Kieran O'Donnell (Limerick City, Fine Gael) | Oireachtas source

I thank the Acting Chairperson. As a former Member of the Seanad, I have great respect for the House. There were 23 contributors to this debate, which is quite extraordinary. It shows how significant the issue is that we are discussing. I propose to give a general response before coming back to some of the specific issues raised that were not covered in my response. I see this as very much an interactive engagement. Several Senators suggested they would like to revisit certain issues in six months. I have no issue with that at all, as anyone who knows me will realise. No one is a fountain of knowledge. I very much take on board everything that comes forward in these discussions. Whatever makes a system better, wherever that proposal comes from, I am very receptive to it.

My brief crosses both the Department of Health and the Department of housing. As such, it is a role that deals with both the health and housing needs of older people. I have been asked specifically by the Tánaiste to look at the issues Senators are dealing with in their communities. I dealt with the same issue for many years. It is about covering all aspects. In the limited time available to me, I will go through my reply and then come back on specific issues. I may not get to every point but I understand copies of my script have been made available to Members.

As Minister of State with responsibility for older people and housing, I welcome the opportunity to discuss and support the enhanced provision of services for older people. I thank the Fine Gael Senators for tabling the motion. The Minister for Health proposes that the motion not be opposed by the Government. Like everyone here, I acknowledge the valuable contributions of older people in Ireland. The Leader referenced what they brought to Irish society in educating their children. In many cases, they made huge sacrifices and had to come through very difficult times. Senator Keogan spoke about how people are living longer. Some people choose to work beyond retirement age. My father worked until he was 80. It suits certain people to keep working and it does not suit others. It is about people having that choice.

Older people are the backbone of any community, including at a voluntary level. Even though they avail of a lot of services, they are also, in many cases, the providers of those services. Ensuring that older people live longer and healthier lives will take sustained and focused investment in our services over the coming years. As highlighted in the motion, the programme for Government sets out an ambitious and achievable set of commitments to improve and expand services for older people, which will be delivered over the term of the Government. There were repeated references to the fact the demographic landscape is changing considerably. Information from the Central Statistics Office, CSO, shows that the population aged between 65 and 84 will increase by more than 65% up to 2044, which is less than 20 years away, while the number of those aged 85 and over will more than double. There are positives to note. Ireland now has the fifth highest life expectancy in the EU and the third highest number of healthy life years at age 65. The growth in our older person population shows that we not only need enhanced services but also more services.

Speakers referred to the carer's guarantee. As per the programme for Government, we are very committed to further funding in that regard. The core message is that the Government recognises that family carers have an essential role in helping older people to live with dignity and independence in the homes and communities of their choosing. It is set out in Sláintecare, which is a cross-party initiative, that people who choose to stay at home must be able to do so for as long as possible with dignity and supports. All speakers referred to carers and the phenomenal work they do.We are funding schemes to the value of approximately €1.9 billion in 2025. The programme for Government commits to continuing to significantly increase the income disregards for the carer’s allowance in each budget with a view to phasing out the means test during the lifetime of the Government. That is directly written into the programme for Government.

The Senator spoke about ALONE and loneliness. Senators will appreciate I am new in the role but it is an area that has been raised by many people. Being practising politicians, Senators will know that if, they listen and an issue comes up two or three times, it is of significance. This is coming up and is something I will look at with the Department. Through ALONE, there are various policy initiatives and funding has gone into that area, particularly concerning mental health. It is an area I commit to looking at again.

Through the HSE, investing in services for older people has been a national priority over recent years, resulting in an increase of approximately €1 billion in funding for services for older people since 2020 to close to €3 billion. This year alone has seen an increase of approximately €350 million on the amount secured under budget 2024.

Although our desired direction of travel is to allow people to remain in their homes, nursing homes play a vital role. There was an increase of €67.6 million allocated to support individuals to access nursing home care through the nursing homes support scheme, which is now funded at €1.2 billion. Senator Boyhan made reference to the review. I met the National Treatment Purchase Fund in the past couple of days and I want to see that review finalised. It is something I am very keen on and also a commitment in the programme for Government.

For nursing homes, €10 million was provided last year to raise standards to meet fire regulations. Recently, I announced €10 million to upgrade premises. It is something we are conscious of.

Senator Byrne and others referenced the availability of public beds in community nursing facilities. A sum of €4 million has been allocated to provide staff and 615 community beds in 2025. This builds on €13.7 million provided in a previous budget to deliver 985 community beds in 2024, which are continuing to open into 2025. It is something I am very conscious of and have spoken to Department officials on. It is something I am very keen on.

Senators spoke about home care. In budget 2025, there was an additional €120 million to maintain substantive increases in home support activity from a target of 22.4 million hours in 2024 to 24.3 million hours this year. The funding has increased by 70% since 2020, from €487 million to €838 million.

I acknowledge the issue raised by Senator Cosgrove who made reference to the staff and the great work they have done. It is hugely important that whatever conditions are there are adhered to, so I take that point. We have a delivery model that involves both the public and private sectors. My main concern is the delivery of a good-quality service to the people on the ground.

Speaking about my priorities as Minister of State, my core priority is to bring in a statutory home care scheme through the Department of Health. The first element is to have a regulated market. That will be achieved and I am progressing that with my officials. This will consist of primary legislation for the licensing of providers, the health (amendment) (licensing of professional home support providers) Bill 2024, secondary legislation in the form of regulations that set out minimum requirements, and HIQA national quality standards. At present, nursing homes are regulated by HIQA. If we bring in a statutory home care scheme, we must have a similarly regulated sector. The first step is to bring in the legislation. We are examining the general scheme that was brought to the Government last May. The Oireachtas Joint Committee on Health conducted pre-legislative scrutiny. The general scheme has now been referred to the Office of Parliamentary Counsel for final drafting with a view to presenting the Bill to Cabinet in quarter 2 of 2025. That is my key focus at the moment.

