Caring for Carers: Motion (Resumed) [Private Members]

Debate resumed on the following motion:
That Dáil Éireann:
notes that:
— for too long family carers have been taken for granted and denied the supports that they and their loved ones need;
— family carers have been wrongly forced by Government after Government to fight for their children’s basic rights to education and vital therapeutic supports, and as the abhorrent practices uncovered by RTÉ Investigates demonstrated, the State does not fight fair;
— the failure of the Government to prioritise family carers in the Covid-19 vaccine rollout programme shows they have yet again been forgotten and forced to fight to ensure the wellbeing of their children and loved ones; and
— carers have been stretched to the limit over the past year due to the Covid-19 pandemic, providing increasing levels of care with less support or respite;
further notes that:
— the income supports in place for family carers are not adequate;
— the income disregard for Carer’s Allowance has remained the same rate for the last twelve years, sitting at €332.50 (€665 per couple), despite steady increases to average earnings and the cost of living in this time;
— the self-employed are currently deemed ineligible for Carer’s Benefit;
— many carers do not currently qualify for free general practitioner (GP) care;
— current waiting lists for counselling in Primary Care extend to over 10,000 persons in need of help;
— the closure of respite, day and overnight services has had a profound negative effect on the wellbeing of carers; and
— the inequitable treatment of carers in respect of transportation services to these vital supports are currently free in some Health Service Executive Community Healthcare Organisations areas, but not in others;
welcomes:
— the renewed commitment in the Programme for Government: Our Shared Future to ‘review and update the National Carers’ Strategy’, and calls for immediate action to do so; and
— the limited Budget 2021 increase to the Carer’s Support Grant; and
calls on the Government to:
— prioritise family carers in the Covid-19 vaccine roll-out;
— work with family carers to deliver the services and supports that their loved ones need and immediately end the practice of compiling and storing secret dossiers on children using information gathered by health, education and social care professionals, shared without the express consent of their parents;
— relax the Carer’s Allowance means test, by raising the income disregard thresholds in order to increase eligibility and payments;
— further increase the annual Carer’s Support Grant;
— increase Carer’s Allowance and Carer’s Benefit in every budget over five years;
— establish a discretionary fund for Covid-19 utility debt to aid carers and people living with a disability struggling with heating and electricity costs;
— extend eligibility for Carer’s Benefit to the self-employed;
— extend an automatic GP visit card to all recipients of the Carer’s Support Grant;
— create an emergency talk therapy fund, to provide sessions with an accredited counsellor or therapist in the private system for carers on referral from a GP;
— ensure that family carers get the respite they need by building up respite capacity, including delivery of hours and overnights through a doubling of public expenditure;
— prioritise the full resumption of respite Day Services in the re-opening and implement the standardisation of the provision of free transport to and from these vital services; and
— update and publish the National Carers’ Strategy in 2021, with a dedicated budget and timeframe to ensure the implementation of all actions.

I welcome the opportunity to speak on today's motion. I am sure many of the 500,000 carers in this State are watching this debate, hoping that they finally get the recognition they deserve. They are sick and tired of meaningless words, along with pats on the back. They are doing the work of the State and are in dire need of a break. As some Members have already said, they have been largely ignored but their value to this State is unquestionable. Carers' goodwill, however, is used against them and they have been taken for granted.

Today's motion seeks to change that to give them the recognition and the supports they deserve. I have spoken to many carers in recent months. All of them told me how much the lack of respite and general supports have put a strain on them. They told me about the feeling of isolation they felt in recent months. They also told me how they have to be more cautious about their every move because of the complex condition of some of the people for whom they care. I had one case where a mother reached out to me. She has three children with exceptional care needs but has absolutely no supports. She is at her wits' end. I have had carers contact me who applied for the carer's payment but who have been waiting months. The list goes on and on.

It is estimated that family carers save the State approximately €20 billion a year. They deserve to see the good they do reflected by the State. The implementation of Sinn Féin's carer's charter would cost a fraction of that with carers and those they care for benefiting as a result. We need to do right by carers. This motion is an opportunity to do that. I especially hope it has the support of those Government Deputies who have spoken out on behalf of carers recently. We hope their words are not meaningless too.

