Seanad debates
Wednesday, 11 July 2018
Commencement Matters
Residential Care
10:30 am
Colm Burke (Fine Gael)
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I do not agree with what has occurred in the past few minutes.
In my Commencement matter I call on the Minister for Health to establish a forum on long-term residential care. I recall that I made such a proposal about two years ago owing to increasing pressure on the State to provide long-term residential and respite care. One of the proposals made called for the setting up of a biannual meeting of all of the key players. They included the Department of Health, the HSE, the Irish Nurses and Midwives Organisation, the Irish Medical Organisation and Nursing Homes Ireland. Such a meeting would allow them to meet and deal with challenges arising in the area. Over 23,500 people live in private residential care settings under the fair deal scheme.We have another 6,000 to 7,000 in community care services. There is going to be a huge change in the demographics, with the number reaching 85 years of age increasing all of the time. The number reaching 65 years of age is also increasing. Therefore, there will be huge challenges. Likewise, there will be huge challenges in hospitals because of the growth in population. The figure used is that 51% of all hospital beds are occupied by people over 65 years of age. If there is an increase in that demographic, there will be an increase in the demand for beds in hospitals. Therefore, there will have to be a faster response from hospitals in trying to provide step-down care facilities. It is in that context that I propose a forum be set up to deal with the issue of long-term care that would meet either once every three months or once every six months to tease out issues arising and that there be a fast response from both the HSE and the Department in order that they would act before issues arose that would have to be acted on urgently. It is in that context that I raise the issue.
Jim Daly (Cork South West, Fine Gael)
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I thank the Senator for giving me the opportunity to address this issue. It is very real and there is no argument about it from my end, as the Senator is aware. I support his endeavours to have it addressed in a broader context and have a facility for all stakeholders and all those with an interest in and a working knowledge of what is going on in the sector. I have no difficulty in that regard. As the Senator outlined, people are living longer than ever before and success in improving health outcomes and extending life expectancy has been achieved. The projected numbers of older people are stark, to say the least.
The report of the Committee on the Future of Healthcare, Sláintecare, supports a significant shift in the model of care to one that is focused on prevention and early intervention and which will provide most care in the community. It is crucial that the appropriate supports be in place to match each person’s needs at whatever point he or she is at in the interaction with the healthcare system. The Senator is a particular proponent of the policy of prevention, rather than cure, and that we work with people in the community to try to prevent difficulties, but we also know that it is a fact of life that a large population will invariably require long-term nursing care in a residential setting, no matter what efforts we make to avoid this.
The Senator will be aware that the Department is developing a statutory home supports scheme. An important step in the development of the new scheme was a consultation process which was carried out in 2017, the purpose of which was to allow everyone with views on this topic to have his or her say. There was a very high response rate, with approximately 2,600 submissions received. A report on the findings of the consultation process was published last month.
Planning for future services will continue and it will be informed fully by the views and concerns of all stakeholders. However, this is not an issue that can be readily progressed by the kind of forum proposed by the Senator. The decisions that remain to be taken are less about what we need to do but about how to do it. It relates in large part to resourcing and the balancing of priorities within the health sector and government overall. I am pleased to inform the Senator that I will host a conference later this year on housing for older people which will bring together key stakeholders to share best practice and discuss how best to meet the needs of older people.
As the Senator knows, I have a particular interest in addressing the long-term care needs of older people in communities and supported living environments. Notwithstanding this, the Senator's point is valid. I support the validity of his request, to have it considered furthe, that we have a specific forum, but what we do not want is a duplication of fora. We want to ensure we build it in, but I do know from where the Senator is coming. I have heard the case being made before and I am supportive and welcoming of it to ensure we can accommodate more voices at the table. The Senator mentioned some of the stakeholders, including Nursing Homes Ireland and the IMO. The conference we will organise in September, October or November will look at the long-term residential care needs of older people, not specifically in institutionalised settings but more in the community in supported housing. All of the people whom the Senator mentioned will have a role to play and a contribution to make. That will be part of the conversation. As opposed to isolating it to residential care settings, we hope to broaden it out.
Colm Burke (Fine Gael)
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The reason I am raising this issue is that Nursing Homes Ireland and some of the other organisations constantly contact me about situations where they go to the Department of Health and the standard response is that it must go and talk to the HSE. Likewise, when they go to the HSE, the response is that it must go and talk to the Department. Their view is that even if such a forum was to meet only once every six months, all of the stakeholders would sit down to talk about the issues and how they could be addressed before they became a real problem. It is in that context that they have raised the issue. They are being told that one party has to consult the other. As a result, they are finding that they have to go back and forth. They state a meeting on a biannual basis would help in dealing with a lot of the issues that arise.
Jim Daly (Cork South West, Fine Gael)
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The basic premise is that nobody has a monopoly of wisdom on what is the right thing to do. They are people who just want to be heard in a forum that is more complete in order that they are not potentially operating in a vacuum where one partner states it needs to discuss an issue with another. I have discussed the matter with Nursing Home Ireland and understand from where it is coming. Therefore, in the interests of completeness, I will certainly have the conversation on the Senator's behalf and progress the matter within the Department and the HSE to see if we can work out the detail of how it would work, be it a forum, a round table discussion or a biannual meeting. We must ensure people's voices will be heard on a more regular basis in a more complete setting where every voice will be represented at the table at a given time in order that answers will be more readily available to them.