investigations and treatment. This lady is chronically unwell and has a dismal quality of life. She was referred to the Coombe in October 2007 and given an appointment with a consultant for September 2008, which is almost one year waiting just to be seen. We can undoubtedly assume that a further delay is imminent should she need surgery and further treatment.

The fair deal plan is money-centred as opposed to being people-centred. The State's plan to apply a levy of up to 15% was bound to create constitutional difficulties and will have to be reconsidered. We need to look at the needs of our ageing population, ensuring those who wish to stay at home will have the opportunity to do so for as long as possible and for those for whom long-term nursing home care is the best option, we need to ensure they will be able to receive this care in a secure, safe and fair manner.

While the fair deal plan advocates allowing people to remain in their home for as long as possible, it is not clear that the measures are in place to support this approach. It is well recognised that home care would continue to rely for its success on informal carers, and families who are already in this situation would argue that the level of respite care available to them is minimal. This will need to be addressed as most family carers have their own young families to look after and, more than likely, the carer is also working full-time. The level of support will have to increase to sustain caring for the elderly over an extended period, perhaps years. The fair deal scheme needs to be taken back to the drawing board and given deeper consideration with further reference to the Mercer report, in particular with regard to looking at PRSI funding of long-term care.

The final issue I wish to raise is the status of women who were precluded from working by virtue of the marriage ban. This occurred in an Ireland of a different time but this small but significant number of women continues to be affected by this ban. Their old age pensions are invariably non-contributory pensions, despite that if they had been allowed to continue working, they would be entitled to a full contributory pension. This subject is raised frequently by women who feel disaffected since their careers were cut short without their consent. These women consequently went on to rear, nurture and educate the men and women who benefit from the prosperous Ireland of today.

I recall one lady who worked in the sugar factory in Thurles in the 1950s. She was personal assistant to one of the managers and both enjoyed and valued her career. When she married in 1961, she was forced to vacate her position. This lady went on to have six children, all of whom were reared and educated on her husband's wage. Money was scarce and although she managed to ensure the family's basic needs were met, she told me that money was so short at times, she could not afford iron tablets when pregnant. It is clear that had she been able to continue working, the family's quality of life would have been quite different.

When this lady applied for the old-age pension, she was informed her contributions fell below the required level to secure a contributory pension and when she highlighted her concerns relating back to the marriage ban, she was told by officials in the Department of Social and Family Affairs that plans were afoot to deal with this issue. However, eight years later there has not been one word about these forgotten women whose children fuelled the Celtic tiger.

I have made a submission to the Green Paper on pensions on this matter. This issue should be dealt with once and for all. These women were not allowed to have a voice in the past but they certainly have a voice now and it must be heard. It behoves us all to compensate these women, albeit in a small way, by ensuring a provision is made through notional assessment to allow this diminishing group to avail of full pension rights. I thank the Minister of State for taking time to attend the House as I appreciate she has a very busy schedule.