Who is going to care for the carers? It is not this Government it seems. The strain on carers and families is horrendous at the best of times. During this pandemic, however, it has been unbearable. We need to invest in carers. Doing so would be a win-win for both families and the State. It would take pressure off hospitals, nursing homes and GP services. Investing in respite should not be seen as a cost because it is not. The savings would be immeasurable. The State would save on many levels. Financially, there would be a saving for the health system, a saving much greater than what is spent on carers. We need to give more to make their lives bearable because they currently are not.

Last week, we heard about the State putting together secret dossiers on families of children with autism to use against them. That is what the State thinks of families who are already struggling and caring for loved ones. I have spoken with carers from Ringsend to Rathmines, from Kevin Street to Kimmage. They are all saying that they are hanging on by their fingertips.

This Sinn Féin motion will prioritise carers in the vaccine roll-out. Carers are caring for highly vulnerable people but, as they are not considered as a group, they fall through the net. It is possible that some carers, despite the huge strain they are under, could be among the last to be vaccinated on an individual basis. Each day carers are not vaccinated is another day they play Russian roulette with loved ones. The stress and anxiety this leads to is having a hugely negative impact on carers and their mental health.

Carers are vital but they are not valued. This motion makes provision to support carers financially, improve the level of respite available and ensure that the compilation of secret dossiers on families challenging the State will end. Day services would also be resumed. Carers do not need any sympathy or rounds of applause. They need action and support. Our motion would deliver the change carers deserve and give them the support they desperately need. Let us not just recognise carers as being vital, let us value them. Let us give carers a break.

I commend my fellow Deputies on introducing this motion. Some 500,000 family carers across the country provide in-home supports every week. They are loyal and dedicated and save this State up to €20 billion each year. In most cases, they work 24 hours a day, seven days a week, with the majority not getting paid for half the hours they have worked. The latter equates to up to 19 million hours per week unpaid. We need to acknowledge the care they provide for the most vulnerable people in our society.

Family carers are not currently scheduled to be vaccinated any sooner than the general population, even though they play a vital role as primary caregivers to people who have very vulnerable immune systems. Since the pandemic began, they have not been offered any personal protective equipment, PPE, or financial support. Family carers are exhausted. A constituent of mine from Navan was in touch with me about this matter. She is looking after a loved one who is sick and who needed to be transferred to the hospital for more in-depth care by doctors. The Department cut this person's family care allowance even though she still travels up to her loved one every day, feeding them, bringing changes of clothes back and forth and tending to their everyday needs.

Family carers need financial supports. We need to look at the eligibility criteria for applications and extend them to help struggling families. Family carers should be needs tested, not means tested. A few weeks ago, I called the local district nurse about an elderly lady who is waiting on home care. I was told that there were 300 people on the list and that the woman about whom I was calling was 80th on it. There is no point in approving people for home help if there is nobody there to provide it. There are not enough HSE carers and private companies are not providing the hours that are sanctioned. The elderly and people's carers are being left out on a limb. The sad thing is that this Government does not recognise that every carer in the country is an unsung hero.

Today, Sinn Féin is providing the Minister and his Fianna Fáil colleagues, as well as Fine Gael and the Green Party, with an opportunity to clearly demonstrate that this Government cares for family carers. Family carers have been severely impacted by Covid-19. Many of them have not had a break for over a year now. As always, they are taken for granted. It is also taken for granted that family carers will just keep going regardless. We must remember that many of these family carers have families themselves. They have children who are put to the back of the row because of their struggle to care for their loved ones. Those children have to watch their mums and dads struggling to keep going financially, physically and emotionally. This struggle is compounded by the lack of respite, the hidden costs of caring and, above all, the fight for services such as physiotherapy, occupational therapy, chiropody and the other therapies these people require.

I am glad to hear the Minister say that €150 million will be provided for community care in the right place at the right time. Those are fantastic words but I got a call this morning to say that our local hospital, the district hospital in Belmullet, is being cut down to 12 beds in the middle of a pandemic. This hospital had 41 beds before Fianna Fáil got its hands on it. This is what the Government is doing to this community. I get so angry when I hear the Minister state that we are providing care in the right place at the right time. Is Belmullet not the right place and is this not the right time?

