Marc MacSharry (Fianna Fail) | Oireachtas source

I move:

That Seanad Éireann--

- notes the HSE National Operational Plan 2013 which states that ‘based on population projections, there will be a significant national deficit of long stay beds by 2016 based on the HSE’s target of 4% of older persons in long stay care’;
- notes the finding by the Centre for Ageing Research and Development in Ireland, CARDI, in its report, Future Demand for Long Term Care in Ireland, that ‘even with greater emphasis on care at home and more resources provided to realise it, the demand for residential care is going to increase significantly in the next decade’;
- notes the concerns of Age Action December 2013 “that the switch in some of the funding from nursing home supports to community supports which the HSE is planning will be insufficient to meet the needs of the sickest of older people who will be affected”
- notes the report of the National Economic and Social Council (NESC), Quality & Standards in Human Services in Ireland: Residential Care for Older People, July 2012, and the recommendation ‘A problem-solving group of those influencing provision of long term care (e.g. providers, the Department of Health, and HIQA) may be useful to examine and address the challenges of providing sufficient quality long term care in an equitable and sustainable way.’
- notes a new report on Ireland’s long-term residential care sector by accountants BDO commissioned by NHI, ‘Health’s Ageing Crisis: Time For Action, A Future Strategy for Ireland’s Long-Term Residential Care Sector’, which estimates that for every 1,000 people who cannot access nursing home care due to the State’s strategy, the cost to the Exchequer will be €273 million annually in addition to the immeasurable impact on people and their families and the acute hospital system;
- notes the comments by distinguished gerontologist Professor Des O Neill that ‘present and future generations will regard with dismay the failure of successive Ministers and senior officials in the Department of Health and the HSE to remedy a deficit, widely recognised for many decades, in nursing home places, particularly in urban areas;’

and
calls for the immediate establishment of a Department of Health led forum to consider and develop appropriate policy relating to long term care of our older population, especially to prevent a crisis in nursing home capacity for the future.".

I welcome the Minister of State to the House. As always, she has got the booby prize of defending certain positions. As I have often stated, no one doubts her personal commitment to these matters.
The motion speaks for itself. There is not much disagreement between it and the amendment. One wonders why that amendment is necessary. In essence, we are calling for an acknowledgement of much of what Government Senators acknowledge in their amendment, but also for the establishment of a focused forum, led by the Department of Health, with the stakeholders to devise urgently a number of steps that can be taken in this regard. I am not sure that we are doing that. While the fair deal scheme is understandably being reviewed, that may be more due to cost than to the roll-out of care for elderly people.
It would be remiss of me not to say that, under the previous Administration and this one in particular, the Oireachtas has not covered itself in glory as regards care of the elderly. The Minister of State's colleague, the Minister for Health, Deputy Reilly, spoke colourfully many times about the people who had nursed, thought and raised us, built this nation and the Civil Service and ensured that this country flourished through the generations. As Minister, sadly, he has forgotten the principles that informed his once robust attacks in the Lower House.
Budget 2014 was a brutal betrayal of older people. There has been a dramatic cut to medical card eligibility and a disgraceful process is afoot in terms of how that system is being administered. Every Member of both Houses has first-hand experience of the issue. People who were in their 80s or 90s and fighting for the right to die had to argue to get their entitlements. There are many further examples of people who lost discretionary cards despite having not one, but two forms of cancer. I could go on, but everyone is aware of these examples.
There has been a hike in prescription charges, a subject that led to the Minister's famous address to the Lower House in which he made the colourful remarks to which I referred. He was right, but he has forgotten the essence of what he was trying to say.
The telephone allowance has been abolished, DIRT tax has been increased and the bereavement grant has been scrapped. These small medical supports, household packages and even people's savings are now under attack. Abolishing the telephone allowance would take some €312 in support from two elderly people over the course of one year. On average, the bereavement grant was paid out to 22,000 people per year. That will save €18.7 million. Could we really not have found that amount somewhere else? Some €25 million will be saved by targeting 35,000 people's medical cards. A privately mooted Labour Party policy considered whether the focus should have been on those earning more than €100,000. It would not have solved every problem, but it would have collected €200 million or €300 million and provided relative protection and stability to the elderly who built this nation, as the Minister rightly called them while health spokesman for the main Opposition party.
There have been cuts to the fair deal scheme. In a moment, we will discuss in more detail the concerns expressed by all organisations involved in advocacy for the elderly, particularly Age Action, about the impact of the HSE's 2014 service plan on the sickest and those who need residential care. Some 22,261 beds will be funded under the scheme in 2014, some 700 less than in 2013. In reality, the 2014 target is 1,702 nursing home beds fewer than the 23,763 that were funded under the scheme at the end of October. In addition to these 23,763 people, 394 people were on the waiting list for nursing home beds in October.
As the Minister of State is well aware, €23 million of the fair deal scheme's 2014 budget is earmarked for the community care sector. While everyone wants to stay, be cared for and pass on in one's own home, it is accepted throughout the world that this is fundamentally impossible for approximately 4.5% of people.

The HSE's 2013 operational plan advocated that to cater for the 4% that would be required there would be a very significant deficit by 2014.

I will not interrupt the Senator and the Minister of State.