Dan Boyle (Green Party)

This Bill is undoubtedly a major improvement on what obtained heretofore. It has had a very difficult gestation. The preceding Bill was rightly found to have legal flaws and the subsequent court decision informed what is a better Bill. That said, it is not widely accepted and Age Action, the umbrella organisation for groups representing older people, has said it remains opposed to the concept in the Bill and is seeking support for a number of amendments to improve it. Consideration should be given to some of these amendments but I support what is proposed in the Bill and recognise it as a vast improvement.

The Bill cannot be taken out of context in terms of how we, as a society, deal with the care needs of our older people. As in the case of most aspects of public policy, the fact we are dealing with it with this sense of priority, while not giving equal priority to other elements of what could be called the care hierarchy, means we are still sadly deficient in meeting many of the care needs of older members of our society.

I categorise the care hierarchy by ensuring as much support can be given to older people in their homes by means of independent living. There is no doubt sufficient resources are not being given. Support should be given to families, communities and care organisations to allow such care needs to be met. Only then should hospitals, health agencies and nursing homes become involved in the long-term care of older people.

The fact we are still failing to adopt a holistic approach is to no one's credit not only on the Government side but on the part of the political system in general. This is an ageing society and we need to adopt a more comprehensive approach to the care needs of older people.

The programme for Government cites a very good example of meeting care needs. The Westgate foundation in Ballincollig in Cork tries to ally day care needs, including services such as physiotherapy and chiropody, with a social outlet. It takes a village approach to meeting the residential needs of a number of elderly people. If we continue to take a segregated approach by dividing up and categorising the care needs of the older section of our population, we will fall short on a constant basis.

There are arguments as to whether the current provision of certain services is cost effective. In the recent European election campaign, I was made aware of the situation at St. Patrick's Hospital in Waterford where the Health Service Executive is closing a ward currently designated for the care of elderly patients. The long-term care needs of these patients will be accommodated either by moving them to a different ward in the same hospital or to a nursing home. Either approach will negative any potential savings the Health Service Executive expects to make. Those patients remaining in the hospital will face cramped accommodation while the original ward remains empty. Moving these patients into private nursing home care will incur a cost either equal to or in excess of the cost of caring for them in the closed hospital ward. When these types of inconsistencies arise, questions must be asked as to why this Bill is being adopted in this form and why we are not looking at the broader picture. Given the demographic realities, such decisions will inevitably come back to haunt us. Although our population is young when compared with those of other European countries, it is undeniably aging. In the context of the extent to which our elderly population is predicted to grow as a proportion of the general population, we are not providing sufficient resources to meet future needs.

As I understand it, Government policy is cognisant that there will be larger numbers of older people who will require long-term care needs in the future, that the numbers requiring private nursing home care will more or less remain at current levels until 2020 and that additional supports will be provided by way of increased supports to elderly people in the home, carers and community organisations and dedicated health agencies. However, the lacuna that exists in terms of the failure to date to introduce a national carers strategy is unacceptable. The process that accompanied the national carers strategy did not produce a clear articulation of how future policy would effectively meet the needs of carers as they themselves have articulated them. The need for such clear articulation is as strong as ever. There is an onus on the Government to produce that strategy in the shortest possible timeframe. My party will continue to argue for this.

In terms of the narrowest confines of what this Bill seeks to achieve, namely, meeting the care needs of a certain sector of our older population, it does so in the fairest way possible. The formulae take account of people's differing financial resources and of the fact that the cost, while never fully met under any particular system, should be contributed to appropriately by the State on the basis of means and the circumstances of the individual. I am pleased to support the Bill. However, I hope it can be tweaked to improve it in terms of its acceptability to those advocating on behalf of older people. I also look forward to a more coherent, cohesive and holistic strategy for the care of older people, of which this Bill can only be considered a small part.