I watched the "Prime Time" programme on carers last week. I was shocked - I am always shocked about these things - but I was not at all surprised. The reason I was not surprised is that I have seen again and again the culture of protectionism that exists within the system the Minister heads up. It is all about protecting the institution and the people who should be at the centre of it come last.

The Minister needs to fix this. I was contacted yesterday by a person who is 85 years of age and living in Swinford who does not know when they are going to get the vaccine and their GP cannot tell them. When they ring the helpline nobody can tell them when they will get it.

In the same way the mother of a youngster with multiple disabilities does not know when they will get the vaccine. They have to watch what is happening at the Beacon Hospital.

Has the Minister done an audit of all of the vaccines that have been distributed? I know this for a fact, having written to the HSE in late January, and told it about this problem where the friends, cronyism and the vaccine fraud was rampant in this country. Has such an audit been done?

I thank Sinn Féin for bringing this motion to the House. It is very important that we get an opportunity to discuss in detail the contribution that our carers and family carers give to the people that they care for and to society as a whole.

Covid-19 has been a disrupter for us all but especially for carers who look after people with underlying health conditions, with severe illness, and people who are particularly vulnerable to the impacts of this pandemic. Ireland has changed so much since Covid-19 arrived on our shores a little over a year ago but for our family carers the change has been monumental. Any supports that may have been there for them previously by way of health supports for those that they are caring for, or perhaps opportunities for respite, have diminished if not totally disappeared. Many people who need the support of a carer have seen their healthcare diminish in the past year and younger people have seen their own progress regress. This type of regression has been very hard for carers to witness over the past year.

Family carers have played a role of great significance in lessening the spread of Covid-19. This can probably never be quantified, such is its size, and their support for the Irish health system is unbelievable. When services were shut down or curtailed family carers continued to care around the clock to ensure that loved ones stayed safe and at home and that they stayed out of hospital.

According to a survey published by Family Carers Ireland last May, 74% of family carers felt that the Government had not responded well to the needs of family carers during the initial stages of the pandemic. I imagine that that figure has not gone down but has gone up. Carers remain greatly worried about the lack of contingency planning should family carers themselves have to self-isolate. Many simply do not have anyone else to take over their caring responsibilities.

Our party has always been a strong advocate for carers and it is very clear in our party that we need to address the outstanding issues impacting the daily lives and well-being of carers, such as the means testing attached to eligibility. We also ask the Government to conduct a study of the income and living costs of carers to ensure that income supports are sufficient for all carers to attain a decent minimum standard of living. No carer should have to live in poverty while providing such an essential service for their loved one and for the State.

The Labour Party has sought to give a voice to carers, as all too often people who care for a loved one do so in isolation while facing a daily struggle. That is why we need a national carers strategy that recognises the value of carers and what they contribute. It must recognise how much the State benefits from them and how much carers save the State. It is difficult to quantify how many carers there are in Ireland at any one time. We all know at least one person who is providing full-time care to a loved one and it is very likely that we know more than one such person.

In 2020 the Irish Health Survey 2019 study by the Central Statistics Office, CSO, estimated that one in eight people aged over 15 is a family carer and that this will increase to one in four by 2030, given the ageing demographic of our country.

This is not just a cohort of our society. This is our society. We are a society and nation of carers but our policy does not reflect that.

A 2020 report, A Study of Young Carers in the Irish Population by NUI Galway, has shown a significant increase in the number of people under the age of 18 who are providing regular care to adults in their families. The report estimates that up to 67,000 children are in caring role roles right now, which represents 13.3% of young people in Ireland, that is, one in eight. These brilliant young people have taken on a role that is far beyond their years and they need proper support from the State. When we speak about carers we are referring to people who work daily to ensure that someone else can meet his or her basic need or function in daily life.

There is no greater work done. People become carers in different ways. Sometimes it is because of an accident or the onset of a condition that requires care. In other cases the process is gradual, perhaps because of a health issue as a result of a physical disability, dementia or something else. This is why it is so important as a society that we and the State recognise the existence of carers as a distinct, unique and plentiful group in the country.

Carers do not want our sympathy and they do not want our pity. They also do not want to be put on a pedestal or canonised. They are ordinary people working to care for their loved ones without the support they desperately need and deserve. Carers are people who have chosen to look after their loved ones and they need that help. What they want and deserve is respect. They need practical help. More importantly, what they often need is acknowledgement of their role, which is often disregarded. This is why the motion is so important. This is what the State should be doing and how the State should intervene. It is what the State has to do better.

