Ivana Bacik (Labour) | Oireachtas source

I welcome the Minister of State to the House. It is always a pleasure to see him back here with us. I commend Senators Seery Kearney, Conway and their colleagues on putting down this important motion and I am delighted to lead the Labour Party response to it. In advance, I wish to second the amendments being proposed by Senator Black. She is due to speak on and will be proposing these. They are very much complementary to the motion itself, add to and enhance many of the aspects of it, and I will speak to those.

This is a very timely motion. Throughout the last year and more, as we have been going through the Covid-19 period with people suffering so much in this country and internationally, we have come to greatly value the role of carers. This period has thrown the often very difficult work carers do into sharp focus. We all realise how much more we should be acknowledging and valuing the work of carers as a society.

Others have pointed out that the Citizens’ Assembly has given us a way forward to provide greater recognition for carers within our Constitution, which is very important. The Labour Party group and others have additional motions on the Order Paper. We all acknowledge the work of groups like Family Carers Ireland and the Care Alliance. This motion is very welcome and it recognises the vast number of carers. According to Family Carers Ireland, there are 500,000 family carers in Ireland who are estimated to save the State a very significant amount of money, who provide approximately 19 million hours of unpaid work per week, and many of whom juggle other forms of paid work and care.

In an excellent article in Saturday’s The Irish Times, Patrick Freyne spoke about the role of a carer from his own personal experience, and asked we could care less about people who care. He also identified a nexus of misogyny, classism and often racism that allows society to see this work in some ways as downgraded or less significant. All of this recognition is very important and it all feeds into this motion.

One of the key difficulties currently with our model for care work is that it is over-reliant on institutional care. We have a funding model in this State that favours institutional care, not just for older people but for persons with disabilities also, as those of us who are on the Joint Committee on Disability Matters are well aware of. This is also the case with the care of children and those with special or particular needs. Our care model is far too piecemeal and is not sufficiently well-structured to meet the real needs of people. A 2019 discussion document from Sage Advocacy, for example, on funding long-term support in care showed a clear preference from among the public and carers themselves to enhance supports for home care rather than having such a strong reliance on institutional care.

For me, and for the Labour Party, this comes most clearly into focus with the fair deal scheme which provides persons in nursing homes with an entitlement to State financial support. We are calling for a new fair deal scheme, one that provides the sort of statutory basis for home care that is so sorely needed. This came again into particular focus for me recently on a walk in a local park where I met a woman of my age who was with her mother who was in her 90s, still lives at home and is supported by round-the-clock care, which is paid for privately by the family siblings.In such situations, the most favourable financial option for families in many cases is to use the fair deal and nursing home care, but we should be moving to decongregated settings and de-institutionalising. There is some recognition of this in the motion. Senator Seery Kearney spoke about the need to ensure that a system is developed for the financing and regulation of home support services. Absolutely, but let us go further and be more radical. Let us create a fair deal that enhances and supports people to be cared for in their homes into their old age. During the pandemic we have seen how important it is that people be supported to stay in their homes, where possible. That should be our default option. Instead of continuing funding models that favour institutions, we should be looking for home care.

This is not just a matter involving older persons. Last week, the Ombudsman published the report, Wasted Lives: Time for a better future for younger people in nursing homes. It contained the stark finding that approximately 1,300 people under 65 years of age are currently living in nursing homes when, in fact, other settings, preferably decongregated settings or community or home settings, would be far more appropriate. There were some very harrowing personal stories from individuals who clearly should not have remained in nursing homes for lengths of time and, in some cases, for years. They would have been patently much better off and more appropriately located in their own homes with supports provided. We are proposing a change to the fair deal scheme to enable people to draw down funds to pay for at-home care and supports as an alternative to care in a nursing home, where that is more appropriate. In particular, for younger persons in nursing homes, we propose that the State should move swiftly to ensure the more than 1,000 younger people who are in those settings inappropriately be provided with alternative supports and mechanisms.

We look forward to continued debate on this issue. There are reforms under way and we welcome them. I support the motion and the amendment proposed by Senator Black.