Nicky McFadden (Fine Gael)

I welcome the Minister of State. This has been an interesting debate and I believe that all Members are singing from the same hymn sheet, that is, they unanimously seek the best for elderly people. While this Bill goes a long way it does not go far enough and, as Senator Twomey stated, the devil is in the detail. I have concerns with the present position with regard to eligibility and with, as some of my colleagues have noted, the availability of beds. The question of who decides on priorities as to who should get a bed in a particular area is a major issue. The local care hospital in Athlone has a waiting list that is as long as one's arm and it is the same for the local public nursing home. How people gain entry to them beggars belief. If possible, I seek clarity from the Minister of State as to how this will be defined in the new system.

I welcome this Bill's policy content in respect of home care support. From my experience, the optimum is to enable people to live in their own homes. However, there have been serious cuts, to which Senator Prendergast referred, regarding home help hours. While Senator Corrigan made the point that money has been put into this area, it is a case of being penny wise and pound foolish to fail to continue to invest in keeping people at home and enabling them to live with dignity there, rather than having them enter nursing homes or ending up in hospital, because that is what will happen eventually. Unless people are cared for properly and sufficiently, they will end up becoming ill and being obliged to enter hospital. In the long run, this costs a lot more money. Having worked in this field, I am familiar with how important it is to have proper therapists and enough public health nurses to deal with people, to spend time with them in their own homes and to provide the tailored individual needs for those concerned. As for the local authority systems, there must be more joined-up thinking to provide comfortable and accessible bathroom and bedroom facilities for people to allow them to remain in their own homes. In the long run, doing so also will keep people happy and at home.

Other Members commented on our society's changing demographics. One statistic I noticed pertained to a 138% increase over a 30 year period in the number of people over 35. Consequently, we must make provision for the elderly now. One should remember these are the people who contributed to the taxation system, who worked all their lives and who deserve to be cared for properly and with dignity. It is a no-brainer to state that proper home care is the proper alternative to residential care.

While I do not wish to repeat everything, another issue on which colleagues have touched pertains to nursing home standards, about which this Bill is to be commended. I welcome the fact that public facilities will be checked upon and overseen. I visited a number of nursing homes during the recent election campaign, some of which were clean and clinical but not very homely. Other nursing homes were fantastically homely and provided services such as entertainment and quality of life facilities. It is not all about therapeutics, it is about people living with dignity and respect, and such considerations should form part of the entire package.

I have very serious difficulties regarding the definition of a couple - other Members addressed this issue. I too welcome the Minister of State's intervention on same-sex cohabiting couples. However, Age Action Ireland referred to another category of people, namely, siblings. Senator Cassidy will identify with the point that there are many elderly brothers and sisters throughout the country who have not been identified in this Bill. Age Action Ireland's suggestion is that two persons living in a shared economic and social relationship should be categorised.

The other amendment I suggest is that the multidisciplinary team of health care professionals should be closely linked to the individual. The Minister of State previously expressed her belief that it should be a multidisciplinary team and this must be guaranteed by the legislation because it is crucial. Another suggestion is that social workers should form part of such a multidisciplinary team. I agree with Age Action Ireland in this regard because social circumstances also have a bearing on the manner in which people end up in nursing homes.

Senator Corrigan touched on the issue of house valuations. What will happen if there is a change in the valuation of a house? How will the 15% be calculated in such circumstances? I suppose the bottom line is that the amount of money charged should never exceed 15%. I would like the Minister of State to comment on that. I commend the Minister, Deputy Harney, and the Minister of State on introducing the initiatives contained in this Bill. I remind the House that a great deal of detail remains to be teased out. However, it is a step in the right direction.