Maire Devine (Sinn Fein)
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I welcome the Minister of State and thank him for taking this Commencement matter. I am here to make a personal representation for the family of Ms Mary Baker. Mary is 80 years old and went to St. James's Hospital in August with a chest infection, ending up with a broken back, leading to paralysis from the waist down.

Paul Coghlan (Fine Gael)
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Please desist from naming individuals.

Maire Devine (Sinn Fein)
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Okay. The family is here so they are okay with it.

Paul Coghlan (Fine Gael)
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They may be but we are not allowed to name individuals.

Maire Devine (Sinn Fein)
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Mary was at five years old put into institutional care, along with her small sister of two years old. She had an horrific childhood, with horrors we can only imagine and which we have heard of through the years about the Magdalen laundries. She protected her small sister and got out of there at the age of 16, never to return. She married happily and has children of her own. She is blind. She asked her children to never allow her back into institutional care. Unfortunately, this is what is being offered by the wonderful staff at St. James's Hospital, who have cared for Mary. They have said she will probably need institutional care as opposed to home care. She wants to go home and she is familiar with that environment, given her disability of being blind. She had a wonderful life going in and out of social events, having hairdos and being in her local community. She was a very independent woman.

Since the news was broken last week by the staff in the hospital, she has experienced extreme distress. She is crying and cannot eat. She just wants her wishes to be fulfilled in that she can be cared for at home with whatever time she has left. She needs more than the average home care package. I know there are difficulties with these packages but I plead for the Minister of State to work with the other Minister of State, Deputy Finian McGrath, on this and meet the family. We should look at the benefit to the State, as the cost of hospital bed stay is approximately €6,000 per week, the cost of residential care could be up to €2,000 per week and the cost of a home care package is significantly lower.

I would like a commitment from the Ministers of State, including Deputy Finian McGrath, who is aware of this, to meet the family and work out the best option in order to fulfil her request for whatever time this woman has left. We need to have compassion and empathy and we must act in the best interests and wishes of Mary.

Jim Daly (Cork South West, Fine Gael)
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I thank the Senator for raising this matter. She referred to a particular case.I believe that it would be inappropriate to discuss an individual's circumstances in public in the Seanad. I appreciate this is a distressing time for the individual. However, I have been advised that the HSE is working closely with the family and that a range of resources is needed which are difficult to source.

The HSE has operational responsibility for planning, managing and delivering home and other community-based services for older people. In addition to the mainstream home help service, which offers support for personal care and help with domestic chores, enhanced home care is provided through home care packages. All those applying for home care are assessed and provided with a service, if appropriate, as soon as possible having regard to their assessed needs and availability of resources. Priority is given to people due to be discharged from acute hospitals who are in a position to return home with supports. However, the resources available for home care services, while significant, are limited and, with the increase in our elderly population, demand is growing year on year. In budget 2018, a further €37 million has been made available for older people's services, comprising €5 million in funding in 2017 and €32 million next year, to further strengthen supports for older people, particularly to facilitate speedier discharge from acute hospitals over the winter period. A significant proportion of this additional funding will go towards home care services. There will always be a cohort of people for whom residential nursing home care provides the best option to meet their health care needs. The nursing homes support scheme continues to be the main pathway through which most people enter residential care. The scheme will continue to be a key support ensuring that older people have access to high-quality care in a location of their choosing. Improving home care services in order that people can live with confidence, dignity and security in their own homes for as long as possible is a key commitment of the Government. Home supports are crucial to helping older people, and indeed people of all ages, with particular care needs to remain where they want to be, at home in the surroundings with which they are most familiar and comfortable. The Government is planning to establish a new statutory home care scheme and a system of regulation for home care services. The Department is currently engaged in a detailed process to progress these issues. The Minister for Health, Deputy Harris, and I launched a public consultation process on the financing and regulation of home care in July of this year. The public consultation is just the start of the broader process of engagement by the Department with interested individuals, groups and service providers on the future of home care. The Government is committed to progressing the development of a regulatory and funding model for home care services as quickly as possible, though I should point out that it is a complex undertaking and will require a significant amount of detailed preparation.

Paul Coghlan (Fine Gael)
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Would Senator Devine like to ask a supplementary question?

Maire Devine (Sinn Fein)
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Yes. I thank the Minister of State, Deputy Jim Daly. I refer to his reference to a location of their choosing. This woman chooses to go home to a familiar environment where there is family involvement and they can dovetail in with a home care package. I could go on. Her daughter lives with her, other daughters and sons live in the vicinity and they already have made alterations to their homes to accept their mother home for whatever time she has left. Will the Minister of State give a commitment that he will meet the family, who are sitting in the Gallery here today, and try to come up with a package that is suitable for all?

Jim Daly (Cork South West, Fine Gael)
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I cannot get involved in personal cases. I think the Senator knows that. As a Minister of State, I do not decide, and nor does the Senator, about resources. That is not a decision for us. I manage the Department from a macro level but individual resources are administered by the HSE. It would not be appropriate for me as Minister of State to direct the HSE as to what families should get the resources that are available. That is a matter for the HSE.