Frank Feighan (Fine Gael) | Oireachtas source

I, too, welcome the Minister who has been here four times in a week. He has probably been here more times than some Members in the past year. I thank him for attending and showing his enthusiasm.

The Government is very determined to support older people to enable them to live independently and with dignity in their own homes and communities. As many Members know, the HSE provides a range of community-based services aimed at ensuring older people receive safe, timely and appropriate care and treatment at the lowest level of complexity and as close to home as possible. The overall funding for services for older people is not insignificant. In 2017 it is €765 million. This includes approximately €375 million for the direct provision of home care. The HSE's national service plan provides for a target of 10.7 million home help hours, 16,750 home care packages and 190 intensive home care packages for clients with very complex needs.

My mother availed of home help. It was absolutely great to have somebody come in for half an hour four or five days a week. The service was very helpful because members of the family were away working. It was great and we really appreciated it. Most of those availing of the service receive a small amount of assistance, but it is not insignificant and they genuinely appreciate it. I pay tribute to the staff who attended to my mother. They showed great care and gave her great joy every day, for which we were very thankful.

By the end of April, the HSE was providing 1,600 packages and 436,000 home help hours. All of the new applicants on the waiting list in my area - Roscommon, Galway and Mayo - had 2.25 hours of home care a week approved for implementation as of 31 March. I wish it was more because the service represents value for money. I am not saying resources are not limited, but I believe money could be taken from other areas and invested in the home help service because I have seen at first hand the work that is done. It must be emphasised that a home care service is allocated to those deemed to be of the highest priority, having regard to the available budget. Despite the substantial expenditure on them each year, demand continues to grow for HSE home care services. It is driven, in large part, by the rise in the number of older people. It is estimated that the number of people over the age of 65 years will double in the coming years, while the number over 85 is expected to treble.

Of course, there is much more to be done. The HSE acknowledges that a shortage of carers has had an impact on the implementation of approved care packages in some areas of the country. It is widely accepted that there is a considerable demand for these services over and above existing service levels. Furthermore, home care arrangements developed during the years with a significant local focus. There is now a considerable variation in accessing services in various parts of the country. Despite these challenges, however, A Programme for a Partnership Government includes a commitment to increase funding for home support services, to improve these supports, to introduce a uniform home care service in order that all recipients can receive quality support seven days a week, where possible, and to review the management, operation and funding of national home help services. The Government wants to improve community-based services in order that people can live with confidence, security and dignity in their own home for as long as possible. To make this happen, the Department of Health is developing policy proposals for the future financing and regulation of home care services.

I agree fully with the Government's view that a statutory home care scheme will help to introduce clear rules for the services for which individuals are eligible and how decisions are made on allocating services. It is a very difficult issue. I would not like to be in the position of trying to allocate services, but I the people who are making these decisions do so in the best interests of patients and as fairly as possible.

I understand a significant amount of detailed preparation needs to be done before final decisions are taken on the form a home care scheme should take and the regulation of services. I also understand the Department is engaged in a detailed process to determine what type of home care scheme is best. Circumstances evolve and we always need to ascertain the best means of delivery. What happened five years ago and what should happen now may be totally different; therefore, reviewing the approach adopted is the best option. The process in which the Department is engaged will consider the future design of both the funding and regulation systems for these crucial services. An important step in the process is public consultation which I believe will be launched shortly. The purpose of the process will be to allow all those who have views on this topic to have their say, including older people, their families and health care workers.

The aim of the national dementia strategy, published in December 2014, is to bring about an improvement in order that people with dementia can live well for as long as possible and have services and supports delivered in the best way possible. A number of priority areas for action have been identified. They include the provision of integrated services, supports and care for people with dementia and their carers.To meet this priority and to support the implementation of the strategy, Atlantic Philanthropies, the Department of Health and the HSE have agreed a core investment programme of €27.5 million, which is very welcome. This programme includes the roll-out of intensive support and home care packages for people with dementia.

To conclude, while there are clear challenges I believe, based on the evidence I have outlined, the Government is committed to supporting older people who want to live independently in their homes and communities. People assume that politicians know everything or that we are experts on everything. Over the years, I have had excellent secretaries who assisted anyone who wanted to avail of home help or the fair deal scheme.

My mother received home help and then went into a nursing home. Like everybody else, I had not dealt with the system. I remember the help I received from the staff in Roscommon about how to apply for the fair deal scheme and what exactly I needed to do. I want to thank the women, in particular, who worked in the public service there and were very helpful. I would tell anybody that the advice and assistance they provide is great. I never thought I would need to avail of such help, but the help was very encouraging. I wish to pay tribute to the staff in Roscommon.