Anne Rabbitte (Fianna Fail) | Oireachtas source

I welcome the Minister to the Seanad. I thank Fine Gael for tabling this welcome motion. I appreciate being allocated time to speak on it.

The motion is a comprehensive one that covers an array of what needs to be done in the older age sector. Last year alone, 24 million hours were delivered when it came to home care. Some 320 day care centres were open right across the country. We have 55 dementia-specific day centres and the motion is calling on a further 20 to be added to that. The budget for meals on wheels has doubled from €3 million to €6 million since 2020. The meals on wheels service is about far more than just a nutritious meal. It is a social connection, the knock on the door. It actually makes up the triangle of care. There are the day centres, meals on wheels and the integrated care of services for older people.

It is also great to see that Ireland was designated age-friendly status by WHO in 2019. The fact that the Minister of State is across two Departments is a welcome opportunity that needs to be embraced. The fact that he has a foot in the Department of Health and the Department of local government means that perhaps we have a more opportune approach in dealing with who is funding what. The age-friendly activities initiative is based out of the Department of local government, but if that Department matches what the HSE or the Department of Health invested, we would see it spread far more widely. At the moment, Meath County Council provides its secretariat. Fantastic work is done there. In my time, I would love to have seen it mirrored in the disabilities sector, as there is such good work being done on it.

I welcome the increasing of funding for dementia-intensive home care packages. There is home care and there are different allocations of hours, for example, seven hours and 21 hours, but a dementia-intensive home care package may be needed where that person has chosen to stay at home, possibly using the Decision Support Service, and does not wish to go into nursing home care and the person's family are honouring that. It could just be the husband in his 70s who is honouring that. The person's care needs change, so an intensive home care package is vital. They are like hen's teeth within the Department of Health, so we would welcome many more.

I welcome two calls in the motion on publishing the NTPF's review of pricing systems in early 2025 and working towards an equitable funding model for the nursing home sector. The NTPF has a duty of care over its financing. It also has a duty of care in determining how its cost base is allocated to the nursing home sector. All of us in this House want to ensure that our family-run nursing homes have the sustainability and financing to ensure they can stay working. We have lost a number of nursing homes because it was not financially viable for a nursing home with fewer than 30 beds to stay open. Now we need to ensure that the nursing home with fewer than 60 or 70 beds is equally funded to deliver services. We need to see how they are graded and how they are awarded the funding.

I live in Portumna where we have Portumna Retirement Village, which is a family-run nursing home with fewer than 65 beds. We have the Killimor nursing home, which this week received a HIQA report of 100%. It is a family-run nursing home in rural Ireland, employing a lot of people but also providing a lot of comfort to people living in the local communities.

Regarding home care, I sometimes wonder whether it is home care we do not have enough of or people. I believe we do not have enough people. We have a great number of providers in that space. We need a more streamlined approach because all I can see are cars running over and back the road from different providers. Everybody wants the 9 o'clock visit slot to get up in the morning and the 7 o'clock or 8 o'clock visit slot to go to bed. We need to have a little bit more of a geographical or centralised approach or perhaps a better mapping system to show if a provider in an area can provide the services. Every provider puts its hand up for the 9 o'clock visit slot but as soon as it is two months into the contract, it says that does not really suit and it will move to the 11 o'clock visit. The resident person is then left in bed until 11 o'clock. That was never the modus operandi.

I have a little story about Dónal who is 77 years old and from the mid west. Dónal has a disability. He requires two people to get him up every morning and two people to put him to bed every evening and he needs his dinner brought to him every single day. Dónal has support from Monday to Friday, with two people getting up in the morning and two in the evening but, unfortunately, only one person is available on a Saturday and Sunday. Every second Saturday, there is nobody available to give him his dinner. When we are doing the proper care planning, Dónal needs to eat seven days a week and we cannot assume he cannot. As a single bachelor man who would be living in an isolated rural setting, that care provider has a duty when it takes on the package to ensure that full delivery is adhered to.