Seanad debates
Wednesday, 5 March 2025
Care, Supports and Enhanced Provision of Services for Older People: Motion
2:00 am
Maria Byrne (Fine Gael)
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I welcome the Minister of State, Deputy Kieran O'Donnell, my colleague from Limerick, to the Chamber. The Minister of State is no stranger to the Chamber. He has been here quite a bit recently and is a former Member of the House.
Seán Kyne (Fine Gael)
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I move:
“That Seanad Éireann:
acknowledges: - the contribution that older people have made to Irish society through raising families, their work, both paid and voluntary and their charitable endeavours;
- that Irish people are living longer and that this presents opportunities and challenges and that living longer is one of humanity’s great success stories;
- the desire for older people to be active and involved in their communities;
- that the potential of our older persons is being unintentionally blocked by poor policy and that ageism, loneliness and undetected treatable conditions are widespread;
- that Ireland was the first country to be designated age-friendly status by the World Health Organisation in 2019;
- the work of charities assisting and advocating for older persons;
- the work of the independent Commission on Care for Older People;
- that the Programme for Government committed to:- publish, resource, and implement a National Action Plan for long-term care of our elderly;calls on Government to: - support older people to live at home and in their own communities by implementing the Programme for Government commitments on older persons;
- continue to significantly increase the income disregards for carer’s allowance in each Budget with a view to phasing out the means test during the lifetime of the Government;
- design a Statutory Homecare Scheme to allow people to stay in their own home for as long as possible;
- increase home care hours;
- rollout the Care and Repair Scheme nationally;
- increase the Housing Adaptation Grant;
- increase funding for the national Meals on Wheels network and develop a plan to ensure there are supported providers in every town in the country;
- expand the Enhanced Community Care programme;
- enhance our network of day centres
- continue to support Community Healthcare Networks;
- increase support for carers – providing training, establishing clearer pathways to services, and improving access to respite;
- fully fund the Carer’s Guarantee;
- continue to implement the local age-friendly strategies enabling the voice of older people through the Older People’s Councils;
- continue to work with The Irish Longitudinal Study on Ageing to support ageing well in Ireland;
- continue to support and enhance the Go for Life national programme for sport and physical activity for older people in partnership with the HSE and the Local Sports Partnerships; calls on Government, in recognising dementia supports, to: - work with the National Dementia Office and key stakeholders to develop a National Dementia Registry to map services, identify needs and the delivery of equitable access to services;
- establish 20 new dementia-specific day care centres;
- include dementia specific provisions across all new community nursing hospitals;
- increase ringfenced home care hours, and funding for dementia intensive home care packages;
- double funding for dementia day care at home;
- double the number of dementia advisers;
- rollout more Memory Assessment Support Services teams;
- rollout more early age dementia supports; calls on Government, in supporting the strengthening of our nursing home sector, to: - increase funding for the Fair Deal Scheme and ensure the waiting list does not exceed four weeks;
- build more public nursing home beds;
- publish the National Treatment Purchase Fund review of pricing systems in early 2025 and work towards an equitable funding model for the nursing home sector;
- provide a career pathway for healthcare assistants.”
Maria Byrne (Fine Gael)
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I understand that Senators Kyne and Boyle are sharing time.
Seán Kyne (Fine Gael)
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We will take approximately 11 minutes and five minutes, respectively.
Maria Byrne (Fine Gael)
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Is that agreed? Agreed.
Seán Kyne (Fine Gael)
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The Minister of State is welcome to the Chamber. It goes without saying that older people have made an incredible contribution to this country. The economic and social success of this Republic is due to the major work, sacrifice and care of previous generations. Many of our older citizens were parents in difficult times in the 1950s and 1960s when money was scarce, opportunities were few and emigration was often the only option left. There resulting sadness and separation were features of the rest of the lives of parents and are still felt often. Education was seen as the great saviour and the route out of poverty. The older people of today sacrificed much to give a good education to their children in order to better themselves. Their efforts have given us the well-educated society we have today, where knowledge is valued by ourselves and the many foreign companies that choose to locate here.
Older people have never played such a strong part in our communities. They remain active and healthier for longer. Older people are visible in voluntary groups and activities. They are the backbone of Tidy Towns groups, meals on wheels and, of course, men's and women's sheds.
I will compliment the work of a number of organisations that have highlighted the contributions of older people and the challenges they face in the Ireland of today. The Independent Commission on Care for Older People has raised the issues involved and has indicated a number of measures that would improve the lot of older people. We also appreciate the great work done by many charities advocating for older persons.
Molaim daoine aosta sa tír seo, daoine a d'oibrigh go crua thar na blianta chun a chlanna a thógáil agus deiseanna agus acmhainní a thabhairt dá gcuid páistí. Is éard atá ón bhformhór acu ná fanacht ina dteach féin chomh fada agus is féidir. Caithfimid scéim reachtúil cúram baile a chur i bhfeidhm trasna na tíre. Teastaíonn an deontas a mhéadú chun gur féidir athchóiriú a dhéanamh ar a dtithe. Caithfimid breathnú ar scéimeanna sciath-thithíochta in éineacht le seirbhísí lae agus tacaíocht sláinte. Tá cásanna maithe trasna na tíre, mar shampla i nDún Mhuire i mbaile na Fairche i gConamara thuaidh, áit a bhfuil ocht dtithe beaga i lár an bhaile gar do na siopaí, don séipéal agus d'áiseanna sa bhaile.
Most older people want to live in their own homes for as long as possible. We need to ensure there is a statutory home care scheme for our older citizens. We need to ensure that the resources are put into adaptations for their houses. I know our local authorities do a lot, and we know the demands on the services and grants they provide. We need to ensure that those grants continue to be available.
We must also look at examples. I know there are examples in the Minister of State's constituency and region. There are wonderful developments, such as in Clonbur in Galway where there are eight houses behind the old convent. They are in the centre of the town. There are eight homes for elderly people. That has given a new lease of life to people who were isolated. Perhaps they were without family or moved into the area ten or 15 years previously. They now have a small community. They are near the shops, the church, the pub and wherever else they want to go to socialise, meet people and be part of the community. I am sure there are hundreds of examples of similar initiatives around the country.
In order to keep people at home, we must consider a statutory home care scheme to underpin the policy and the desires and needs of older people and their families. There are always examples of people who are quite happy to go into a community setting or become part of an active nursing home or whatever else, but the majority of people want to live in their own homes for as long possible. I would like to stay at home for as long as possible when I get to that stage and I am sure most of us would. We would also want our parents and loved ones to be able to stay at home. As I said, we need to ensure that the adaptations that local authorities deal with, including ramps, stairlifts, accessible kitchens and showers, and all of those supports, are provided and there is sufficient funding for them.
Home care hours are important for people as they become older and less mobile. Everyone's family is different. I have made this point quite often. There are seven of us in my family and we were able to look after our father at home throughout all of his illness until he passed. That was great, because we were able to keep him at home. We had a rota and were able to do what needed to be done, with the great help of our mother and a small amount of home help. Not every family can do that. There are families where one person is at home and three or four others are in different parts of the country. Some siblings may be abroad. There are also families with an only child. There may be elderly people who were not fortunate enough to have children or made the choice not to have them. There are many different scenarios and types of families out there, but they all deserve to be given the best possible care.
Home care hours are important, as I said, and their expansion is important. The enhanced community care programme provides excellent care for older people in the communities. We need increased home care hours in those cases. Carers provide both great support and company for older people.Unfortunately, we have had problems recruiting adequate numbers for the role of care, so we need to improve support for carers and provide caring to encourage people to take up what is one of the most valuable roles, namely, caring for our older or infirm. In many cases, carers are themselves elderly, and in those cases we have to be mindful of the carer's welfare and well-being as well as that of the person being cared for.
Unfortunately, however, not everyone can be cared for in the home and, as I said, some older people may make a decision that they want to go to a form of nursing home or assisted living. We need to ensure there are adequate nursing home beds. We can all give examples of State investment, such as in St. Anne's nursing home in Clifden, where €35 million is committed and planning permission is granted, which will proceed, but there are also other examples where beds are empty because of staffing issues, whether in Áras Mhic Dara in An Cheathrú Rua, Galway, or other examples. We need to ensure there are adequate public beds and, obviously, private nursing homes have an important part to play as well. There is a worrying trend of local nursing homes closing for various reasons, mostly to do with the funding model for nursing homes, which has long been highlighted by many in their representative bodies.
We also need to look at the fair deal scheme, and one of the commitments relates to reducing the timeline for decisions to be made on the scheme. For many of these issues over recent years, and certainly from ten years ago up to recently, we could say they were funding related. We did not have the funding to provide sufficient hours or to fast-track the fair deal scheme. Funding is not as much the issue now as are the staffing and the resourcing of the important roles such as carers that are committed to.