Carers need respite. Some may need support and some may need training. Some need downstairs bathrooms at a critical time or an extension to ensure that there are bed facilities. The delays that occur through the local authority infrastructure can last for years, just weeks or months, and this gives rise to further despair and discomfort for those who operate as carers and those who need care. No matter what side of the House we are on, we can all agree that the system is cumbersome to try to navigate. Absolutely everything is a fight and there is always a long list. Everything lacks transparency and, fundamentally, there is a lack of decency. It is no wonder that our carers are at breaking point. Some feel absolutely burnt out and exhausted but they cannot take a day off. They cannot even take an hour off. They have to continue working and caring because they are doing so for someone they love in order to ensure that person does not have to attend a primary care facility or a hospital. This is why we need a new carer's strategy with short, medium and long-term perspectives.

As a society, we must make a strong and unambiguous statement of solidarity and appreciation regarding the work done by all carers but it must be followed up with a resource strategy that can be implemented as soon as possible. We need to say to carers loud and clear that they are not alone and that they are cherished, and this needs to be backed up. As a decent democratic society we should commit to working together to ensure that people who need care receive all the support they can be given and that those who provide care will be valued and assisted. We must also ensure that carers receive paid leave. Five days of paid leave would not be too much to ask. It would be a bare minimum.

The existing system of State support is too rigid and there are too many rules. The requirements are unnecessarily onerous and restrict people's ability to balance care with work, study, paid work or caring for their families. Too many carers are suffering burnout, as we in this House have all witnessed, and serious ill-health caused by the stress and strain of their care work. These proposals must be implemented.

We are learning an awful lot from this pandemic. We are learning an awful lot about what our health system is capable of, or indeed what it is not capable of. People and workers are extending themselves beyond levels they never thought they could. Carers are doing the job they have always done. They have always had to extend themselves 100% every day. We cannot let the pandemic pass without ensuring we finally and fully acknowledge this and support them with a proper strategy of care. We should treat them with the decency and respect they deserve. Too many carers are suffering from burnout. Too many are living on or below the poverty line. This is something we cannot stand over as a State. It is fundamentally indecent and must change. I thank the proposers of the motion and I look forward to hearing the rest of the debate.

I move amendment No. 1:

(a) To insert the following after "with less support or respite":

"— despite promises from previous Governments to find a solution, many carers fall between the cracks in the Irish State Pension system and face a retirement characterised by financial uncertainty;

— the Programme for Government commits to finding a 'pension solution' for carers;

and

— there is a need to ensure that no carer is denied a pension, or receives a reduced-rate pension, due to significant periods spent in caregiving;

acknowledges that:

— there is no economic or social argument that should deny people who spend significant portions of their working lives in caring roles financial security in their old age; and

— whatever the cost of the benefit to the Exchequer, it could never equal the economic and social benefit to the State from the work of long-term carers;"

and

(b) To insert the following after "timeframe to ensure the implementation of all actions":

"— implement a pension solution for carers that ensures people who spend the majority of their working lives in caring roles can look forward to some element of financial security from the State;

— remove the 20-year limit on credited Pay Related Social Insurance (PRSI) contributions for carers;

— disregard the need for 520 paid PRSI contributions for carers who have spent in excess of 25 years in a caring role, and treat credited contributions the same as paid contributions for the purpose of calculating State Pension benefits; and

— make a statement of its commitment to caring for carers by the institution of a dedicated long-term carer’s pension scheme to ensure the removal of other anomalies in the PRSI and social welfare system which leave many people (the majority of whom are women) without access to financial security in retirement as a result of spending the majority of their working lives in caring roles — this would involve a pension payable at the same rate as the maximum State Pension (Contributory) which would not be means tested."

I thank Sinn Féin for tabling this motion. The Social Democrats will fully support it. Family Carers Ireland estimates that family carers save the State €20 billion a year. This is an astronomical figure. Despite the indisputable value and worth that family carers provide the State, they have never been afforded proper respect, dignity or remuneration for their work. How we treat carers directly reflects and affects how we value those who need care.

