Maire Devine (Sinn Fein) | Oireachtas source

I again welcome the Minister of State. As a member of the all-party group on dementia, under the tutelage of Senator Kelleher, I welcome that the House is doing something about this issue. My office will attend the launch of the Alzheimer's Society of Ireland's prebudget submission and I appreciate all the work the Minister of State has done and continues to do on this issue.

As a nurse, I believe hospitals are the last place for those diagnosed with dementia or in need of care. It leads to a more rapid decline, longer periods of confusion and crippling immobility over years. It is not a positive ageing strategy.

I want to say outright that Sinn Féin has worked extremely hard on this issue, in particular my colleague, Deputy Caoimhghín Ó Caoláin, who produced a booklet in recent months. It gives a comprehensive overview of the recommendations on home care services and dementia care. I believe the Deputy's recommendations deserve proper consideration. He has called for the issue to be addressed for over two years. The proposals would free up reliance on our acute hospitals, which is an important point.

I have consulted with Age Action and it told me in no uncertain terms that there is a crisis regarding the numbers waiting for access to care services at home and a significant disparity across the regions. I hope the motion is the beginning of addressing these problems.

I also spoke to a manager in a home care provider. He sees the urgent need to address the inequality of service provision and the distinct and unique care needs for those suffering with dementia. We need to be absolutely clear that increased investment does not go towards wholly private home care companies. We need to support not-for-profit services which are extremely stretched and are trying to do their best to provide other services, such as meals on wheels, which are embedded within communities.

Such organisations are very concerned about and cognisant of giving carers a fair wage for the outstanding and, at times, very difficult job they do. I have grave and serious concerns about private companies, and there are ethical considerations, given the recent example of residents who could not, would not or were unable to avail of social activities being charged €5,000 for same in nursing homes. They were billed for services regardless of whether they availed of them.

We know private nursing homes cherry-pick residents. They squeeze every cent out of vulnerable people. They rely on a time-to-task method of working, which dictates times for tasks. There is no value placed on human interaction, which is the most therapeutic intervention and the most effective care for our elderly.

When Fianna Fáil calls for certainty of entitlement, that needs to be a bit stronger and protected within legislation. I and my colleagues are working on this issue. I presume we will get the support of Fianna Fáil when we are able to debate the matter. Care is not just for those with dementia. Rather, it is also for those with MS, mobility issues and moderate to severe disabilities. It is important we examine those issues.

We have concerns regarding the nursing homes support scheme being extended to include home support. I do not think that is possible because the scheme is designed specifically for long-term residential care. Currently, supports, though inadequate and underfunded, are provided free of charge to the end beneficiary based on an assessment of need. Sinn Féin believes they should continue to be provided on this basis.

I ask the Minister to address two points. The Minister of State, Deputy Helen McEntee, the previous Minister of State with responsibility for this area, called for a public consultation in January with a six-month deadline. Is there a report and, if there is, could the Minister of State share it with the House?

The Assisted Decision-Making (Capacity) Act is long overdue. It will address the needs of vulnerable people. Those people, and their advocates, will be able to have a choice of where they go. If a person does not want to go to a nursing home or hospital, but instead wants to go home, we, as legislators, and the Government have a responsibility to provide for that. Perhaps we should do things first and not wait to be threatened by legislation. We should involve ourselves in embracing older people and those with disabilities who prefer to stay at home and live in their communities.