This motion, on which I compliment my party colleagues in Fine Gael, calls on the Government to do a range of things that are committed to under the programme for Government. This is something that came from our party manifesto and that of Fianna Fáil and the measures are now part of the programme for Government. There is a commitment by the Government and the Minister of State to enact them and I look forward to hearing how he foresees them being enacted, what his priorities are and how the actions, which we all want to see, which will be taken.
Dementia is another area that is talked about in the plan, which commits to looking at the establishment of 20 new dementia-specific day care centres. Dementia is a horrible disease and these people are additionally vulnerable. It is important that there be dementia-specific beds and day care centres and, again, in the case of St. Anne's nursing home in Clifden, which I mentioned, there will be dementia beds in that development, which is to be welcomed. We need to look at ring-fenced home care hours and funding for dementia-intensive home care packages and at doubling the funding for dementia day care in the home. Those are commitments under the programme for Government.
It was touched on earlier, and is part of the programme for Government, that we will continue to significantly increase the income disregard for carers. I know this is part of a different Minister's role but it is very important. We need to feed into that in the context of how it is going to be rolled out. It is going to happen over the lifetime of the Government and not in one fell swoop. Which citizens or specific cases are going to be prioritised? Will it be our disabled persons, which might be a commonsense place to start? These are questions we need to look at.
Manus Boyle (Fine Gael)
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I second the motion.
As we know, there are a lot of problems in healthcare with the increasing population and people living longer. I met a group of carers in Killybegs on Monday. They are caring for their loved ones at home and crying out for respite but they cannot get it. Respite is nearly a thing of the past in County Donegal. One family I was working with were offered respite for 27 September of this year. That is totally unacceptable for someone who cares for their loved one 24-7 in their own home. Carers need a break too. They are living with this day in, day out. The recruitment embargo for carers needs to be lifted urgently.
Another issue in Killybegs relates to dementia, which my party colleague Senator Kyne touched on. Dementia is a very big problem. Of the 15 carers I met, ten have dementia patients and they care for those people day in, day out.
Day care centres need to be opened five days a week but since Covid-19, this has not happened. So many depend on day care centres for their meals, activities, health monitoring and social outings. Home care hours need to be increased to support people living at home and I concur with Senator Kyne, who made the same point. We need to try to look after people at home for longer and that will impose less of a burden on the State.
On support for people with disabilities, since I was elected to the council in June, four or five people with disabilities have told me there are not even public toilets in some parts of Donegal for people with disabilities. We need to increase funding for the fair deal scheme and ensure the applications do not take longer than four weeks to be processed. We should also accelerate the housing adaptation grant, increase funding for the national meals on wheels programme, support the nursing home sector and call on the Government to do so.
On the issue of older people, too, I was in an emergency department on Sunday night and was saddened to see what is going on for older people coming in using wheelchairs. One older person was there for seven hours, from when I went in and until I came out, sitting in a wheelchair. In this day and age, we need to have some kind of a fast-track system for somebody who is aged and using a wheelchair to try to get them through the system a lot more quickly.
Mental health issues also need to be addressed. People are suffering in silence. A man I met last week told me that if he came down the pier with a broken arm or leg, I would try to help him, but that nobody understands what he is suffering. There is an issue there and we need to try to help people when they need it.
Patients have to travel for four hours on a bus from Donegal to Galway to get cancer support services. In this day and age, that is too long and something has to be done about it. Donegal needs a fully supported cancer care service and I am calling for one for Letterkenny University Hospital. This is essential for a county the size of Donegal. When I was knocking on doors in June, I met some former Senators, and one issue that arose was the isolation and loneliness of older people at home. They really feel it and since Covid, they feel it a lot worse. They have been so isolated and people are now afraid to call to them because of what they might catch. Those days of going to visit your older neighbours are kind of gone in the rural communities.
One issue has come home to roost to me since I was elected to the council in June. I was approached by a couple of older people who are nearing the end of their lives. They wanted to get closer to home and be moved into a community hospital but no beds were available. For my last days anyway, I would like to be near to my home. We should try to do something there. It might be for only a week at most, but it is important for that person to spend that week with their loved ones in the town they know, where they can look out the window and see the sea or whatever. That needs to be addressed.
I thank the Minister of State for coming to the House. I hope he will take on our points.
Maria Byrne (Fine Gael)
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Before we move on, I welcome Senator Joe O'Reilly to our Visitors Gallery. He is accompanied by his wife Mary, his sister Caroline and his son Alexis. I hope they will all enjoy their visit to Leinster House and the Seanad. They are very welcome.
Victor Boyhan (Independent)
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I welcome the Minister of State to his important Ministry. I have no doubt he will do an exceptionally good job.He is fiercely committed and applies himself to the challenges put in front of him.
I thank Fine Gael for using its Private Members' time to afford us an opportunity to discuss and debate care supports and enhanced provisions for services for older people. That is important. There are many asks in the motion. I am familiar with them, as Fine Gael Senators will be also, having prepared them. As the Leader said, all the suggestions, asks and proposals in the motion are in the programme for Government. Sadly, many of them were in the previous programme for Government but they were not delivered. We must move forward, but it is important to take time to look back at the previous two programmes for Government to see why these things did not progress. There is learning for us in that. I am not being critical as there may be very good reasons that they did not progress as fast as they should have. I ask the Minister of State to look at that.
I will deal with four specific issues relating to the asks set out in the motion. One refers to enhancing our network of day centres. Councillor Geraldine Donohue in Loughrea brought to my attention today that the Seven Springs purpose-built day centre in Loughrea has not returned to its pre-Covid opening hours and services. The service is being operated in a hotel. Taking this example as a single issue, will the Minister of State ask why this purpose-built day centre, which is a significant intervention, is not available to the people of Loughrea? I will send him the details. I wanted to flag this matter as this debate presents me with an opportunity to do so.
The motion refers to a fully funded carer's guarantee. I support that. I will touch on the fair deal scheme and how it relates to nursing homes because I have served two terms as a director of the National Treatment Purchase Fund. As such, I am fully up to speed regarding the difficulties. There are difficulties and unfair aspects of that which I will touch on later. The motion also refers to publishing the National Treatment Purchase Fund pricing review in early 2025. As that is a commitment in the programme for Government, I take it as a given, notwithstanding the motion. We should get ahead and do that, if possible.
Enabling people to age with confidence, security and dignity in their own homes and communities is clearly a policy of the Government which all of us in the House supports. It is important that we have a collaborative approach involving the Government, communities, the voluntary sector, healthcare providers and individuals to advance that policy. Supporting ageing in place remains a central focus of the Sláintecare health reform. Let us go back and look at Sláintecare and see how that dovetails with the issues presented here today.
Quality of life for older individuals is vitally important in assessing suitability for housing, physical and mental health services. Real opportunities for community and cultural participation are key dimensions for the well-being of older people.
I commend the former Fine Gael Member, Tánaiste, Minister and MEP, Frances Fitzgerald, who is now the chair of Home and Community Care Ireland. HCCI is, significantly, an all-Ireland body. All Members received a copy of a HCCI strategy titled Rising to the Challenge: Building Better Care, Stronger Communities. I emailed a copy of it to the Minister of State's office. I ask him to have regard to that. I wish Frances Fitzgerald every success in rolling out that strategy.
As a former member of the National Treatment Purchase Fund board, I understand the concerns of Nursing Homes Ireland. I welcome the Government's express commitment to work towards an equitable funding model for fair deal pricing, which remains outdated and deeply unfair. Since 2018, 77 nursing homes have closed, leading to the loss of 2,800 beds. This has added pressure to the acute hospital bed services. A reformed, equitable, transparent and sustainable funding model for nursing homes is essential to prevent further closures and ensure older people receive appropriate care for their specific needs This afternoon, Nursing Homes Ireland circulated a document providing key details of the fair deal's "inequities", as it describes them, and broken promises and notes the urgent need for funding and reform. I also sent a copy of that document to the Minister of State's office today. I ask that he look at it to see how we can work to progress the issues raised in it. The programme for Government includes a commitment to proceed to publish the figures for the National Treatment Purchase Fund. I ask for that to be fulfilled.
It is all very well supporting this important Private Members' motion, but the Minister of State will be judged on the delivery of the key aspects of his Ministry and the key aspects of this Private Members' business. I wish him well. It is important that we work. I ask the Minister of State to give a commitment that he will come back to this House within six months to give an update on progress on getting the initial stages of these proposals off the ground, working with all stakeholders.
Teresa Costello (Fianna Fail)
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I welcome the debate and support the motion. We can build on the positive steps taken by the Government in the previous term, particularly in focusing on the needs and care of older people.
This is a subject close to my heart. Care and respect for older people are things that truly drive me as a politician. Some of my dearest friends in recent years have been my elderly constituents and their experiences have shaped my perspective. For far too long, the needs of older people in our society were not given the proper focus they deserved. The years pass quickly and sooner than we realise we will either be the beneficiaries or the victims of decisions made regarding our ageing population.
