Marc MacSharry (Fianna Fail) | Oireachtas source

I compliment Senators O’Donnell and van Turnhout for their initiative in tabling the motion. We are all great at talking in these debates and not so great at coming up with innovative solutions. I agree with much of what Senator Burke said. I am sure we will all agree with each other in the debate as there will be no contention.

As my favourite Minister of State, Deputy Kathleen Lynch, is aware, the problem is that she is the one who is left with too few resources for her entire portfolio which encompasses mental health, ageing and the elderly. Those are the people who are more vulnerable in society and their voice is not as loud as it ought to be. When we have debates such as this, we all agree and tomorrow, unfortunately, it is a case of business as usual once again.

We must push the boat out and think outside the box. I suggested previously in the House that a pilot scheme could be set up whereby the means test for the carer’s allowance would be abolished, with protocols to encourage the 12,000 people who do not need to be in care to go home with the assistance of an aunt, niece, first cousin, neighbour, brother or child. The Minister of State should ask the Minister for Finance, Deputy Michael Noonan, and the Tánaiste, Deputy Joan Burton, to consider that. In addition to the support outlined and the provision of the carer’s allowance of some hundreds of euro per week, those people should be given a medical card and, where necessary, a home care package to assist. Protocols could be put in place to ensure that people are not just on the make in terms of becoming a carer for someone who does not need a carer. No doubt there are enforcement measures and assessment criteria that would see through such applicants.

The cost per week for district nursing homes run by the HSE in Sligo and Leitrim ranges from €900 to €1,550 and various sums in between. It is not as simple as one being better at delivering the service than others; it is to do with the complexity of patients’ needs and the services that are provided. If one takes away the carer’s allowance, a number of home help hours, include the respite grant and a medical card, and take away the prescription charges, the per week charge would struggle to get to €800 as opposed to sums ranging from €900 to €1,550 to keep a person in a nursing home. I accept we are in an era where we are trying to reduce social welfare and we do not want social dependency but there is not an elderly person in a home in the country who does not have a relative capable of providing a level of support that might facilitate them in their home, who does not have a job and who would not be prepared to do this work. A carer provides flexibility that a person in a 9 a.m. to 5 p.m. job, five days a week, could not provide. That would be something worth doing. It could be done on a pilot basis, for example, in Sligo, or even for one nursing home or a group of nursing homes to see whether it would work, how much it costs and what could be saved. Given all the factors involved, such an approach must be worth trying. It is not the case that I am looking for any credit.

I would welcome a response from the Minister of State on the issue, not today, but after she speaks to her officials, the Department of Social Protection, the Taoiseach and the Tánaiste to see whether we could try such an approach. Perhaps we could get all parties to put it into their manifestos in advance of the election whether that is in February, March or whenever. It could be a real winner, not for votes but for older people. The votes would undoubtedly come but that is not the point.

None of us has covered ourselves in glory in recent Administrations. When the money was available we had one-upmanship and pensions and supports increased. It was never enough. When it came to cutting back there was too much of a focus on taking the money back. It was easy to do that and people just had to accept it.

I do not wish to be overly political but let us consider the savings made on prescription charges. Before the election the charges were to be abolished. The then Opposition spokesman on health, Deputy James Reilly, was most vociferous on the almost criminal aspect of the charge. It is difficult to disagree with that perspective. Then the charge was increased from 50 cent to €2.50. One could ask how much we collected. I suspect it was a negligible amount.

The same is true of the changes to the criteria for medical cards for those aged over 70. There were other small changes such as to the telephone allowance and the respite grant. We all welcome the return of the latter, as it was a key support to the 77,000 families that are in receipt of the carer’s allowance. Carers save the Government of the day €4 billion a year in terms of the care they provide. What divides me politically from perhaps the Minister for Social Protection or the Minister for Finance in recent years is that people who were earning more than €100,000 a year were expected to be hit by another 1% or 2% in the more difficult budgets of recent years. They would not have liked it, nor would they have wanted it and it would not have got anybody any votes but they were better heeled to sustain the hit rather than the few hundred million euro that was saved or gathered as a result of increases in such measures as the prescription charge increase or the cut to the bereavement grant, changes in criteria for the medical card and the drug payment scheme increasing from €120 to €144. They made a significant difference to people’s lives. As someone with a mortgage and everything else who has faced up to the recession as best I can, if asked whether I would have been prepared to pay a little bit more for the relative security of those older people, I think I would. I urge the Minister of State to please look at that as a possibility. By all means, she can come back and tell me I am crazy and why, but I think it is worth a try. Let us hope there is never a recession like this again, but if there is, next time I hope we can focus on taking that little bit more from the people better placed to sustain it, even though they will not like it.

There is a nursing crisis in this country that is caused by a number of different reasons. First, we are training one third fewer nurses per year since 2008. That is bearing out now. I read a press release from the INMO today which outlined that the number of nurses at the beginning of 2008 was 39,000 while today there are 34,200. There are approximately 4,800 fewer nurses in the system. Inevitably, that takes its toll on things such as home help. An aggressive recruitment policy is not paying off, largely because pay and conditions are being judged as insufficient by graduates themselves who want to go elsewhere. There is also competition from private nursing homes. That is another area on which the Minister of State must focus.

I have tried to be innovative and come up with suggestions. I hope the Minister of State can try to take them on board and come up with a response.I commend the Minister of State on her commitment to her job but I condemn the lack of foresight on the part of her colleagues in government to provide her with the resources she needs to look after the most vulnerable in society in terms of those with mental health issues and the elderly.