Éamon Ó Cuív (Galway West, Fianna Fail)

I thank the Senator for raising this matter. Ba mhaith liom buíochas a ghabháil leis an Seanadóir as ucht na ceiste seo a ardú inniu. Mar a deir sé, baineann an cheist seo go príomhacha leis an HSE, ach baineann sí le mo Roinn freisin.

In the last budget we protected the half rate carer's allowance which I believe was only introduced in 2007. Before last year's budget the carers' groups had very much prioritised this issue. We also made no change to the rate of payment to carers over 66 years, but like all working age payments, carer's allowance for those under 66 years was cut. I got the very strong impression from the carers' groups I met before the last budget that their main concern was to protect the half rate carer's allowance.

The Senator said I flew the flag when it came to pensioners. I did not. I was asked a question which pre-empted decisions to be made by the Cabinet in the budget. Anybody who tries to wriggle out of me before the budget what the Cabinet might do on any subject will not receive an answer because it is not a matter for me to give one. As the Senator is aware, the Cabinet makes decisions collectively. Somebody tried to wriggle out of me an answer on what the Cabinet might do next November and then spun the story that I would cut the old age pension. That was being pre-emptive and against all proper processes in government. I was very disappointed when people interpreted my reluctance to answer the question as being tantamount to a decision. Equally, it could have been said I had not ruled out a massive rise in the old age pension. I said I could not in a piecemeal way pre-empt what Cabinet would do next November in the budget. Unfortunately, that will have to remain my policy on all these issues. Irrespective of what questions I am asked about the budget, I will not give answers until decisions are made. Therefore, nobody should read anything more into any non-committal answers I give on the budget. If the Senator were to ask if I could confirm whether there would be would a €100 rise, I would say I could not rule anything in or out; therefore, one could say I had not ruled out a €100 rise. It might be a little unrealistic, but the principle is that one cannot pre-empt Cabinet decisions on budgetary issues.

I am concerned that some older people have been given the impression that the Government has made a decision to cut pensions. It has made no decisions and I regret any upset caused to older people. That is the last thing I would want to do and I am sure the Senator would not want to do so either.

The overarching policy of the Government is to support older people to live in dignity and independence in their own homes and communities for as long as possible. Where this is not possible, the Health Service Executive supports access to quality long-term residential care where this is appropriate. Notwithstanding the significant overall economic pressures facing the country, the Government has continued to prioritise services for older people, as reflected in the additional funding of €10 million provided in the last budget to expand home care packages nationally. These packages often contain a significant home help component at individual recipient level.

The HSE national service plan 2010, approved by the Minister for Health and Children earlier this year, commits the executive to providing the same level of service for home help as in 2009 - almost 12 million home help hours for approximately 54,500 people, an increase of more than 5,000 home care packages for 9,600 people and a total of 21,300 day care places which we estimate cater for up to 80,000 people. Between 2006 and 2010 there was an additional investment of more than €200 million to enable the HSE to develop community based services for older people.

Other important initiatives are also being undertaken at a strategic level. Arising from an evaluation of home care packages, published by the Department of Health and Children in December last, the HSE established a task group to progress this year various improvements in home care provision. The Department accepts the need for a more standardised approach to the regulation of home care generally, whether by public or private provision. This year the HSE intends to finalise and circulate standardised access and operational guidelines for the delivery of home care packages; adopt and disseminate a voluntary code of quality guidelines for home care support services for older people; and develop and publish a procurement framework for home care services. The Department is also considering the overall regulation of the community sector in the light of the recommendations made in the report of the Commission on Patient Safety and the report of the Law Reform Commission on the legal aspects of carers.

The Senator will appreciate that all developments in the area of home care must be addressed in the light of the current economic and budgetary pressures. The Health Service Executive has been asked to make a rigorous examination of how existing funding might be reconfigured or reallocated to ensure maximum service provision is achieved. This requires a stringent ongoing review of the application of the resources available. The Health Service Executive has operational responsibility for the delivery of health and social services. It is, therefore, incumbent on it to review, as appropriate, the home help service at local, regional and national level in the context of changing circumstances and overall service priorities.