I also feel strongly about how the shift of vital services such as banking and Revenue to predominantly online platforms has left many independent, capable older people prematurely dependent on others. These individuals are now forced to rely on others for tasks they could once handle themselves in person. This is an issue I am deeply passionate about. We need to provide more in-person options for those who prefer or require them. That said, I acknowledge that, during the previous Government term, important steps were made in the right direction to address the needs of older people. I was pleased to see a focus on this issue and hope to see the momentum continue.
I will take a moment to compliment healthy age friendly homes co-ordinators in South Dublin County Council. What started as a pilot scheme a few years ago has now become an initiative that I wholeheartedly support. Many of my elderly constituents have benefited from this scheme. I can honestly say it has been one of the most successful initiatives I have witnessed since being elected. The service provides valuable advice and support. I highly recommend that anyone over the age of 66 take advantage of a session with one of the co-ordinators. I will happily refer anyone their way.
Another initiative I am proud to highlight is the age friendly housing scheme. Watching these developments populate my constituency has been a great experience. These homes enable people to live comfortably and independently in their communities. In Tallaght, for example, we have several of these successful developments, namely, Maplewood, Fernwood, Old Bawn and Sean Walsh Park, all of which have enriched the surrounding communities.
On housing, when building new homes, adequate consideration must be given at design stage to ensure that, structurally, homes being built will be suitable for people as they age and their needs change. Our population is living longer.
The care and repair service is another excellent initiative and one I would like to see expanded. I had the opportunity to spend a day with a care and repair team and I was impressed by the genuine care they showed in completing small tasks which, left undone, can cause stress to older people. This service is another that I often recommend to my constituents.
In terms of dementia care, I welcome the call for increased funding and supports, particularly for carers. Access to day care centres is often a lifeline for carers who may be looking after someone requiring 24-hour care and who frequently experience poor sleep patterns. The journey for carers can be isolating, tiring and lonely. We need to ensure they receive the support they need as well.
I will address an issue regarding patients with dementia or Alzheimer's disease when they present at accident and emergency departments.They should be seen and treated without delay. Long waits in accident and emergency services are difficult for anyone, but for dementia patients and their carers they can be an agonising and distressing experience. This needs urgent attention. It can be difficult - I know from personal experience - to contain a dementia patient while waiting in a cubicle in a busy emergency department. It is traumatising. I could speak on this motion for hours, but I will conclude by saying I wholeheartedly support it and look forward to seeing further improvements in the provision of services for older people.
Nicole Ryan (Sinn Fein)
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I welcome the Minister of State. We are here to discuss the future of healthcare for older people, an issue that affects every family, every community and ultimately every one of us as we age.
We support this motion and welcome any focus on the needs of older people in our healthcare system. However, supporting a motion does not mean we ignore the reality of the crisis at hand. There is a world of work to be done, as the Minister of State will be aware, and the Government has left much of it undone for far too long. Fine Gael presents an ageing population as if it were a sudden crisis that blindsided it. However, let us be clear, this is not a new problem. The rising number of older people in Ireland has been known about for decades. Yet instead of planning and preparing for it, Fine Gael has allowed our healthcare system to deteriorate year after year. Today, hospitals are dangerously overcrowded, home care services are underfunded and older people are left waiting too long for the care they deserve. The ageing population is not the crisis. The crisis is the failure to plan for it.
The numbers speak for themselves. Some 13,972 people were left on trolleys in January alone. That is a new record for overcrowding. Some 28,593 hospital appointments were cancelled, a staggering increase of 5,000 compared with the previous year. Waiting lists remain out of control because there is still no real plan for tackling hospital overcrowding. The Government has failed to invest in the staff, infrastructure and services needed to meet growing demand. Instead, Fine Gael continues to waste money on expensive outsourcing while hospitals struggle to cope and yet, instead of real solutions, it tells us that an ageing population is the problem. That is not leadership. It is just an excuse. A crisis demands a real plan with a clear vision for the future where older people receive the care, dignity and independence they deserve.
Older people should have the right to remain in their own homes for as long as they possibly can. We need to introduce a statutory home care scheme to ensure consistent and fair access to home support. We have to provide adaptation grants to make homes age-friendly, reducing the need for nursing home care. We must move away from an over-reliance on acute hospitals and expand community-based care, which includes primary care, pharmacies and rehabilitation services. We need to properly fund day care services, respite care and dementia supports, ensuring that older people can access care close to home.
We should look at cutting unnecessary outsourcing and instead invest in hospital capacity, modern medical equipment and digital healthcare systems. In addition, we need to train and recruit more GPs, nurses and allied healthcare professionals to try to reduce waiting lists and improve care.
Loneliness was mentioned and it is becoming a major public health issue, especially among older people. We need an action plan to combat the loneliness and isolation people feel by funding social supports, mental health services and community spaces where the elderly can thrive, meet and socialise. Too often, older people face neglect, abuse and poor standards of care in facilities that lack proper oversight. We must enact adult safeguarding legislation and establish a dedicated safeguarding authority for older people. Sinn Féin has proposed a care partner scheme which would give family members a formal role in the care of loved ones in nursing homes and hospitals.
I am clear that we support this motion, but that is not enough. A motion is not a solution. We need action on this. Care should be delivered at home where possible, in the community where practical and in hospitals when necessary. Older people deserve dignity, independence and respect. We need a whole-of-government approach to this, one that tackles healthcare, housing and social supports together. This is not only about statistics. It is about our parents, our grandparents and one day, it will be about us as well. It is about fairness, dignity and delivering a healthcare system that truly works for all generations.
Patricia Stephenson (Social Democrats)
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I thank the Minister of State for coming today and thank the Fine Gael Senators for bringing forward this motion. We are talking about older people and sometimes we do so as though they are a homogenous group. However, I am sure we all know lots of older people who are living their best lives, hiking and skydiving. We need to think about them as individuals and the different supports we want, beyond thinking about older people as being helpless.
I broadly support today's motion, but there are some vital considerations we need to discuss when we talk about enhancing care provision. Unpaid carers make up some 6% of the population and we still have a means test for carer's allowance. I recognise there has been a commitment to remove it within the term of this Government, but we need to see a commitment to do so this year. It is putting a huge amount of financial strain on families and it is punitive. I am sure everyone spoke to carers who are struggling on the doors during the recent general election campaign. This would be a quick way of putting human rights back into the care space.
More than 1 million people in Ireland report having a disability. This group is at significantly greater risk of experiencing poverty, social exclusion and unemployment and facing a whole range of different barriers around transport, housing and education. The fact is that disabled people, including older people, are fighting for basic supports they should be entitled to and that should be a human right. That is not okay in 2025. It was never okay, but the fact is we are still seeing people fight for basics. That needs to change. Like ending homelessness, which was not seen in the programme for Government, older people are similarly unseen in it, which is a great disappointment for many of us. There is no specific reference to older people throughout the comprehensive section on building a healthier future, which is an omission, given today's motion.
The Social Democrats have advocated for such measures as a commissioner for ageing and older populations who would ensure oversight and advocacy, which is also missing from the programme of Government, and a senior Minister for disability. To create financial stability for older people, we would also like to see a linking of the State pension to at least 34% of the average wage to ensure financial security for people who are no longer working. We are deeply concerned about the continuing privatisation of services and care for older people and would like to see a public system.
I will speak about the point Senator Costello - she is not in the Chamber - made on the challenges of the digitalisation we keep seeing. The digital-only provision of public services is discriminatory. While that is how many of us work and live our lives, many people in our lives, such as my mother, are blocked from accessing many things in the digital space.
While I support elements of the motion, we can go further. We need to focus on structural change and delivery of these things.
Frances Black (Independent)
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I welcome the Minister of State to the Seanad and congratulate him on his recent appointment. I look forward to working with him across his important brief in the coming term. I am grateful to the Fine Gael Senators for bringing forward this important and timely motion on care, supports and the enhanced provision of services for older people. It is certainly an area in urgent need of political will, resources and funding by the Government. I welcome the commitments relating to older people in the recently published programme for Government which are reproduced in the motion before us. There is no doubt about the clear need for a statutory home care scheme and dementia supports and to secure the future of the nursing home sector.
I am concerned in particular about the workers in the sector, particularly regarding low salaries, precarious conditions, access to pensions and limited pathways to further career progression. I therefore ask that this form a central part of our conversation on reforms moving forward, especially to avert any potential industrial action by workers in our care homes. Ireland’s population is ageing fast. The Central Statistics Office predicts that almost one in four people will be over the age of 65 by 2050. In 25 years, we want older people in Ireland to be able to live happy, healthy and active lives. The time to prepare for that is now. We all know that the quality of the care received by elderly people, and particularly the vulnerable in need of specific care and supports, articulates the values and principles of the society in which we live. By this measure, the State is not meeting its responsibilities.There are many heartbreaking personal testimonies of the State's failure to safeguard the rights of elderly people, which is a major cause of concern. It is important that we act now to get the supports, the services and, crucially, legal protective frameworks in place as we prepare for the future.
