andDr. O'Connell asked the Minister for Health whether he has accepted the recommendation that the concept of the county home should be abandoned; and, if so, what alternative he proposes to provide in its place.
Ceisteanna—Questions. Oral Answers. - County Homes.
7.
Dr. Browne
If the Deputies have in mind the question of the abandonment of the classical concept of the county home, including indiscriminate admissions, inadequate facilities for treatment of chronic sick, and poor standards of accommodation generally, the answer is in the affirmative. This does not mean, however, that homes in which satisfactory standards of accommodation and facilities for the proper care of patients have been provided in recent years need to be abandoned. To the extent to which these homes may be lacking in facilities for medical assessment and treatment, these will be provided in the course of further development of the services for the care of the aged.
In the statement which I issued in conjunction with the publication of the report, I outlined the policy already being followed in the planning and provision of accommodation for the aged and the efforts being made to encourage the growth of community care services.
8.
Dr. Browne
andDr. O'Connell asked the Minister for Health the total number of county homes in Ireland in which major reconstruction has been carried out since 1951 in that part of the home other than the hospital section.
Six schemes involving major reconstruction work and new buildings have been carried out at county homes in sections which cater for persons other than the chronic sick, and work is in progress in three other county homes. Tenders have been approved in relation to two other county homes, and are under consideration in relation to one other.
How many does that leave in which major construction work has not been or is not about to be undertaken?
The Deputy will have to put down that question. There are so many of these institutions that it is very difficult to remember all the numbers concerned by heart. I am afraid I do not know.
What is the position in relation to the one in Clifden, County Galway? What progress is being made?
There are schemes in progress in Killarney, Carrick-on-Shannon and Castlebar. Tenders have been approved for Ennis and Longford. Tenders are being received for a county home at Sligo. There have been a number of improvement schemes in Enniscorthy, Thurles and Cashel. It is a long list.
There are no extra beds in the new county home at Castlebar. We have an acute problem of old people in that county.
The Deputy will realise the position if he has studied the statement I issued on what we are doing on the report on the Care of the Aged. I also indicated that the report was being studied in respect of decisions that had not already been made in relation to the care of the aged.
The report is dated 1968. Has it been studied since then? It was published only the other day. Why has it been held up since 1968?
There was some difficulty in getting it printed. The report was given to me two or three months after I became Minister for Health.
It was not available to the Minister's predecessor?
It was not available until then. This is a long-term effort. Although it was written in 1968 it may take, as in other countries, a number of years to implement all the proposals.
If it was studied in 1968, something should be done about it now.
9.
Dr. Browne
andDr. O'Connell asked the Minister for Health whether the 58 married couples living in county homes are furnished with accommodation which permits them to live together; and, if not, whether he proposes to furnish such accommodation where needed.
The Deputies must be aware that county homes were designed on the basis of segregated accommodation for the sexes and that accommodation for married couples was not provided.
A three-tiered structure for special institutional accommodation for the aged is recommended in the report. It will be obvious that it would not be practicable to provide accommodation for married couples in short-stay assessment units or long-stay hospital units. It is intended, however, to provide a certain amount of accommodation for married couples in the new homes for the aged which are to be provided for persons who require institutional care for other than medical reasons. Planning with this end in view has already commenced and it is expected that work on ten such homes will be commenced this year. The primary aim of the services for the aged, however, will be to assist persons to continue to live in the community for as long as possible with the aid of supportive services.
Is it not quite scandalous that we should continue to retain this deplorable practice, going back to the nineteenth century, of forcibly divorcing married aged people who have to go into our county homes by making them live in separate parts of the home and not providing married quarters for them?
A great deal of money is being spent in the form of capital and current expenditure on gradually improving the position and care of necessitous aged people. We are now making further progress.
There are 58 married couples.
I am very glad that progress is being made in accordance with the growth in the economy.
"Those whom God has joined, let no man put asunder."
10.
Dr. Browne
andDr. O'Connell asked the Minister for Health the total number of married couples with children living in county homes.
Since health authorities are under an obligation to provide shelter and maintenance for those who are unable to provide it for themselves out of their own resources, it may occur from time to time that married couples and their children avail themselves temporarily of accommodation in county homes. The problem does not appear to arise frequently. I have ascertained from health authorities that no married couples with their children were accommodated in county homes over the past year.
When these people are accommodated in county homes, is the mother separated from the father and are the parents separated from the children in these homes?
This is too complex a matter. There are so many circumstances——
The answer is either "Yes" or "No".
It was not so in the past year. It did not arise. None were accommodated in 1969.
When they are accommodated? If, this year, such a situation should arise——
I am quite content that none were accommodated in 1969.
How many mothers are accommodated with children?
There are circumstances in which mothers go to hospital and, for example, the children cannot be cared for immediately by relatives or by any other person. Occasionally, there are circumstances in which parents have to seek accommodation temporarily in the county home or one parent has to seek accommodation because she has been deserted by her husband. I am very glad to say that there was no case last year. We have quite enough problems to face without discussing something which did not take place last year.
How many mothers alone? The Minister has not given figures.
I do not intend to take up the time of this House in discussing a problem which in fact did not exist last year in relation to this question.
Such problems could exist at any time in this year. It is about time the Government solved them. They have had half a century to solve them. That is what we, in these benches, are complaining about.
The advances we have made in the health services here compare very well with those in other countries, including countries with a much higher income per head than ourselves.
Rubbish. The greatest single argument against the re-unification of Ireland are the health services provided in this State.
11.
Dr. Browne
andDr. O'Connell asked the Minister for Health the total number of county homes in the Republic and the total number of old person inmates in 1940, 1950, 1960 and at the most recent date.
There are now 34 health authority institutions providing services of a type formerly available in county homes and there are ten other health authority institutions parts of which are used for that purpose.
Information is not available in relation to the year 1940 as to the number of aged patients in county homes but from such information as is available it is estimated that the total number of persons of all ages in residence on 31st March, 1940, was about 10,500. The report of the recent inter-departmental committee states that on 31st March, 1950, the number of persons in county homes over age 65 was 4,766. On 31st December, 1960, the number accommodated was 7,430. The most recent available figures are in respect of 31st March, 1969, when the number of aged county home patients was 8,104. It should be noted that in regard to the years 1960 and 1969 considerable accommodation additional to that available in 1950 had been made available.