Wednesday, 24 March 2010
Cuirim fáilte roimh an Aire, an Teachta Ó Cuív, go dtí an Seanad. Go pearsanta, ba mhaith liom comhghairdeas a dhéanamh leis as ucht an Roinn úr atá faighte aige. Cé go raibh go leor deacrachtaí agam le scéimeanna agus ciorraithe éagsúla, measaim gur cailliúnt mór í don Roinn Gnóthaí Pobail, Tuaithe agus Gaeltachta nach mbeidh an Aire ann a thuilleadh. Tá a fhios agam go bhfuil a chroí sa Ghaeilge agus sa Ghaeltacht. Tá súil agam go mbeidh an Aire úr, an Teachta Pat Carey, chomh bríomhar is a bhí an Aire, an Teachta Ó Cuív, sa phost sin. Gabhaim comhghairdeas pearsanta leis.
I wish to raise the matter of home help supports provided by the State to people who need them, in particular the elderly but not necessarily all of them. I have raised this issue on many occasions in this House. From early last year I was notified of a series of cuts to the hours of support being provided by the HSE to patients in Donegal. The HSE intended to cut the level of support to 52,000 hours per month, a reduction in the region of 2,246 hours per month. An energetic campaign was waged at the time with public meetings and a large demonstration of almost 1,000 home care support workers, patients and relatives. There was interaction between the HSE unions and delegations. I led a delegation and an agreement was reached at the end of the process that there would be no further cuts for 2009. It was agreed that 52,500 hours per month would be provided for the rest of 2009. I have been informed in a reply to a parliamentary question that the level of service to be provided in 2010 is a further reduction. The HSE is proposing to take away 6,500 hours compared with the end of last year, a total of 78,000 hours to be taken away from patients in County Donegal who require home care support. I understand from previous replies that the Minister will say that Donegal has a high level of home care support hours, the third highest in the State. However, there is a higher age profile in Donegal and the Minister is no stranger to that part of the country. The service should follow the need and demand.
I have outlined to the House on many occasions the importance of providing a service to those people. It makes the difference between getting out of bed or being confined to bed all day. It makes the difference between going hungry or having a hot meal provided. I know of many hardship cases where people have been affected by the cuts which went very deeply. The most recent cut was in excess of 1,700 hours per month and now it is proposed to cut 6,500 hours per month. I fear what this will mean to many of our elderly who need this support.
I ask the Government to look at its priorities as it has got them wrong. Nobody in Government intentionally sets out to hurt people but these decisions are the wrong decisions. These people need the support and the help. This decision should be reversed before we have to rely on people to come out onto the streets and lead a campaign to get the HSE to reverse the decision last year. It was reversed to a certain degree at the end of the year. I hope the Minister has some good news for me and, more importantly, for the individuals who rely on this service.
I thank Senator Doherty for raising this issue as it provides me with an opportunity to update the House on Government policy on community services in general. This Government is committed to supporting people to live in dignity and independence in their homes and communities for as long as possible. Where this is not feasible, the health service supports access to quality long-term residential care where this is appropriate. We are continuing to develop and improve health services in all regions of the country and to ensure quality and patient safety. A key element of Government policy is the provision of community services such as home help, home care packages and day care. In the HSE national service plan for 2010, approved by the Minister for Health and Children earlier this year, the HSE has undertaken to provide almost 12 million home help hours to 54,500 people - the same level as the planned level for 2009 - over 5,000 home care packages to over 9,500 people and 21,300 day care places which we estimate cater for up to 80,000 people.
The HSE's national service plan for 2010 is to assist 14,400 people in the west with home help. This is the same target number of people as in 2009, and marginally higher than the outturn achieved last year. The target number of hours of home help for the west in 2010 is 3.5 million, the same level targeted for last year. Between 2006 and 2010 an additional sum of over €200 million was provided by this Government to the HSE to increase these services to enable older people to remain at home and in their communities.
The Health Service Executive has operational responsibility for the delivery of health and social services, including the provision of home help services in Donegal.
All developments now have to be addressed in the light of current economic and budgetary pressures. The executive has been asked to make a rigorous examination of how existing funding might be re-configured or re-allocated to ensure maximum service provision is achieved. This requires a stringent ongoing review of the application of the resources currently available.
Unfortunately, due to the current industrial reaction, the latest information available to me is from last December. At that stage, in the first quarter of 2009, the HSE in Donegal provided 54,246 home support hours per month. This was in excess of budgeted hours, which were set at 52,000 hours per month for 2009. Since 2003, there has been a 60% increase in home help hours delivered to older people in Donegal. In addition, 191 people in Donegal benefit directly from home care packages. The local health office provides the third highest number of home help hours per head to those over 65 years of age out of 32 local health offices nationwide.
The HSE indicated in December that it intended to achieve efficiencies in service delivery by reviewing the scale of provision on Sundays and bank holidays in particular, where premium pay rates apply. Its aim is to meet patient needs through a variety of supports, including public health nursing, day hospitals, day centres, home care packages etc. Any person who is dissatisfied with the level of home support can appeal the decision to the HSE appeals officer in the north west.
I regret that I do not have any more up to date information than this at present but if the Senator wishes to raise this matter again once the current industrial action has ceased, I will endeavour to have the matter re-examined at that stage.
The Government has made considerable improvements in recent years to enhance home care provision generally across the country, including in 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 manner possible, taking account of evolving circumstances at national and local level.
I acknowledge the Minister is taking this matter on behalf of the Minister for Health and Children but it is amazing that the information that has been provided is the same information that was provided in June 2009.
I have two documents in front of me. One is a document signed by the local health manager in Donegal, John Hayes, which clearly outlined the hours to be delivered for the remainder of 2009 were to be 52,500, information the Minister for Health and Children does not know according to the reply. The other is a response to a parliamentary question dated 13 March 2010 to Deputy Arthur Morgan, my party colleague, that clearly outlines that it is envisaged that the HSE Donegal would provide approximately 46,000 home help hours per month in 2010 in accordance with the 2010 service plan. That service plan was agreed by the HSE.
It is unbelievable that the Minister for Health and Children does not know what hours will be provided in 2010, three months into the plan, and does not know what was agreed last August. I am dumbfounded a Senator would know more than the Minister for Health and Children. We are talking about 6,500 hours, a total of 78,000 per year being withdrawn. This is a serious matter. People are already losing their hours. I appreciate the Minister has no more information but it is ridiculous this is happening.
The Minister said these cuts must be made in light of economic circumstances. I am talking to families that are breaking down in tears because a parent has lost support and they do not know how to deal with that. When the same people see that €12 billion will be pumped into Anglo Irish Bank, they cannot understand it. It is all about priorities and the Government must get its priorities right. The fact the Minister for Health and Children did not even know what was happening in Donegal eight months ago is unacceptable. Should she still be Minister if this is the case?
If we had let Anglo Irish Bank go, we would have had to pay the depositors and it would cost much more than we will have to invest. Those who suggest we would let the depositors go do not understand the nature of the deposit base of banks. People should take a more balanced and informed view of the choice between letting the banks go bust and ensuring we do not have to pay out the deposit base of the bank. If the Senator is talking about money, I can assure him we are taking the cheaper option.
The target number of hours for a home help for the west is 3.5 million, the same level targeted as last year. If there is some realignment within the western region, that would be a matter for the HSE regional management and I suggest the Senator takes the matter up there directly. The number of hours is the same in 2010.