The Law Reform Commission has identified the area of adult safeguarding - keeping adults and, particularly, older adults in the State’s care safe from harm - as one in which Ireland is glaringly lacking a unified and cross-sectoral approach. In the major report from last year, the Law Reform Commission stated that reform of this area must “entail comprehensive, cross-sectoral legislation which assigns responsibility for regulation and oversight to appropriate bodies, and provides powers, duties and obligations for those who interact with adults, who may be at-risk adults, across different settings.” The call for a major legislative overhaul has been echoed by civil society, patient advocates, organisations representing older people, and elderly people themselves. It is clear that a unified and comprehensive approach is needed and that legislation must be brought forward to implement that.
In 2017, my Civil Engagement Group colleagues and I introduced and progressed the Adult Safeguarding Bill. The Bill, for the first time, proposed a particular regulatory framework for adult safeguarding that was rights based while also proposing additional protections and supports for adults who may be at risk of exploitation or abuse and were unable to protect themselves. I am delighted that the Law Reform Commission saw fit to include the issue of adult safeguarding in its fifth programme of law reform. This was on foot of a hearing at the Joint Oireachtas Committee on Health in October 2017 and followed the passage of the Bill to Second Stage in the Seanad earlier that year. The cross-party consensus from politicians, legal experts, civil society and advocates on the need for this change is, therefore, crystal clear. What is the status of these proposals in his Department is? I would be grateful if the Minister of State could provide an update in his reply.
In April 2024, the Law Reform Commission published the draft adult safeguarding Bill 2024 and the criminal law (adult safeguarding) Bill 2024. As the Minister of State knows, the LRC has statutory responsibility for identifying gaps in legislation and recommending change. When the LRC publishes a suite of legislative initiatives totalling almost 200 pages, there is a clear responsibility on the Government to respond. It is a concern that adult safeguarding receives no mention in the motion or in the programme for Government.
In addition to legal change, the LRC has made several important recommendations. It has called for safeguarding duties to be legally imposed on the providers of certain services, the establishment of a social work-led adult safeguarding body, a statutory duty to report harm, statutory powers to receive reports of harm of at-risk adults, and the extension of barring and safety orders under the Domestic Violence Act 2018 to address domestic abuse against at-risk adults.
A large body of expert legal policy and political work has been delivered at the Minister of State's door as he assumes this role and I have no doubt that he has a mountain of work ahead of him, but the House has already agreed unanimously that this issue is critical and must be addressed. I would be grateful if he could update the House with his plans in this area. Older people across Ireland today and in future deserve a protective legal framework that respects, protects and fulfils their rights to safety, security, and happiness.
Anne Rabbitte (Fianna Fail)
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I welcome the Minister to the Seanad. I thank Fine Gael for tabling this welcome motion. I appreciate being allocated time to speak on it.
The motion is a comprehensive one that covers an array of what needs to be done in the older age sector. Last year alone, 24 million hours were delivered when it came to home care. Some 320 day care centres were open right across the country. We have 55 dementia-specific day centres and the motion is calling on a further 20 to be added to that. The budget for meals on wheels has doubled from €3 million to €6 million since 2020. The meals on wheels service is about far more than just a nutritious meal. It is a social connection, the knock on the door. It actually makes up the triangle of care. There are the day centres, meals on wheels and the integrated care of services for older people.
It is also great to see that Ireland was designated age-friendly status by WHO in 2019. The fact that the Minister of State is across two Departments is a welcome opportunity that needs to be embraced. The fact that he has a foot in the Department of Health and the Department of local government means that perhaps we have a more opportune approach in dealing with who is funding what. The age-friendly activities initiative is based out of the Department of local government, but if that Department matches what the HSE or the Department of Health invested, we would see it spread far more widely. At the moment, Meath County Council provides its secretariat. Fantastic work is done there. In my time, I would love to have seen it mirrored in the disabilities sector, as there is such good work being done on it.
I welcome the increasing of funding for dementia-intensive home care packages. There is home care and there are different allocations of hours, for example, seven hours and 21 hours, but a dementia-intensive home care package may be needed where that person has chosen to stay at home, possibly using the Decision Support Service, and does not wish to go into nursing home care and the person's family are honouring that. It could just be the husband in his 70s who is honouring that. The person's care needs change, so an intensive home care package is vital. They are like hen's teeth within the Department of Health, so we would welcome many more.
I welcome two calls in the motion on publishing the NTPF's review of pricing systems in early 2025 and working towards an equitable funding model for the nursing home sector. The NTPF has a duty of care over its financing. It also has a duty of care in determining how its cost base is allocated to the nursing home sector. All of us in this House want to ensure that our family-run nursing homes have the sustainability and financing to ensure they can stay working. We have lost a number of nursing homes because it was not financially viable for a nursing home with fewer than 30 beds to stay open. Now we need to ensure that the nursing home with fewer than 60 or 70 beds is equally funded to deliver services. We need to see how they are graded and how they are awarded the funding.
I live in Portumna where we have Portumna Retirement Village, which is a family-run nursing home with fewer than 65 beds. We have the Killimor nursing home, which this week received a HIQA report of 100%. It is a family-run nursing home in rural Ireland, employing a lot of people but also providing a lot of comfort to people living in the local communities.
Regarding home care, I sometimes wonder whether it is home care we do not have enough of or people. I believe we do not have enough people. We have a great number of providers in that space. We need a more streamlined approach because all I can see are cars running over and back the road from different providers. Everybody wants the 9 o'clock visit slot to get up in the morning and the 7 o'clock or 8 o'clock visit slot to go to bed. We need to have a little bit more of a geographical or centralised approach or perhaps a better mapping system to show if a provider in an area can provide the services. Every provider puts its hand up for the 9 o'clock visit slot but as soon as it is two months into the contract, it says that does not really suit and it will move to the 11 o'clock visit. The resident person is then left in bed until 11 o'clock. That was never the modus operandi.
I have a little story about Dónal who is 77 years old and from the mid west. Dónal has a disability. He requires two people to get him up every morning and two people to put him to bed every evening and he needs his dinner brought to him every single day. Dónal has support from Monday to Friday, with two people getting up in the morning and two in the evening but, unfortunately, only one person is available on a Saturday and Sunday. Every second Saturday, there is nobody available to give him his dinner. When we are doing the proper care planning, Dónal needs to eat seven days a week and we cannot assume he cannot. As a single bachelor man who would be living in an isolated rural setting, that care provider has a duty when it takes on the package to ensure that full delivery is adhered to.
Linda Nelson Murray (Fine Gael)
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I will take just a minute and focus on one thing. I fully support this motion, which is very close to all our hearts. A year ago yesterday we lost our dad, who was the most beautiful man. My dad was sick for many years with his heart and hip problems and with cancer but he overcame it all and lived to just short of 88. He loved collecting his pension, going to choir and he loved life. However, the many illnesses he suffered made him less agile, along with 60 years of standing at a bench making furniture, which was a job he absolutely loved. The housing adaptation grant was a game-changer in my dad's life and in all our lives. We had put a bedroom downstairs in the house but he did not have close access to a shower or bathroom and the housing adaptation grant sorted that out.
They say ageing is an extraordinary process where you become the person you always wanted to be. All of us honoured with representing people should ensure we do all we can so our ageing population can live as they want to. I love helping people access this type of funding. In County Meath, €3.5 million was allocated to the housing adaptation grant last year and I reckon the council could have done with twice as much.
As I said, I am going to be short and sweet and ask that we allocate a much higher amount to housing adaptation for our older people. Let them live where they are most comfortable.
Noel O'Donovan (Fine Gael)
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I welcome the Minister of State to the Chamber and congratulate him on his appointment. I had engagement with him in his previous role and he showed energy, drive and determination when he visited Bantry after the recent flooding so I am sure he will bring a similar type of work to this Department.
It is timely to have this debate on improving supports for elderly people as our first Private Members’ motion. I finished college in 2011 and will never forget the words of one of my lecturers who said in the next ten years there would be more people over 65 than under 25. That is a statistic that has always stayed in my mind, so it is timely we are having this discussion.
In my first contribution in this Chamber I spoke about the issue of loneliness briefly and I raise it again. It is an issue we are not tackling as a society and a country. The effects it has on a society are profound. Loneliness is not just about being alone. It is often about feeling disconnected, unheard and unseen. It is also about feeling you are a person of very little value to society and can creep up on anyone from a child trying to make friends in school to the woman navigating motherhood on her own. Such a pressing area of loneliness is just how steadily it can pry itself into the lives of the elderly people in our society, especially those who are struggling to keep up with the societal commitments of the modern age. In such a busy and growing society it is often overlooked just how small the world of an elderly person can become. I often meet elderly people and they talk about listening in to the work of the Oireachtas and following what we do online so I am sure there are many people looking in on our proceedings today. I hope they know we are working on their behalf.
