Feargal Quinn (Independent)

I welcome the Minister of State and what she had to say in her contribution. I compliment her on the enthusiasm she has displayed with regard to resolving this problem. I agree with Senator Bradford that the majority of older people would much prefer to be cared for at home rather than in nursing homes. As a result, we must give careful consideration to the carer's allowance. Since last month, we are aware of the strength of feeling among older people with regard to anything that might hinder them.

I do not have much personal experience of nursing homes. However, one of my wife's aunts entered a nursing home and I recall how valuable the care she received proved. I was executor of her will and I am aware that she appreciated that care. Everything we can do to provide assistance in this area will be worthwhile.

In the earlier debate, I referred to my concerns about people asking Ministers to spend more money without making alternative proposals. I am, therefore, very reluctant to suggest courses of action to the Minister of State. However, I wish to make a number of points. The national quality standards for residential care settings for older people undoubtedly represent a positive step forward. However, there have been numerous drawbacks, including the delay in implementing the nursing home support legislation — the fair deal — and cuts in home-care packages.

In the interest of improving standards in this area, the Irish Medical Organisation and the British Medical Association in Northern Ireland launched a joint policy document, "Care of Older People on the island of Ireland" on 2 October. The document in question suggests that there be clear lines of communication among all agencies and workers involved in the care process and indicates that this includes the areas of acute and primary care. It also suggests that all sectors should have round-the-clock access to details of older people's medication and clinical conditions. The document states that for those living alone in their homes, domiciliary and other health care services should be appropriate, co-ordinated and of a high standard, with minimal bureaucracy. It is difficult to disagree with these points.

The document further states that older people should be asked to identify their needs, that services should include opportunities for social interaction and that nutritional care should be made a priority. The latter two aspects are extremely important. One of the difficulties I encountered when my wife's aunt entered care was coming to terms with people, particularly younger individuals, using her first name rather than addressing her by using the salutation "Mrs." or "Miss" followed by her surname. We must take into account people's need for privacy in that context.

The document to which I refer contains evidence to the effect that the elderly are less likely to receive clot-busting drugs when they suffer heart attacks or strokes. These people should have the same access to such drugs as those in any other age groups. It is surprising that this issue, which must be addressed, emerged from the report in question. It is worthwhile drawing attention to "Care of Older People on the island of Ireland", particularly in light of the Health Information and Quality Authority's nursing home standards, because it highlights the numerous drawbacks that continue to obtain in nursing homes and in home care.

The other point I wish to make relates to the possibility of increasing the fuel and living alone allowances. This year has been extremely tough for the over 70s, particularly when one considers their concerns regarding the possibility that their medical cards might be taken away. Next year may be even more difficult for them. Increasing the fuel and living alone allowances would go some way towards assisting the elderly in society.

Members are always asking that additional moneys be spent. It is with reluctance, however, that I refer to the €2 increase in the fuel allowance to €20 per week from January 2009. Age Action Ireland has reported that many older people to whom its representatives have spoken indicated that they cut down on food and fuel costs during winter. If they do so, the elderly open themselves up to the dangers of respiratory illnesses and circulatory problems. Each winter, there are a great many deaths as a result of cold-related illnesses. Most of the victims are older people.

There has been no increase in the living alone allowance since 1996. Age Action Ireland indicates that up to 2,000 older people could die this winter as a direct result of inadequate heating. That is shocking. Ireland has one of the highest levels of excess winter deaths in Europe and there has been a 21% increase in winter deaths here compared with 10% in Finland and 14% in Austria. Neither of these countries has a climate that is as temperate as that which obtains in Ireland.

The Government could make an important and worthwhile contribution in respect of the areas to which I refer. Such a contribution would serve as a gesture to the many people over 70 years of age who are of the view that they were treated unfairly in the budget. I accept that this may be a different matter altogether but we have not paid adequate attention to the subject of those who need forms of care other than nursing home care.

I welcome the Minister of State's comments. I also welcome the proposals contained in the legislation, which I hope will be introduced as soon as possible.