People with disabilities and illness who are outside the workforce are consistently the most at risk of poverty. This motion has many merits and is actively trying to undo some of the long-term damage of family carers' work being taken for granted, ignored and significantly undervalued by our State, as well as more recent issues arising from the pandemic and the recent scandal involving the Department of Health compiling and storing private and intimate information on children and families.

I have stated many times that Covid has exacerbated pre-existing inequalities and made visible inequalities that we should never be allowed to unsee. To go back to "normal" would be a failure of the State. Let us remember what normality means. For many family carers, it means fighting tooth and nail for basic rights to education and services for their children. Earlier this week, I am sure we all heard of seven-year-old Lexi Forde, whose family was told she would not be seen by the HSE school-age support services until late 2026. Though this seems to have been a mistake, we have all heard and made representations for children and families in similar situations across the country. Normality for these families also means potentially having their privacy invaded by the State when fighting to keep these rights, as we learned from the courageous action by Shane Corr. Normality for carers means greater financial hardships and instability, and poorer mental health, with carers more likely to report a form of depression than non-carers, according to the Irish health survey of 2019.

I take this opportunity to read some quotes from carers who responded to Family Carers Ireland’s survey, Caring Through Covid. One respondent said: “I was already burnt out from caring 24/7 but now doing it without school, respite, home support and night nurses I’m totally exhausted and since we can’t see any other family I feel forgotten.” Another said: “My mental health is suffering, I have always been strong and a solid ‘coper’. I have navigated many challenges in life but this is by far the most difficult.” Another said: “Having no break or support is affecting my own well-being which affects the level of care I can give.” These experiences of family carers were gathered between 14 April and 5 May 2020. Burnt out, exhausted and forgotten: nearly a year on, these feelings are only amplified.

I want to particularly mention the urgent need for the emergency talk therapy fund, referenced in the motion, which would provide family carers access to sessions with accredited counsellors and therapists, as well as the need for increased respite capacity and full resumption of day services. I also reiterate a call to reconvene the NPHET vulnerable people subgroup, a point I raised with the Tánaiste back in late January but which is still to be acted upon. Members of this group have been calling for family carers to be included in the vaccine roll-out for some time and their expertise and insight was invaluable prior to it being disbanded in August 2020.

Despite the merits of this motion, of which there are many, I want to discuss two amendments which the Social Democrats have put forward with the aim of addressing the pension gap for carers. The result of this gap is that thousands of carers neither qualify for a contributor State pension due to significant periods out of the workforce while they are providing care, nor a not-contributory State pension due to it being means-tested. As we can all appreciate, there can be a stark difference between what one qualifies for and what one deserves. Currently, these carers who slip between the cracks do so because they do not qualify for a State pension payment, not because they do not deserve or have not earned such a benefit. It means financial insecurity for many family carers in later life and the only reason for this is that they have dedicated significant portions of their working lives to their caring role.

I would like to include the voice of family carers and will read in to the Dáil record statements from family carers about this very issue, sourced from the State of Caring 2020 by Family Carers Ireland. One said: “If I wasn’t caring, I would be working full time and eligible for a pension when I get older. But because I’m an unrecognised carer my entitlement to a State Pension may be at risk.” Another said: “I had to give up my career to care for my son full-time. It’s been years now. No career. No income. No pension. Nothing left.” Another said: “I will have no pension due to years of caring. I’m worried to the point of anxiety/panic about my future years.” All of these statements from family careers are harrowing. It should not be the case that carers are literally losing sleep because they may not be able to qualify for a pension later in life due to them performing necessary and valued caring work to the benefit of the State.

Not only are we guilty of not supporting carers in their present-day situation, we are also guilty of putting their future at risk by not committing to a State pension for carers. We must care for carers both now and in the future, when they reach old age. This is what the amendments put forward by the Social Democrats are trying to ensure through the institution of a dedicated long-term carer's pension scheme.

Family carers who are the parent of a child with a disability or illness can be particularly vulnerable and disadvantaged when it comes to the arbitrary rules relating to qualifying for State pension benefits. The awarding of 20 years of credit for periods of caregiving as opposed to having that time disregarded is welcome and very helpful for many carers. However, it is practically useless if the carer does not have a minimum of 520 paid contributions, the equivalent of ten years in the workforce. In cases where a parent may not have worked for ten years prior to caring for a child, this can be incredibly difficult to make up. We must remove this bizarre 20-year limit so we can acknowledge the contribution of people who have spent sometimes twice as long caring, and disregard the need for 520 paid PRSI contributions.