The European Commission found in 2022 that Ireland had the highest rates of loneliness in the EU, with 20% of Irish people feeling lonely most or all of the time. That is a staggering statistic. Having the highest rates of anything so detrimental would have alarm bells ringing all over the country, so why is that not the case with loneliness? We have to do more. People often do not realise loneliness is not just about sitting around or waiting for the doorbell to ring and the kettle to boil. It is also an increase in the risk of depression, heart disease, anxiety, stroke and Parkinson’s disease. Loneliness is smoking 15 cigarettes a day. Loneliness can be a premature death. ALONE’s loneliness task force found the mortality effects of loneliness can be even greater than many of the lifestyle and traditional clinical risk factors we treat as serious attacks on our State’s health. It is a silent pandemic. We cannot look at this and not recognise it as a national public health crisis. Loneliness is not an inevitable aspect of life and it is time we start believing that. We must recognise loneliness is not just a personal issue requiring one’s own rejection of it but is also a societal issue we need to work more effectively on. We must look at supporting community initiatives, sports clubs, cultural centres and volunteer organisations that play a pivotal role in diminishing the risk of loneliness.
Digital exclusion is another matter and something we urgently need to tackle to ensure people do not feel they are left behind in a rapidly changing digital society. Supporting initiatives that seek to help older people learn and access these digital spaces independently is something we can do as a society to tackle this threat. Society cannot just support these initiatives without ensuring there is a way to access them. Being from west Cork I can recognise the importance of accessible transport services as a way for people to form connections in their community. They physical isolation of people, especially in rural Ireland, is something I am all too familiar with and the way we progress our society should foster connection, not isolation. I commend the previous work done in this area by our now Tánaiste and a predecessor of mine, former Deputy, Jim Daly, when he was in the Department. In 2019, a €3 million fund was announced to support community initiatives that alleviated loneliness. The pandemic arrived after that and we all know what that did to the prevalence of loneliness, so we must get back on track and start the conversation again. To do that we must fully understand and realise what the issues affecting loneliness are and why it is there within our society. I ask the Minister of State to work with ALONE in this area. It has called for research to be carried out in a number of areas. We can resolve this if we think outside the box a little bit. Let us consider the number of students in our communities who are off on summer holidays in weekends. We could get them back working in the community. There could be tax incentives in line with the SUSI grants. We can do more on this if we think outside the box. I thank the Minister of State for his time.
Aubrey McCarthy (Independent)
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I extend my gratitude to the Minister of State for joining us for this crucial motion on care, support and enhanced provision of services for older people, which I am totally supportive of. Our ageing population presents challenges and opportunities, as has been outlined by many Members. It is a privilege to contribute to this important discussion.
I highlight the extraordinary contribution, which has been mentioned, made by family carers and professional caregivers across our country. Every single day thousands of carers provide selfless, compassionate support to older individuals. This must not, and does not, go unnoticed. They do so at a significant cost, sacrificing their well-being, financial security and, often, career opportunities. Without their unwavering dedication our health and social care systems would unravel and collapse under the pressure, so we owe more than just words of gratitude; we owe concrete support and that is what this motion is about. That is why respite care and financial assistance are essential. The introduction of a non-means tested carer’s allowance would be a huge transformative step in recognising the carers’ invaluable work.
I draw the Minister of State’s attention to a heartbreaking issue I come across daily through my work at Tiglin at the Lighthouse, namely, elderly homelessness. Often when housing and homelessness are being discussed we do not focus on the older cohort. Many of those we see queuing for food at our Lighthouse café on Pearse Street are older individuals. They are part of a growing number of long-term homeless in our society. Just last night the Lighthouse organised a tradfest for the St. Patrick’s celebrations and we had jigs, reels and lovely music. It was organised by Councillor Clodagh Ní Mhuirí and our manager Allen Bobinac. It was a wonderful occasion and I was deeply grateful to the musicians and volunteers but it is sad to see so many older people coming along to events like these. Even though they are uplifting events, it is essential they remind us of the need for lasting solutions for accommodation, etc., and care allowances. We urgently need to develop more age-friendly housing and liveable communities. The right housing stock, which should be affordable, accessible and located in key areas and in walking distance of key amenities, is essential and can enable older people to downsize if they wish while maintaining their independence and also their quality of life. I have been working with Wicklow County Council on discussions on liveable communities that cater for all generations and I am excited about that going forward, though I realise there is a mountain to climb and a lot of work lies ahead.In this context, I also commend exceptional initiatives like the McAuley Place initiative in Naas. It is an innovative community which integrates housing and social engagement for older people. It ensures that not only do they have a safe and comfortable home but also access to activities, amenities and opportunity. The facility in Naas has its own art and lifestyle centre where we have regular concerts. It has a volunteer-run café with the most amazing home-baked food. It is all designed to foster a sense of belonging, connection and well-being for the elderly residents. McAuley Place was the brainchild of one lady called Margharita Solon who had issues with her own family regarding care. She campaigned for years to make life better for the older generations. That is why McAuley Place shines as an example of what we can do. If the Minister of State has not visited it, I would urge him to do so. It has the full support of the business community in Naas, of which I am one, and also Kildare County Council. It is a model that could be replicated in every county in Ireland.
The issues that I have raised and other Senator have raised align closely with the programme for Government. I urge the Minister of State to prioritise these commitments and take decisive action during this Seanad term. I echo Senator Boyhan’s request that he come back to the Chamber within six months and we address this so together we can ensure that older people in Ireland are supported, respected and empowered to live full meaningful lives.
Margaret Murphy O'Mahony (Fianna Fail)
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I welcome the Minister of State to the Chamber. I congratulate him on his appointment and wish him the best of luck. I thank Fine Gael for bringing forward this excellent Private Members' motion. It was well thought out, so well done lads.
We, in Fianna Fáil, welcome this debate and the fact the Government is supporting the motion. Fianna Fáil is committed to making sure that all of us can age well, with dignity and support. We want people to stay in their own homes for as long as possible but with the correct supports. Since coming into Government in 2020, Fianna Fáil has expanded home care hours, day care services, at-home dementia care and meals on wheels. We also established a commission on care for older people to identify the best ways to support ageing and we are committed to implementing the recommendations. Dementia services are a key priority for us in Fianna Fáil with 32 new cases of dementia diagnosed every day across this country. We have already set up 53 dementia day care centres, 25 memory clinics and more than 30 dementia advisers. At the moment, there are three dementia-friendly towns. However, we are determined to do more.
Every effort must be made to ensure that people can stay in their home as long as they want to with the correct supports. Ultimately, this costs the State less and so is a win-win. While acknowledging the contribution of older people, may I also acknowledge the contribution of those who care for the older person, both paid and unpaid? Carers play a crucial role and must be looked after and acknowledged.
I also acknowledge the work done in the many local district hospitals throughout the country. Many of these, including the one in Bandon, could do with extra capacity. It would be great if there was an extension to the one in Bandon. I presume that is true of many across the country.
We need to plan for an ageing population as people are now living much longer. Nursing homes will form a big part of this and need our support as legislators. I support the strengthening of our nursing home sector and increased funding for the fair deal scheme and we must ensure the waiting list does not exceed four weeks. These things often happen in a hurry and we need to act swiftly on them. We need to build more public nursing home beds. The NTPF review of the pricing systems must be published early this year, which we are well into, and must work towards the funding model for the nursing home sector.
We need to provide a career pathway for healthcare assistants with perhaps better training, higher wages and better status. They are often run ragged trying to get from one place to the next. Better working conditions for them would be very welcome.
I hope the Seanad acknowledges the contribution older people have made to Irish society by raising their families, through their work, both voluntary and paid, and through their charitable endeavours during their lives. I support the programme for Government commitment to publish, resource and implement a national action plan for long-term care of our elderly and its commitment to increase the income disregards for carer’s allowance in each budget with a view to phasing out the means test during the lifetime of this Government.
Gareth Scahill (Fine Gael)
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I am sharing three minutes with Senator Brady.
I welcome the Minister of State. I did not have the chance to thank him for the work he did in Lough Funshinagh in Roscommon in his previous role, so I thank him for that. It is a privilege to speak to the Minister of State today on an issue that affects every family and community in Ireland, namely, the care and support of our older citizens. As a society, we have a duty to ensure older people can live with dignity, security and independence for as long as possible. We want to support them in saying their own homes and communities where they feel most comfortable and connected. That is why we must take meaningful action to enhance care services and ensure that every person receives the supports needed.