As well as delivering on the legislative elements of this commitment, my Department is working to ensure the future statutory scheme can be delivered equitably, transparently and at scale, and based on standardised assessments of needs. Ongoing work programmes are addressing the future financing of home support, the reform of the model of service delivery and the breadth of issues relating to this.

I have dealt with the issue of loneliness and a few other issues.

A number of contributors referenced my dual role in housing. I want to do substantial groundwork around right-sizing. Senators have referenced age-friendly schemes that are highly effective and work very well. It is an area we need to examine both in terms of people who want to rent and social housing provision, but also in the context who people who may wish to downsize in the private sector. It is something I am very keen on and will progress further within the Department of housing.

Senators referenced the care and repair models.

I will deal with questions raised by Senators. Senator Kyne referenced the statutory home care scheme, and that is a priority for me. Senators Boyhan and Keogan referenced the housing adaptation grants. I worked on that scheme when I was a Minister of State at the Department with responsibility for local government. I am very familiar with that scheme and want to get to 100% of costs being met if income is below €37,500. I am open to any suggestions about this scheme. It continues to fall under my remit in terms of both Departments. I want to have a scheme that allows for deductions in nursing in home fees and carer’s fees so it is a scheme I believe in passionately and that is always open to improvements.

I take on board Senator Boyhan’s point about coming back and the review on pricing. The Senator might send on the information about concerning Councillor Donohue in Loughrea. We can follow up on that.

Senator Costello made reference to difficulties experienced by older people online. I will look at this matter.

Senator Ryan mentioned the statutory home care scheme, adaptation grants and adult safeguarding legislation. The programme for Government commits to a national adult safeguarding policy. We hope that will be brought forward very shortly. It is a huge body of work and we are committed to that.

Senator Stephenson referenced digitalisation and the carer’s allowance.

Senator Black referenced adult safeguarding, which I have addressed.

Senator Rabbitte made reference to home care packages, home carers, funding and so forth. She also made reference to Dónal, who was from the mid west. If there are issues we can help with, she might let us know.

Senator Murray referred to the housing adaptation grant and the impact it had on her dad. We will not cover everything here but if issues come up, write to me. I will meet people and we will do whatever we can because we owe it to the older section of society. That is the reason our party, in particular, and the Tánaiste, Simon Harris, were passionate about having a Minister specifically for older people, with that Ministry lying between health and housing to bring those synergies together. That is where my body of work is at.

Senator O’Donovan mentioned loneliness and I take that on board.

Senator McCarthy referred to age-friendly housing. That relates to right-sizing of housing in both the social and the private sectors. In terms of policies, an awful lot of good work is being done. My role as a politician is to bring more policy structure and ensure it is nationally applied. A number of local authorities have financial contribution schemes for people who want to downsize or right-size, but it is not universal so we need to look at that.

Senator Murphy O'Mahony made reference to the work of carers and the ageing population.

Senator Scahill referred to ESB and vulnerable groups. We will follow up on that.

Senator Brady mentioned retirement villages. I very much take on board the points Senator Tully made about a particular boarding home. Perhaps she could come back to us on that and we will follow up on it for her.

Senator Kennelly made reference flooding and what can be done.

In response to Senator Ní Chuillin, the programme for Government refers to a review of the immunisation scheme. Perhaps she could follow up with the relevant Minister on that. It is not under my specific remit but it is relevant to older people, so perhaps we can follow up and do something about it.

Senator Cosgrove spoke about staff, and I have covered that.

Senators Costello and Kelleher spoke about loneliness.

Senator Lynch referred to the Assisted Decision-Making (Capacity) Act, which comes under the remit of the Department of children. We will follow up on it.

Senator Keogan spoke about housing adaptation grants. I want to improve them. We have done a considerable body of work in that regard but, as with everything, we are always looking to make further improvements.

Senator Byrne, who is my colleague in Limerick and the Leas-Chathaoirleach, referred to nursing homes. I have already addressed the issues relating to public beds and the home supports.

My role is a new one that dovetails between the Departments of health and housing. I am energised by the assignment and the role. I want to work with everyone. I am practical by nature. I will go to Inchicore tomorrow to look at a pilot scheme involving the Departments of Health and Housing, Local Government and Heritage. It is a scheme for older people, a retirement village, and I want to see how it works in practice. I want to bring forward a policy that will give rise to a statutory home care scheme. We all have elderly parents and they all want to remain in their homes. The question is whether we can extend that. We still need nursing homes. They are huge part of the sector, but what can we do? For me, as Minister of State, it is about looking at a structured approach. The first step is to regulate the area like we do nursing homes. That has to be done. The next step is to look at what is involved for the care staff and how we define statutory care. Then we move on to how we can roll it out. It is a huge body of work I want to do, along with other areas.

Another area that is extremely important is that of dementia. It came up repeatedly. It is a significant part of the programme for Government. I want to see a register for dementia up and running and to get the other areas, such as the 20 centres, rolled out over time.

We had a good debate. I enjoyed the engagement and look forward to further engagement. People will know from the past that I enjoy a robust discussion. I may not agree with everything, but I will certainly listen. I thank the Senators.