Keith Swanick (Fianna Fail) | Oireachtas source

Fianna Fáil is happy to support this legislation, which stems from a Law Reform Commission report published five years ago. The legislation provides for a regulatory framework and legal standards to be put in place for professional home carers engaged in the provision of care to people in their own homes. Similar legislation based on the Law Reform Commission report was published by Deputy Billy Kelleher in 2012.

As Senator Colm Burke stated, it is recommend that HIQA should be given additional regulatory and inspection powers to ensure that appropriate legal standards are in place for undertakings that provide professional home care.The report did not propose that the HIQA regulatory and inspection system would apply to informal carers such as family members. That is important in so far as it has allayed fears among people in the community. I heard that at first hand in the practice. The report made 29 recommendations for reform of the law and also included a draft health Bill to implement them, which is the one before the Seanad today. The LRC pointed out that it is well known that the proportion of people living in Ireland who are aged over 65 has been increasing in recent years and is projected to increase at an even greater rate in the coming decades.

I wish to highlight a few welcome provisions in the Bill, but I will not go through them all. It provides that palliative care be included in the definition of professional home care. That is very important, as it is a basic human dignity that people can spend their final days in their own home, surrounded by their loved ones - friends and family. The assessment must include an assessment of companionship, which is also very important. As a rural GP I am very well aware of how mental illness affects the elderly population. Those elderly people are often without a voice. Companionship needs may include preparing snacks and monitoring diet and eating. Malnutrition is rife in this country and we do not realise it, especially among the elderly population who have chronic diseases such as chronic obstructive airways disease. Other elements of companionship include arranging appointments, reminders for medication, which is also important because it is estimated that half of all medications are taken incorrectly in this country. In turn, that would prevent admissions to secondary care.

In developing a Bill such as the one before the House it is important that it is matched with investment in primary care. By that I do not necessarily mean primary care centres, although they are important in certain locations. I am referring to the provision of care in terms of bodies on the ground - the provision of nurses and GPs. It is about the activity that happens within the primary care centre more so than the bricks and mortar of the centres. If the Bill is to work we need investment in the carers who provide the front-line services in communities.

In terms of making home-care packages a statutory right, that was the aim behind a Fianna Fáil Bill introduced by Deputy Willie O'Dea in the Dáil prior to the recess. If passed, the Bill would be an enormous step forward in helping to empower older people. It would enshrine in legislation their right to services to allow them to stay in their own homes and communities for as long as possible, which would not only benefit the individuals concerned and their families but also the State due to less demand being placed on long-term residential care services. It is time we gave older people a greater choice in determining the care they receive.