Colm Burke (Fine Gael) | Oireachtas source

I welcome the Minister of State to the House. I thank my colleagues for bringing forward this Private Members' motion. We face a major challenge in this country over the next number of years to how we develop policy in this area. Just because someone reaches a certain age does not mean that there is suddenly a dependency. One lady who lives in my area is 99 years of age and still drives a car. I have a connection with another person who is 91 years of age who is confined to a wheelchair and lives on her own. She wants to live on her own because she does not want to go into a nursing home. People can live on their own and can continue to live the life they want to live rather than being confined to a nursing home. We need to examine how we do that and how to bring about the necessary changes to make sure more and more people can stay in their own homes and live there for a longer period of time.

It is interesting to read the vision statement "Positive Ageing Starts Now" which sets out quite clearly:

Ireland will be a society for all ages that celebrates and prepares properly for individual and population ageing. It will enable and support all ages and older people to enjoy physical and mental health and wellbeing to their full potential. It will promote and respect older people's engagement in economic, social, cultural, community and family life, and foster better solidarity between generations. It will be a society in which the equality, independence, participation, care, self-fulfilment and dignity of older people are pursued at all times.

It is a very important vision statement and we need to make sure that every word of that vision statement is followed through on. I brought in a Private Members' Bill, the Health (Professional Home Care) Bill 2014, which set out quite clearly why we need to improve the monitoring of home care and to make sure that we plan for home care provision and that there is proper supervision and regulation of it. The whole issue of home care is about making sure there is proper planning, risk assessment, a care plan, and that it deals with issues such as the handling of money, which older people worry about, manual handling, training, and the cost of that. It is important to look at this.

The Law Reform Commission report set out that the guiding principles of the proposed legislative framework should be independent living, privacy and dignity, quality of care, and the protection of adults in receipt of professional home care. It is important to develop a proper structure to provide home care for people who want to remain at home - that is the vast majority of people. One of the things that has occurred over the last few years in the HSE is that a person who provided home care used to call two or three times a day for an hour each time, and suddenly that was cut back to half an hour. It is inadequate to expect someone to travel to a person's house, when it takes 20 minutes to travel there and 20 minutes to go home, to get paid for half an hour. We need to review that kind of approach and make sure that when people provide home care they are paid for an adequate period of time at the person's house so that they can actually properly look after the person.

When we reviewed the structure there was a greater demand for home care so there was a certain budget. It is a budget that needs to be increased over the next few years if we want to keep more and more people out of nursing homes. If one looks at the figures, one will see that there are 585,000 people over the age of 65. That will increase to 990,000 people between now and 2030. We could immediately respond and say we need to create more nursing home beds but there is a cost factor there, whereas for every person who goes into a nursing home we can at least look after four or five people at home for the same cost of a nursing home bed.