It is great to hear the motion is supported across the House today. We have highlighted some of the issues across the motion. These include its call to design a statutory home care system. One of the most important steps is the formal home care scheme to ensure people can remain in their homes for as long as possible. By providing structured and reliable home care, we can empower older people to maintain their independence while receiving the necessary support. A number of Senators mentioned increasing home care hours. There is the rolling-out of the care repair scheme nationally. Small home repairs and modifications can make a huge difference for older people living safely at home. Expanding that scheme nationally would provide practical support to thousands of households.
We want to increase the housing adaption grant. For many adapting a home to meet mobility and accessibility needs is essential. By increasing this grant, we can help more people modify their homes to improve safety and comfort. We want to expand the meals on wheels programme as nutritional and social interaction are critical for wellbeing. Enhancing community care programme will strengthen the delivery of healthcare services closer to home which will reduce pressure on hospitals and ensure better care in local settings.
We call for investment in day care centres and community healthcare networks as day centres provide vital social, recreational and care services, help to combat isolation and support mental and physical well-being. Strengthening our community healthcare networks will ensure better co-ordination of local health services.
Yesterday, we spoke about a senior alert scheme. The programme for Government talks about the carer’s allowance and reducing means testing for the carer’s allowance over the lifetime of this Government. I also want to highlight the ESB vulnerable customers list. Another thing that has not been mentioned is the Local Link services. They could be used and more focused on bringing those isolated and elderly people into the towns.
This is about more than just policies and funding. It is about people. Our parents, grandparents, neighbours and friends deserve a society that values and supports them at every stage of life. A society is judged by how it treats it most vulnerable. By expanding and improving these services, we can ensure that every older person in Ireland receives the care, dignity and respect they deserve.
Paraic Brady (Fine Gael)
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I thank the Minister of State for being here today. As some of my colleagues said, he has delivered in some of his past roles. I thank him for all his work in the past and for engaging with elected representatives across Ireland.We welcome the increase for meals on wheels in the programme for Government. After the last storm and what we have seen, it is incumbent on us to make sure meals on wheels services have heater boxes and facilities where they can deliver hot meals to our elderly. That must be throughout Ireland. The hot meal boxes are available in some counties and not in others. These are a necessity for meals on wheels. We must invest in hot meal boxes.
As we know, our population is living longer. I commend Senator Rabbitte on what she discussed regarding age-friendly activities. Men’s and women's sheds, senior citizen clubs and social clubs are the backbone of what makes our elderly tick. We need to fund these and give them the rights supports, and I do not mean small amounts of funding where they have to go to a local authority to look for €1,000 to bring senior citizens on bus trips and tours. I mean serious funding needs to be given to these groups so they can support communities.
I like the initiative somebody mentioned in regard to our students. Students are very important too. There could be an initiative where transition year students call into elderly people on a weekly basis as part of a health and well-being programme. That is something we should look in our schools. It would a good initiative.
I refer to a retirement village model to which elderly people could move. They could downsize and somebody on the social housing list might be able to move into their home. That could be looked at. They could access services in a retirement village and they would be close to a population centre, the shops, the church, the doctor and to those who call into them. If we are intent on looking after the elderly, it is incumbent on us to ensure all large planning applications include small retirement villages. If we are building 90 or 100 homes in a town, we must include ten affordable houses for our elderly.
Pauline Tully (Sinn Fein)
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I am supporting this motion. There is nothing in it one could not support, although it is perplexing that Fine Gael has tabled this motion. It has been in government since 2011 and have not implemented many of the calls contained in it even though they were in programmes for Government. I echo the calls of my colleagues that the Minister of State comes back in and gives us a progress report in a number of months.
People are living longer. It is projected there will be more than 1 million people aged 65 and over by 2030. That is only a few years down the road. Many people in their 60s, 70s or 80s are active and are still out working, but there are challenges for people as they age. There are usually higher levels of ill health and a greater demand on social and healthcare services. We need to invest in those.
I commend a number of voluntary organisations in my area that provide support to older people, such as Kilnaleck social services. Cavan has a positive age group. They do wonderful work with older people, providing meals, bringing people on trips, and organising activities, exercise, education and so forth. They are dependent on fundraising for the most part. More support needs to be given to voluntary organisations for the important work they do in combating isolation among older people.
We need to invest more in preventative health measures. For example, we have a stroke strategy but sufficient funding has not been given to implement that strategy. There can be many good strategies and implementation plans but if they are not funded they sit on the shelf. More funding is needed to ensure various health strategies are implemented.
If possible, most other people want to live in their own homes. Last year there were more than 5,000 people on a waiting list for a home care assistant. Approximately 10% of older people approved for home support had no carer at that stage. Hundreds, maybe thousands, of people have been assessed and approved for an increase in hours and even though the funding is there, there are no carers. They and their families are trying to get by with insufficient caring hours.
Unless there is a strategic approach to workforce planning across the health and social care sector, that is not going to change. We need a pay agreement in the sector and greater public investment in the home care sector. There could be a career pathway for carers, with advanced skillsets, and a greater role for nurses and other health and social care professionals in delivering care in the home. There is a shortage of community nurses at the moment, which is having an impact on people being assessed for home care hours. That is something that needs to be addressed.
The lack of home carers is leading to a delayed discharge from hospital for many people. We have had thousands of people in hospital longer than they needed to be because they could not go home as there was no one to provide the care they required in their home. Beds are being used when they should not be. We should be able to send people home. They should have sufficient care at home to look after them.
There is a commitment in the programme for Government to remove the means test for carer's allowance, which is absolutely essential. Family carers feel forgotten and unappreciated. Many say they are isolated and lonely and encounter health challenges of their own. Removing the means test for the carer's allowance will go a long way to combatting that.
I raised with the Minister of State's predecessor, the Minister of State, Deputy Butler, the boarding out regulations and the need for them to be updated. Despite her assurance they would be looked at, and her officials telling me they were being looked at, nothing has happened or changed. Boarding out regulations are when an individual or family can take an elderly person into their home and care for them. These are people who do not require the medical care of a nursing home but cannot live at home on their own or choose not to in order to live in the community. There are a number of these providers in my area. Since 1993 this scheme has not been changed. It was reviewed 15 or 16 years ago but very little change was made. The funding provided by the HSE has not increased. Many of them are operating at a loss and will have to consider career changes, which means the people living in the homes and being cared for there will have to go into a nursing home, which is going to cost an awful lot more. We are talking about thousands of euro of a difference between what a person is charged in a nursing home and in a boarding out facility. This is something that should be looked at and rolled out. ALONE, the organisation supporting older people, supports this. It works really well. I call for it to be standardised across all CHOs, or regional health areas, because that was a problem. It was not standardised before and people were paying different amounts. People pay a certain amount of their pension and the HSE pays another amount. Different amounts are being paid by different people. If people from different areas come together in one house, such as on the border of a number of counties where certain areas meet, it can cause problems. Will the Minister of State look at that? It relates to SI 225 of 1993. That needs to be updated to ensure this can continue. The people providing this need more support.
Mike Kennelly (Fine Gael)
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I welcome the Minister of State and congratulate him on his appointment. I know from the last Ministry he held that the elderly are in good hands. Seanad Éireann acknowledges the contribution older people have made to Irish society. They have shaped the country's economic, cultural and social fabric. Our elderly have historically been active in their local communities, contributing through volunteerism, organising social events and participating in religious community organisations. In our society older people serve as a foundation of family life. They play key roles in raising children and providing stability, often as caretakers for their own grandchildren.They have built this country to where it is right now. Honouring our older generation is something deeply rooted in Irish culture. Ireland was the first country to be designated age-friendly status in 2019 and we have continued this. Ireland will host the WHO global age-friendly conference in 2025. In the programme for Government, we are committed to advancing our social core models, which support older people to live full and independent lives with the correct wrap-around supports.
How can Ireland meet future care needs? The programme for Government states that we will support older people to live at home and in their own communities. The best way to achieve this is to increase the housing adaptation grant, which has been mentioned several times in these contributions. In recent times, the grants have been improved. I thank the Government for doing that. It does not get too many claps. Increased funding and broader eligibility criteria are making it easier for people to access financial supports for necessary modifications. Unfortunately, however, the costs are out of reach now for most of the works that have been permitted and approved. For example, the cost of a level access shower five years ago was completely different from the cost right now. People cannot afford it. These grants are a crucial tool in allowing people to remain in their homes longer, which is a key factor in promoting independent living and improving quality of life for the elderly and those with disabilities. Offering these grants will encourage preventative care, helping individuals make necessary adjustments before health problems become severe. This proactive approach will reduce long-term healthcare costs. I have seen first hand what the housing adaptation grants can do for people. It is a game-changer for people living alone to know they can stay in their house full-time. If the grants can be increased again in 2025, within budget restraints, it will mean that people can stay in their homes longer. The works I have seen first hand, as I was saying to Senator Nelson Murray-----
Joe Flaherty (Fianna Fail)
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You are over time, Senator.
