Keith Swanick (Fianna Fail) | Oireachtas source

I welcome the Minister of State, Deputy Finian McGrath, to the House. The home help scheme is under pressure. As the Minister of State will be aware, two weeks ago the Irish Independentreported a harrowing story regarding a 70 year old woman who spent 105 hours on a trolley in Limerick hospital and her family's expressed fears that she would die if a fire started. This is the direct result of a lack of investment in home help hours and step-down nursing support facilities. The HSE figures reveal that 79 patients have been stuck in public beds for six months due to a lack of step-down facilities and home help hours; by mid-September 745 patients had not been discharged despite being medically fit, which is staggering, and that over 1,000 people were added to the home help waiting list in the last four months, with the waiting list now at 7,300.

As recently as the last two weeks, local Councillor Joe Flaherty and I met representatives of a newly-formed carers group in County Longford who passionately articulated the frustration of carers, their families and the wider community. The system is broken and the patients and their loved ones are paying the price. The group provided me with details of several cases where additional hours have been approved but the families have been told the additional hours cannot be commenced before Christmas owing to an embargo. The hours have been approved but they are not being provided which, in the main, is the issue.

There are two distinct groups of carers in crisis. There are patients who have access to family carers and patients who do not have families to care for them. The latter cohort is the worst affected as in many cases they receive no care. We routinely hear, as I do in my practice, of patients left soiled or lying on a floor, perhaps unconscious or with a broken limb after a fall, until such time as a neighbour or a good samaritan calls to the House. In regard to family carers, the real risk for them is the absence of an effective home care structure and, subsequently, family burn-out which, in turn, leads to further illness in the home and additional expense on the system rather than a saving.These families are tired, frustrated, upset and disillusioned with a system that has failed them. The most troublesome and worrying trend about which the new carers' advocacy group told me was that they had been warned not to complain or their existing hours would be cut. It has reached the stage where many carers are afraid to speak out. If that is true, it is a fundamental injustice and extremely worrying. I seek clarification on the matter from the Minister of State.

There is a clear and obvious need for an advocacy group for family carers, independent of the HSE. It should be positioned to articulate and champion their concerns. As I mentioned, I met the group in Longford two weeks ago. I met a woman by the name of Majella Meade who has been battling illness since 2014. She tried to balance her recovery with her work in caring for her patients. However, the toll was too much and she had to give up the job she loved. Sadly, her father passed away in May this year but not before living an additional 18 months with his family. The priceless extra time was thanks to the care and love of his family. The health of Majella's mother, Mary Jane Meade, deteriorated after her husband's death. She has vascular dementia and requires full-time care and supervision in the home. The family has a carer who calls for one hour each day, five days a week. If Majella wants to go to the shop or see the doctor because she has her own health needs, she has to rely on a neighbour to help. The community nurse in Longford has provided great support for the family.

The family have been assessed and it was proposed that they receive three calls per day and two over the weekend, but that has not happened. If it had, it would have meant a major improvement. However, the family heard that there was an embargo on extra hours and, therefore, a delay because of budget overruns and overspending on the national children's hospital. We need to ensure that once hours are allocated, they are honoured and that people receive the care they need. There is a shortfall in the number of carers, but we need to ensure the qualifications of carers are up to speed. The most important point on which I need clarification concerns families being threatened with the loss of hours if they do not put up and shut up. If that is true, it is a disgrace. We need clarification on that matter and perhaps an investigation.