Paschal Mooney (Fianna Fail) | Oireachtas source

I welcome the Minister. While the motion and Government amendment are similar, the Fianna Fáil Party will divide the House on the issue because, as my colleague, Senator MacSharry, noted, we do not wish to the status quo to continue. Although others have made many of the points I propose to make, it is important to emphasise them in the context of the contributions that have been made. Senator Quinn's contribution focused on the value of those over a particular age who wish to continue to live long, fruitful and productive lives. If there is anything the Government can do to eliminate the culture of ageism that persists in certain parts of society, it will be applauded for doing so.

The motion notes 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, their families and the acute hospital system". Unlike Senator Noone, I support Senator MacSharry's call for the immediate establishment of a Department of Health led forum to consider and develop an appropriate policy on the long-term care of the older population, especially to prevent a crisis in nursing home capacity in the future.

The Fianna Fáil Party can be accused of many things. In the years immediately after the crash any Government, irrespective of its political colour, would have been forced to address the immediate problem and engage in crisis management, as occurred under the previous Government led by the then Taoiseach, Mr. Brian Cowen. Fianna Fáil has always been proud of its heritage, policy and outlook on care for the aged. We stand on our record in that regard and no one, on any objective analysis of our policy over the decades, could argue with that view. The motion continues our proud tradition of looking after the aged and most vulnerable.

The Health Service Executive's operational plan refers to having in place sufficient long-stay bed stock to meet the needs of the growing elderly population for the next two years. As has been noted, beds are not evenly spread geographically and certain areas have an under-supply while others having an over-supply. The HSE service plan for this year provides that the overall number of people to be supported in long-term care has been reduced by 700. It justifies this reduction by referring to a shift in emphasis in the model of care to home and community supports, which will, it states, enable an additional 1,000 older people to continue to live at home. I applaud the concept of people living independent lives for as long as possible. My late mother - God be good to her - continued to live in her home and looked after herself independently until she was hospitalised and passed way at the age of 86 years. I am a strong supporter of any Government policy or HSE service plan that shifts the emphasis to independent living. However, the issue is the need to ensure that those who wish to live independent lives in their own homes receive all necessary support services. Home care and home help, to which Senator Quinn referred, should be maintained and strengthened. Sadly, however, both services have suffered as a result of the economic downturn. If the Government is serious about saving money, it would allow people to live at home rather than be placed in institutional care.

The 2014 target is to reduce by 1,702 the number of nursing home beds funded under the scheme at the end of 2013. Some 394 people were on the waiting list for a nursing home bed in October 2013. It is not clear from the plan what how the 1,700 people who will not secure a nursing home bed next year will be cared for. The Centre for Ageing Research and Development in Ireland, CARDI, produced a report entitled, Future Demand for Long Term Care in Ireland, which noted that there has been an increase of 59% in the number of people in the State aged more than 65 years who are using residential long-term care. It also notes an increase of 57% since 2006 in the number of people who use formal home care. At a time when thousands of medical cards for people 70 years and over have been withdrawn, community supports are under severe pressure and health care demands are increasing as a result of the ageing population, Age Action has expressed deep concern about how the Health Service Executive will meet the needs of the most vulnerable older people in 2014. This is a recurring theme in the contributions made thus far, at least on this side of the House. How will the HSE and, by extension, the Government meet the needs of the most vulnerable of older people based on the figures provided, including the reduction in funding?

The Nursing Homes Ireland report, Health’s Ageing Crisis: Time For Action, A Future Strategy for Ireland’s Long-Term Residential Care Sector, states that Ireland's population is ageing, with notable growth in the cohort of the population whose care needs have been independently assessed as requiring long-term residential care. This is a sad development. One would expect that with modern medical care, the number of people requiring long-term residential care would decline. Perhaps this development raises questions about health policy and the manner in which the Government approaches the medical needs of those who are elderly. The population of those aged 65 years and over has been increasing at a faster rate than in other European Union member states. We frequently hear we have one of the youngest populations in Europe but it is sometimes forgotten that the older population is increasing at a faster rate here than among our neighbours. This is surprising considering that in some European countries, notably Germany, the cohort of those aged 65 years and older is set to cause a major crisis.

A new and emerging trend in Ireland's demographic profile is the substantial increase that has also taken place in the number of people over 85 years of age. This cohort is forecast to rise by 46% in the period to which I refer.

I fully support both the motion and the recommendation to the effect that the Department of Health should establish a forum to consider and develop appropriate policy in respect of the long-term care of elderly people in order, primarily, to prevent a crisis, as outlined very eloquently and in great detail by my friend and colleague, Senator MacSharry, in the context of the provision of nursing home care.