Mike Kennelly (Fine Gael)
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I am sorry. Over recent times we have seen a rise also in burglaries. I am proposing that older people be reimbursed when they install home alarms, so they can live without any threat to their safety. I wish to formally propose that after all the storms, especially Storm Éowyn. We should seriously target our elderly and sick people living at home and ensure funding is immediately made available to install a generator and all associated works for our elderly in the next budget under the housing adaptation grants.
The out-of-hours services provided by SouthDoc in the Listowel and north Kerry area is not there. I call on the Minister to appeal to the SouthDoc service to come back and reinstate their work hours.
Evanne Ní Chuilinn (Fine Gael)
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I am not going to repeat anything. I support everything that has been brought up this evening. I want to mention one thing. Currently, there are five vaccinations recommended by NIAC for older people. Three of them are provided for free under the immunisation programme nationally while two are not, namely, shingles and RSV. There is a commitment in the programme for Government to implement the recommendations on the potential expansion of the national immunisation programme. This would be a good time to revisit that. The Minister might be able to come back to us with an update on the timeline. Today, the former deputy chief medical officer, Ronan Glynn, launched a report on the programme, saying it would save the health service money in the long term. That is probably obvious. One of the vaccines is for shingles. We know that shingles attacks the body when the immune system is low. It can affect people straight after chemotherapy or during pregnancy. I got shingles as a pregnant woman. It is not fun and is very painful. It affects older people a lot as well. A vaccination programme would keep older people out of our overcrowded hospitals and GP waiting rooms. Carers have been mentioned a lot today. It would also affect them. Many people have to take time off work to look after their older relatives when they get sick. There would be an impact there as well. Unfortunately, we are the outliers in Europe, as 13 European countries fund a free shingles vaccination programme, including the UK, Greece and France. I do not want to put the emphasis on money because it is about health and minding our older people. However, a 2024 report from the Office of Health Economics estimated that rolling out all five vaccines would prevent 375,000 cases of diseases, 74,000 hospital admissions and 1,400 deaths.
Nessa Cosgrove (Labour)
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While much of the content of today's motion has merit and is welcome, I must echo my colleague, Senator Tully, in saying that Fine Gael has been in government since 2011. I would hope that the commitment from this motion will continue. I welcome the motion's acknowledgement of older people's worth and value as contributors to society, not just economically but in terms of raising family, and the recognition of their contributions as volunteers throughout our society. However, there is much which remains unstated and which is particularly pertinent to this debate. Older people, by continuing to live in their own homes, in their own communities, among their own people, act as stores of wisdom and knowledge and provide tremendous stability, especially to those younger than themselves. I recognise the work of ALONE, which does tremendous work throughout the country. In my area, I have relied on them often as a county councillor. Senators have spoken about the half a million family carers, many of whom carry out completely unpaid work because they exceed the income threshold. I am delighted to see that the abolition of the means test is included in the programme for Government. I hope it is more than just an aim to phase it out and that it actually will be phased out.
For the purposes of today, I would like to concentrate on professional care workers and home care assistants. Whether older people remain in their own homes or move into a nursing home, they are often able to recognise that they provide richness to the lives of their carer. The truth is that all of us like to be useful. Feeling useful in and around the home helps to combat loneliness, which has come up a few times today. This in turn improves health outcomes, particularly in terms of longevity and cognitive function. However, unless we meet the basic care needs of individuals, we are not going to be able to meet the needs outlined here. Even Ibec, in its Better Care, Better Business report from February 2024, not only recognised the shortcomings in professional care but also identified some of their causes. In 2024, the HSE employed fewer home care assistants than in 2017 while only 40% of home care hours are directly delivered by the HSE. There are vast differences between rates of direct employment depending on where one lives. In Donegal, 90% are HSE-employed and 10% are in the private sector. In Sligo-Leitrim it is 50:50. Why is there such a difference? Yet again, we see what happens when the State's responsibilities are farmed out to the private sector.
Despite commitments made to ensure that home care workers receive a living wage and are paid for mileage and travel time, these rules are regularly flouted. Workers employed directly by the HSE benefit not only from better starting pay of €35,000, as opposed to a minimum annual remuneration rate of €30,000, but also from additional benefits which their counterparts in the private sector do not receive. There is no such thing for private care workers, and often there can be a pay difference of €14,500 between someone at the top of the HSE pay scale and a private sector worker. Beyond the patent unfairness of this situation, low pay has had a significant negative impact upon family prospects for migrant workers who want to be reunited with their families and on whom the sector is very much dependent. There are glaring differences between private and public sector workers. I urge that the State look towards a fully publicly funded sector with employment opportunities for all working within that sector.
Laura Harmon (Labour)
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We are an ageing population, as has been mentioned. The population is projected to grow by 800,000 by 2040 with an extra half a million people over 65 by that point. I have been really struck in the community in Cork South Central by the older people I have met on the doors and some of their stories have stayed with me. One woman told me she has nothing to do, that everyone belonging to her has passed away and she is just waiting to die now. I meet people all the time who say they only see their grandkids on Skype as their sons and daughters could not afford to live next to them. The housing crisis is also contributing to this issue of loneliness.The ALONE organisation has said there has been an 83% increase in renters in old age and that 25% of the people they engage with do not own their own home. We are currently in the midst of a housing crisis. We cannot have a whole generation of people renting when they are pensioners - those from my generation and younger. If that is the case, we are going to have a serious ticking time bomb on our hands. It is not clear how people are going to be able to afford to live.
I also wish to raise infrastructure. Accessibility is a big thing, for example, being able in the first place to leave your home and walk to the shop or travel around your local community. I met people in Cork city who live near The Lough and have not been able to even get up to it because they have acquired disabilities or they are in wheelchairs. They cannot physically get from A to B. We must look at expanding funding for active travel so that local authorities can apply for more money for footpath repairs. I meet a lot of older people who tell me they do not want to walk on the footpath. They walk in the middle of the road, which is completely unsafe and unacceptable. We must fund more local community services, in particular mobile library services. We must also ensure we reduce energy poverty for older people. I support the calls by other Senators for a loneliness strategy in Ireland setting out how we are going to tackle this issue.
Garret Kelleher (Fine Gael)
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Gabhaim buíochas leis an Aire Stáit, an Teachta O’Donnell, as ucht teacht isteach chun buaileadh linn chun na hábhair thábhachtacha seo mar gheall ar chúram tacaíochta agus seirbhísí níos láidre a chur ar fáil do dhaoine aosta. Cuirimid go léir fíorfháilte roimhe.
It was Mahatma Gandhi who said the true measure of a society is how it treats its most vulnerable. That point was made by a previous speaker. At a time of budgetary surpluses and relative economic prosperity it is incumbent upon us to ensure that we do everything we can to support elderly people and their families to the very best of our ability.
I remember being in primary school in the late 1980s and early 1990s when I learned that the life expectancy of Irish women was around 72 years and Irish men was perhaps slightly less at 71. It is now not uncommon for older citizens to live well into their 90s and beyond, and we must make adequate provision to ensure that policies and supports adapt accordingly.
As has been alluded to by Senators Kyne, Rabbitte and Murphy O'Mahony, we must address some of the issues that exist in the nursing home sector. The disparities that exist between HSE nursing homes and private and voluntary nursing homes are something that must be addressed. For example, a disparity in pay exists between professionals. There is a need to recognise the qualifications of healthcare assistants as well as to recognise them as healthcare professionals in multidisciplinary teams that are looking after the elderly.
Also in the case of nursing homes, we must address the disadvantage for residents when it comes to accessing services and supports such as physiotherapy, etc. That is something we need to look at.
Loneliness is something that has been referenced by a number of speakers in this debate. It is very important. I remember listening with interest during the course of the pandemic to the contributions that were made by the likes of Dr. Rónán Collins, who spoke about social isolation during the pandemic. That is not something that is unique to the years of the pandemic and we must look to act in that regard. It would be a positive move to seek to include the likes of experts such as Dr. Collins, who was a candidate for election to this Chamber on one of the university panels, to ensure that we improve services and that this aspect of elderly care is not overlooked.
Reference was made to Tidy Towns organisations. I am a member of a Tidy Towns organisation in my community. We are very much reliant on older people. We have volunteers in excess of 90 years of age who are actively working. The contribution they make to the likes of Tidy Towns organisations, men's sheds and women's sheds was mentioned.
Joe Flaherty (Fianna Fail)
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Senator Kelleher is eating into the remaining time of his colleagues.
Garret Kelleher (Fine Gael)
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Gabhaim buíochas leis an Cathaoirleach Gníomhach.
Eileen Lynch (Fine Gael)
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I welcome the Minister of State to the Chamber and congratulate him on his appointment. I am delighted that we are having this very important discussion. I fully support the motion.
Like many of my colleagues, I also strongly believe that community-based living and healthcare are the way forward to allow older people to live for longer in their communities. As has been noted, we have an ageing population and people are living longer. We must look at new solutions, such as making private retirement villages with on-site healthcare provision, the norm.