Family carers who are the parent of a child with a disability or illness can also be disadvantaged when applying for the non-contributory State pension due to their partner’s income or in some cases, land owned by their partner. I will use a fictional case study to illustrate how arbitrary and unfair the State pension scheme can be. Mary is 69 years old. She entered employment at the age of 17 in 1969. Nine years later, she gave birth to her first child who was born with a disability which resulted in him needing full-time care. Mary did not return to her previous employment but instead became a carer for her son. When Mary reached the age of 66 in 2018 she was advised by the Department of Social Protection that, as she had only 460 paid contributions, she would not qualify for the contributory State pension. Despite having contributed so much to the State by caring for her son, Mary was rendered at risk of poverty in her later years. Mary’s husband was employed as a civil servant and paid a class B stamp prior to 1995 so his Civil Service pension was fully assessable in the means test for the non-contributory State pension. Therefore, Mary did not qualify for the non-contributory State Pension, was unable to receive an increase for a qualified adult and could not make voluntary contributions. Despite caring full-time for her son for 43 years and making a significant contribution to the State, Mary was not entitled to any State pension. This situation is replicated in families all over this country. Being able to guarantee a pension for all family careers, regardless of how long they have spent in the workforce or other PRSI and social welfare anomalies which are complex and nuanced, is not such an insurmountable task. It could be done through a dedicated, long-term carer's pension scheme which we are calling for in our amendment. This would go a long way to respecting the worth and value of all family carers.

Given the value of the care provided by family carers, estimated at €20 billion per annum, no carer should be denied a pension or receive a reduced rate pension for dedicating part of his or her life to providing much-needed care for another. Previous Governments have promised to find a solution for these cracks in the pension system for family carers and there is a commitment to finding pension solutions for carers in the current programme for Government. It is past time these promises were fulfilled. There is no economic, social or moral argument for denying carers financial security in their old age. Whatever the cost to the Exchequer, it could never equal the economic and social benefit to the State from the work of carers.

I commend our amendment.

I support this motion and thank Sinn Féin for tabling it. For too long, the hard work of carers has gone largely unrecognised, unsupported and unpaid by the State. The State and the Government have failed to care for the carers in our society. Every day, carers do crucial work supporting our most vulnerable but this and successive Governments largely view their work as a way to save money and for the State to outsource its responsibility to families, while providing those on the front line with very limited support.

The closure of respite centres and day services hit them hard in the past while, as did the previous cutbacks to these services. Despite promises, they continue to be left in limbo when it comes to pensions. Carer's allowance and carer's benefit are simply inadequate, with low income disregards and unnecessary barriers for those who are self-employed. It is very simple: they need their work to be recognised as work. They deserve a living wage for the work they do, complete with proper entitlement to a pension.

This motion also correctly condemns the actions of the Department of Health in putting together dossiers on children, as exposed by "RTÉ Investigates" last week. Why is the State creating secret dossiers on children with autism whose parents are involved in legal action with the State? Why, instead of helping these children, is the State interested in spying on them in order to try to defend itself? Which Ministers for Health were aware of this? Did they sign off on it? Did the Tánaiste, Deputy Varadkar, know of this when he was Minister for Health? Did the Taoiseach, Deputy Micheál Martin, know? How on earth can it be justified to compile private information on vulnerable children from health, education and social care professionals, in order to block or damage their legal cases, without any consent from the parents? Rather than supporting these families, the State was engaged in alarming and sinister covert surveillance. We now hear that the head of the Department has refused to address the health committee next week and that the Government is refusing to address the Dáil on this matter for weeks. This cover up will not wash and will not be accepted by people. The families who have been monitored by the Department should be notified immediately. The Ministers and senior officials who allowed it to take place should be named and made to account for themselves.

This motion also refers to the vaccine roll-out and the campaigning by family carers to get access to the vaccine as soon as possible. Obviously, this is now all up in the air in light of the Government's latest change of tack on the roll-out. What is most striking about this change of tack is the lack of public health infrastructure to be able to implement the roll-out that was previously agreed. One year into a pandemic and the Government is not able to target particular groups, which it had previously said was best practice. It is shocking.

