Pearse Doherty (Sinn Fein)
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Cuirim fáilte roimh an Aire Stáit. The first time I raised the subject of this Adjournment debate - the decision of the Government and the HSE to withdraw home help services - in the Seanad was approximately six weeks ago, when it first reared its ugly head in County Donegal. This evening, I am calling on the Minister for Health and Children to reverse her decision to reduce by 2,246 the number of home help hours being given to the elderly people of County Donegal. Since I became aware of this issue and started to ask questions about it and raise it in the Seanad, I have received numerous replies from the Minister, Deputy Harney, and from HSE officials. I have been given many figures and statistics setting out the various numbers of hours that are apparently being provided. I appeal to the Minister of State, Deputy Haughey, to put such information to one side this evening. I am not as interested in computer data and statistics printed on paper as I am in the elderly people of County Donegal - Mary, Johnny and Paddy. I am concerned about people like the 97 year old woman whose home help services have been completely withdrawn, or the wheelchair-bound father whose services have been reduced to just 15 minutes a day. The people to whom I refer dug deep when this country needed people to dig deep. They went to hiring fairs before they were teenagers and were hired off to other families. When they went to Scotland to work as tattie hokers, they sent money back to their families and communities at home. Many of them lived through very difficult times, including the First and Second World Wars. When their country needed them, they stretched out their hands. They want their country to respond to the serious needs they have today.

As I said earlier, Fianna Fáil is shaping a new type of Ireland. When I say it is an Ireland of which I can no longer be proud, I accept that I am making a strong statement. This issue involves more than statistics, numbers of hours and other forms of data - it goes to the core of what we are all about. It is shameful for any Government to treat the elderly as they are being treated at present. At a national level, the Government is withdrawing almost 27,000 hours of critical home help support on the basis of computer data, rather than on the basis of need. It is completely wrong and utterly unjust. In my view, it is one of the worst crimes the Government has committed in recent years. I appeal to the Minister of State to encourage his colleagues to do the right thing at this late stage. A great deal of damage has been done to elderly people and a great deal of hurt has been caused to their family members.

The terms of employment of home care workers have been changed. Some of them are now working just three hours a week, which makes absolutely no sense. I noticed today that the Government has sent 1.3 million postcards, at what must have been a phenomenal cost, to homes across the country to tell people about guarantees that mean nothing. The House debated the matter earlier. In some cases, the postcards have been sent to people in County Donegal whose loved ones are having to cope with reductions in front-line services like home help hours. The Government does not have the cop-on to understand it is more important to give people an additional 15 minutes of home help support - to help them get out of bed, onto a commode and back into bed, for example - than it is to send postcards around the country. It needs to get its act together.

The issue I have raised is at the root of the problem of where this country is going. What type of country is this Government shaping? While I accept that we have to make decisions if we are to get the country back on track, we should not attack people who need the State to provide help so they can get out of bed, get onto a commode, get washed and get back into bed. The Minister of State knows it is wrong to cut services of this nature. I am sure the Taoiseach knows it as well, so why is it continuing to happen?

IMPACT and SIPTU have organised a protest for 2 p.m. this Saturday. I hope thousands of people will take to the streets to speak with one voice of their anger and disgust at what the Government is doing. I appeal to the Minister of State to give the people of Donegal the answer they are looking for. The Government should promise to review this matter and ensure that any cuts deemed necessary are made on the basis of the needs of patients and elderly people, rather than on the basis of the impression that County Donegal has a higher need than the HSE has budgeted for. I remind the House that it is proposed to reduce by 2,246 the number of home help hours being provided in the county. I do not know how much that will save, but it is not worth taking the dignity of our elderly people, which can never be paid back. I appeal to the Minister of State to give us the right answer tonight.

Seán Haughey (Dublin North Central, Fianna Fail)
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I will respond to Senator Doherty on behalf of my colleague, the Minister for Health and Children. I thank the Senator for raising this issue and thereby giving me an opportunity to reaffirm the Government's continued commitment to services for older people and, in particular, the important area of home help services.

The Government's policy on older people involves supporting them to live in dignity and independence in their own homes and communities for as long as possible. If this is not feasible, the health service supports access to quality long-term residential care, where appropriate. This policy approach was renewed and developed in the partnership agreement, Towards 2016. The development of services for older people throughout the country reflects the prioritisation of, and significant investment in, this area by the Government in recent years. For example, additional funding of just over €200 million was provided to develop or expand community-based services between 2006 and 2008. This additional funding related to home care packages, home help, meals on wheels and day or respite care, for example. Home care services are delivered either directly by, or on behalf of, the Health Service Executive, in partnership with the voluntary sector or through private providers, as appropriate.

I will set out the position in relation to home help. It is expected that the HSE will spend €211 million on the home help service this year. Over €55 million in development funding has been provided since 2006. The number of home help hours being provided has increased from 10.8 million in 2006 to almost 12 million this year. The number of people benefiting from the home help service has increased from 41,400 in 2006 to approximately 54,500 this year. Home care packages, which are a relatively new initiative, were introduced in 2006. They were developed across the country through the Government's phased investment of €120 million in new funding. Home help packages consist of a variety of community-based services and supports, including a significant home help element in many cases, to best meet the needs of older people. Home help clients may have significant medical, nursing or therapy requirements. They may have recently been discharged from hospital. They may be at risk of admission to hospital if their needs are not met in a planned way. The HSE service plan envisages that approximately 8,700 people will benefit from home help packages at any one time. Over 11,000 people will benefit over the course of this year.

It is important to stress that, notwithstanding its current financial pressures, the Government has made every effort to protect home care services for older people. This year, the HSE aims to deliver the same quantity and quality of home help and home care packages nationally as it delivered in 2008. I understand that the HSE in County Donegal provided 54,246 home support hours per month in the first quarter of 2009. This was in excess of the number of budgeted hours, which is 52,000 hours per month for 2009. Since 2003, there has been a 60% increase in the number of home help hours delivered to older people in Donegal. In addition, 191 people in Donegal benefit directly from home care packages.

Of this country's 32 local health offices, the local health office in Donegal provides the third highest number of home help hours per capita to those over 65 years of age. The HSE has indicated that it intends to achieve efficiencies in service delivery by reviewing the scale of provision, particularly on Sundays and bank holidays when premium pay rates apply. It aims to meet patient needs through a variety of supports, including public health nursing, day hospitals, day centres and home care packages. Any person in County Donegal who is not satisfied with the level of home support being provided can appeal the decision to the HSE appeals officer in the north west.

It is clear that the Government has made considerable improvements in recent years to enhance home care provision across the country, including County Donegal. There is no doubt that demand can, at times, exceed service resources. I am satisfied, however, that the HSE will continue to deliver the home help service in the best possible manner, taking account of evolving circumstances at national and local levels.

Pearse Doherty (Sinn Fein)
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Will the Minister of State take a clear message to decision makers at Cabinet level to the effect that this issue is not going to go away? The response the Minister of State has been asked to deliver tonight on behalf of the Minister for Health and Children, Deputy Harney, is complete and utter nonsense. I have that response already and it is devoid of any real facts as regards what is happening on the ground, the real people in the real stories. I ask him to take a clear message to the effect that the people of Donegal are not going to tolerate this. This is not the last that the Government has heard of this.