I want to raise the challenges posed by the Assisted Decision-Making (Capacity) (Amendment) Act 2022, which was enacted in 2023, given the difficulties it provides for many elderly people and their families. While this legislation was a significant step forward in protecting the rights of individuals with impaired capacity, it definitely has not been without its difficulties.
While enduring power of attorney is still valid should a person lose their mental capacity, such an agreement now needs to be registered. The danger of the Assisted Decision-Making (Capacity) (Amendment) Act arises where an elderly person loses mental capacity and does not have a power of attorney in place. The Assisted Decision-Making (Capacity) (Amendment) Act then kicks in. The legislation is currently affecting many older people. When we look at dementia alone, Ireland exceeds the broader European trend, with the number of people with dementia expected to almost double by 2050. A key factor in this change appears to be the significant increase in the number of people aged over 60 and in particular in the over-85 age group, which will more than triple between 2018 and 2050. There are a lot of people living with diseases which will impact their mental capacity.
The Assisted Decision-Making (Capacity) (Amendment) Act is incredibly complex. It essentially gives decision-making power to a nominated relative or independent decision maker by order of a court when a person is no longer competent. While the system is designed to be flexible, in reality it is not. It is completely overwhelming for individuals and families, and even for professionals who are trying to navigate the process. I say this as a solicitor who has dealt with it and who finds it incredibly complex. This view is reflected by colleagues in the legal profession.
The paperwork involved can create delays and confusion, which makes it much harder for people to access the support they need in a timely manner. A second issue relates to resource constraints in regard to implementation. The Decision Support Service, which overseas the implementation of this Act, has faced significant backlogs and funding challenges. Many people in need of this decision-making support have struggled to get timely assessments or assistance. Without adequate resources the system risks failing those it was initially designed to protect.
As I indicated, awareness and training are such a problem with his Act. Healthcare professionals, legal experts and individuals affected by it are still not fully aware of how it works and what is the best way to implement it. This is not helped by the delays that are then faced in the court system. The complex nature of the legislation is damaging older people's rights. Without widespread education and training and, potentially, the simplification of the Act, there is a risk that the rights of the vulnerable individuals that it is trying to protect will not be upheld. The Act is a step in the right direction, but these challenges must be addressed to ensure it serves those who need it most.
Sharon Keogan (Independent)
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I thank the Minister of State for coming in here today. Last year in the budget the Government allocated €93 million for the housing adaptation grant for older people and those with disabilities. I welcome that. I also welcome the increase in the grant to €40,000, which means it is a 100% grant for those earning under €37,000. The extra €10,000 was a great move, and I think it is adequate.
However, the process can be cumbersome for persons seeking the housing adaptation grant. They must get two written quotes. They must get builders to visit. As the Minister of State is probably aware, we have a shortage of builders in this country this moment. It is also very tough to get a builder to do the work. People must also get certificates from their doctor.People do not need a certificate from their doctor, or to meet any other medical requirement, to access housing aids, but they need it to qualify for the housing adaptation grant. Will the Minister of State please consider getting rid of that requirement? Clerks of works can go to someone's home and see that he or she is suffering from dementia. They can see the situation of people in their 80s, like Linda's father. They do not need people to meet all the requirements that are being asked for in regard to occupational therapists and doctor's certificates. If the Minister of State would consider dropping the medical requirement for the housing adaptation grant, it would be a very worthy change.
Following Storm Éowyn, there were calls in the Chamber for the provision of a generator to every house. That is not practical. The ESB has on its website information regarding a toolkit for the elderly. The Minister of State might consider providing funding for that emergency kit through the community alert or age friendly groups. It includes things like flashlights, candles, a battery radio, a 120 V adapter for car charging and water, which people could buy with the funding.
In Duleek, we have an absolutely fantastic age friendly housing scheme, via the church, located near the shops and the medical centre. We need more affordable housing and provision for affordable downsizing. Let us imagine the capacity that could be given to families if more age friendly housing schemes were provided in communities.
Some people do not want to retire and are happy to keep working. They want to contribute, no matter whether it is for ten or 15 hours a week or whatever else. We need to look at how we can adapt taxation policies to favour the older people who contribute so much to our society. We lose a wealth of knowledge when CEOs and so on retire. Those people could go into a charity tomorrow morning and make a contribution. The taxation of their pension should be reduced. Let us make the working environment attractive economically to give older people the option to keep working should they want to do so.
Maria Byrne (Fine Gael)
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I welcome Deputy Devlin and his guests to the Gallery.
I support the motion and thank Senator Kyne and all who were involved in putting it together. Many positive suggestions have been made, one or two of which I will mention. An issue that needs to be examined is the difference between private and public nursing homes and the fact there is possibly not enough public provision. As the Minister of State knows, the waiting lists for St. Camillus hospital in Limerick are unbelievable. Unfortunately, there are not enough beds to benefit the number of people who want them. He recently visited the dementia nursing home in Bruff, County Limerick, which I have also visited. That facility is of so much benefit to people who have dementia and it is also a great support to their families. The tearooms offer china cups, which helps to bring people back to their past. Such facilities provide residents with supported living conditions. If we could see more of those types of nursing homes around the country, it would be of great benefit to older people.
I compliment the sports partnerships on the amount of work those involved do with older people, from walking days to chair yoga and other activities. We talk about the fact we are all living longer but some of that is down to levels of activity. More support must be given to the sports partnerships to expand those programmes. They are very beneficial, particularly to people living on their own who are given an opportunity to go out and meet colleagues. That approach addresses the whole living alone factor. People have the ability to go out and meet colleagues and friends. They make friends out of these gatherings. This area needs extra support.
Another issue is the provision of home help hours. An allocation on half an hour or three half-hours a week is of little benefit. People need more security and more support.
Joe Flaherty (Fianna Fail)
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I welcome the Minister of State to the House and congratulate him on his new role. I worked closely with him on the housing committee in his previous incarnation. I saw at first-hand the volume of work he got through. I have great expectations and hopes for him in his new role. The floor is his, with 15 minutes to respond to the debate.
Kieran O'Donnell (Limerick City, Fine Gael)
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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.
Joe Flaherty (Fianna Fail)
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I thank the Minister for his comprehensive response. It is evident that he engaged in great detail and with great enthusiasm with today's debate and we are seriously heartened by what we can expect from him in the lifetime of the Government.
Kieran O'Donnell (Limerick City, Fine Gael)
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May I thank my officials as well?
Joe Flaherty (Fianna Fail)
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Certainly. I thank the officials for attending. I call the Leader to respond. He has five minutes.
Seán Kyne (Fine Gael)
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I will not take five minutes.
I thank the Minister of State and his officials for being here. I also thank the Minister of State regarding his enthusiasm for the important role he holds.
It is important to say that life expectancy figures place Ireland ahead of the EU average reflecting the country's strides in healthcare improvements over successive Governments. That is important, as is the family support many people receive. Ireland has the fifth highest life expectancy in the EU at 82.6 years. That did not happen by accident. It happened because of the initiatives of the Government, the cross-party initiatives, the proposals put forward, the committee discussions and the various strategies that are put in place to improve people's lives, including education so that people know what they should be doing, whether they do it or not, to try to live longer, such as giving up smoking. Some 79.5% of Irish residents reported their health is good or very good in a recent survey. That is the highest percentage in the EU. That is again reflective of policy initiatives and strategies that have been put in place.
I welcome the Minister of State's commitment to the statutory home care scheme. It is important that it be one of his top priorities. As a former member of the health committee, I know that the licensing of professional home care support providers came before the committee for pre-legislative scrutiny and we want to see that progress in the coming year. I look forward to that.
Members raised many common issues, including housing adaptation grants, loneliness, the fair deal scheme and public and private nursing home beds. I mentioned the small community of Clonbur, where there are eight homes behind the old convent, close to amenities. A local group organises it and determines who gets those houses on the basis of who is most deserving. That has been a life-saver for people who were living miles away. One of the initiatives I would like to see is the roll-out of more of those across the country. They would be small groups of houses, such as eight, ten or 20 units with wraparound services that are not in the middle of nowhere. They need to be close to the shops, church and wherever else people want to go,.the community supports and day care centres. Those models work. I am sure the Minister of State knows of other cases. They are important. They are a great interim solution for people who live at home whose family lives far away and is worried. They can still live at home in a community setting with wraparound supports, where people can visit, the meals on wheels service is available, a nurse can come in and people can have community support. That would be a great initiative. I ask the Minister of State to look at it as something we can work on and deliver.
Joe Flaherty (Fianna Fail)
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When is it proposed to sit again?
Seán Kyne (Fine Gael)
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Tomorrow at 9.30 a.m.
Joe Flaherty (Fianna Fail)
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Is that agreed? Agreed.