Maire Devine (Sinn Fein) | Oireachtas source

I thank Senator Colm Burke for bringing this Bill before the House. I wish to respond to a comment made about discharges from hospitals. How callous is the national director of acute hospitals in trying to persuade nurses to forcibly remove patients from their beds, but sin scéal eile for another day?

Sinn Féin will support this important legislation which will safeguard and protect older people. Those people have made Ireland what it is today. They are the backbone of the country. The issue is extremely important in this ever-changing world where the background of technology has changed as well as societal behaviours and there is more widespread use of both private and public sectors in the provision of essential care. In order to support people in their later years it is important that a proper regulatory framework is put in place which will give older people and their families the comfort and confidence of knowing their physical, mental, emotional and-or financial well-being will be safeguarded by regulatory legal powers.

The provision of private home care has grown enormously and advertisements are constantly on television for it. Several workers in the sector contacted me as they knew I had previous nursing experience to check out what was going on as they thought certain things were wrong. They were very concerned and their response was really humane. They were like whistleblowers. Many of the companies just ignore elderly people lying in bed with incontinence difficulties and leave them there for a long time. They do not want to put in the extra hours or the extra work as they are overwhelmed. The area needs to be regulated, which is the reason the Bill is so important. The experience of some home care staff has left them aghast at some of the practices. The Bill is a very practical and much-needed step.

Home care is the care that the vast majority of older people and their families seek, as opposed to residential care. Many feel imprisoned when they go into a nursing home. It suits some but not all, but often there is no choice available to people. I note the progress of the Assisted Decision-Making (Capacity) Bill. There will be much more demand on the resources and we must build up the provision of home care and community care and keep people where they belong and feel comfortable. That is what they deserve rather than being made to feel they are a burden on society and must be locked away or sent to prison.

The basis of the Bill is built around the principles of independent living, privacy and dignity for people requiring home care, quality of care and most important, protection for people who receive care. We agree with and fundamentally support those principles and have no hesitation in supporting the Bill. We also welcome the proposed introduction of a register of all home carers and the introduction of an assessment of need, which are essential in moving towards the principles outlined.

We have a concern about how the measures contained in the Bill will be implemented and adhered to. Ultimately, the responsibility for adherence to standards will fall to HIQA. I know HIQA and I commend its work. As previous speakers said, it is a success story for a relatively new authority but the demand for its services is growing. The added responsibility of regulating home care providers would stretch HIQA at a time when it is already stretched to the limit. More supports and resources will have to be provided to HIQA to give the Bill any teeth.

The Bill specifically deals with professional home care. I acknowledge the care that is provided by thousands of family carers all over the country. A significant amount of care provided to older people is done by unpaid family or friends in people's own homes. Perhaps that angle could be examined on another occasion because Age Action and ALONE have raised cases of abuse, mostly of a financial nature. I am conscious that it does not relate to the Bill before the House.

The current State policy of care for older people is based on two pillars: first, financial support for nursing home residences, which has been the priority and we must move away from that being the sole focus; and, second, the provision of home help, home care and day care for older people. Despite the fact that most care is provided for people living in their own homes, the vast bulk of State funding is spent on nursing home care. The policy is a failed one as nursing home care demands huge resources. Nursing home care is needed for some citizens obviously but there are many people who do not need it but end up in a nursing home. Insufficient resources are directed towards the provision of home care compared with other countries, especially Scandinavian countries. That is an evident policy failure on the part of the State. In Sinn Féin's alternative budget, we proposed an additional €32.4 million in supports for older people. The funding was intended to increase home-help hours, which would cost €20 million and an increase in home-care packages by 10% which would cost €12.4 million.

We are committed to the provision of health care services and social care services with equal access for all, based on need and to the greatest extent that resources allow. That right is especially relevant for older people. We are all aware that Ireland’s population is ageing and our current services will not sustain our population into the future.

I welcome the Bill and congratulate Senator Colm Burke. The Bill is progressive and it will implement safeguards for older citizens whom we respect and treasure. New politics should not be just piece-meal. It is an opportunity for progressive change. My party's alternative budget is consistently dismissed as fairytale economics. We all know it is not bonkers economics. It is costed and it gives value for money. People should open their eyes and their hearts to it and get some idea of what it contains.It contains a vision to deliver a fairer society, in particular, for what could be considered a very vulnerable group in the community.