It is also very galling to carers that while they are none the wiser about when they will get the vaccine, the head of the Beacon Hospital seems to be distributing vaccines to whomever he wants. The idea of it being left to the Beacon Hospital to hire someone to investigate what happened there is simply not good enough. The Garda should be involved to establish if a crime was committed and there should be a rapid public audit, involving the IMO and patient representatives, to see if there was other misallocation or misappropriation of public resources. The CEO of the Beacon Hospital, which is a private hospital, has been caught red-handed and he must go. He used his position of power to steal at least 20 public vaccines and use them as if they were his personal property. If a cleaner went in and robbed 20 vaccines, he would be arrested for theft. It should not be any different because it is the CEO of billionaire Denis O'Brien's private hospital. It is the same hospital, let us remember, that in January was refusing to sign up to allow its facilities to be used for surge capacity. Again and again, private hospitals have put their profits and greed before public need. This underlines the need to end the two-tier health service and bring the private hospitals into a quality, single tier national health service.

I thank Sinn Féin for bringing forward this very important motion. I also thank the carers in our State who have done an amazing job of looking after their loved ones, year in and year out for long periods. My sister gave 20 years of her life to looking after my mother, and she did it 24/7 without question. It is not an easy thing to do. All of the statistics show that making this sacrifice comes at a high price in a person's life.

In dealing with families and people who are challenged mentally or physically, people who have visual and auditory challenges and those who become old, the legacy of the State is the tradition of outsourcing, which is disgraceful.

Some people believe outsourcing is a relatively new process that capitalist societies do but the Irish State has been brilliant at it since its foundation. In the past, it outsourced to charities attached to religious institutions and the legacy of that is section 38 and section 39 workers, many of whom also are not paid properly or are not in receipt of decent pensions.

That outsourcing has also been to the family. The family in Ireland has a strong tradition and culture but it comes at the high price of the State ignoring carers. As has been said already, who is going to care for the carers? That is why we should not only pass this motion but we should pursue every aspect of it with vigour over the next few years in order to ensure that carers get the justice they deserve. Carers often work 24-7. They get a respite payment annually but many of them are not able to do much with it, especially since cutbacks in respite have been prevalent, particularly in HSE settings, in recent years. We ran three or four campaigns in the past ten years to stop respite wards in Cherry Orchard Hospital being closed. We won some of them but we lost others. That has meant a reduction in the availability of respite beds to people in our communities who do a tremendous job of looking after the elderly, the frail, the disabled and those who are challenged or suffering from dementia at home.

The savings to the State resulting from people being cared for at home are estimated in one record at €10 billion a year and in another at €20 billion a year. The CSO reckons there are more than 500,000 carers, not all of them in receipt of benefits or allowances. In a country of 4.5 million people, we are talking about one in eight or one in nine members of the population, from the age of 15 upwards, engaged in home caring. This tells me that the Government should begin to recognise the very valuable contribution of that cohort of people no matter who they are or where they are. Two in three provide 100 hours' care a week. One in four provide 50 hours a week without any allowance or benefit. One in three have been diagnosed with depression, four out of ten with anxiety, two thirds suffer with their own physical ill-health and two out of three say their health has suffered as a result of caring for their loved ones. Access to routine supports have been seriously reduced since austerity began in 2009. Many of them do not receive home help or training in how to shower somebody, move them in the bed, lift them, carry them from their wheelchair into the bed or to toilet facilities. That is a complete neglect of those people who do an amazing job.

There is a massive heap of issues that have to be addressed. Like others, I want to read what Donna, who is aged 34, has to say about caring for her husband who has had multiple sclerosis for the past three years. She asked me to do that. She stated:

I have sat and watched over the last 12 months as profits from airlines and travel have been prioritized over my life and everybody else's in this country. I have not received [any] extra money for PPE, sanitizer, [extra] electricity for being in the house ... I have done my bit, I have singlehandedly, without any home help, looked after my husband for the last 3 years.

What does the Government tell carers? It tells them that they can go to hell and look after themselves.

We have to ensure that issues such as the supports that are available, the training that should be available, an increase in the payment for a job that is saving this State billions of euro a year and an assurance that every single one of those people will be entitled to a proper pension are dealt with. Nobody really understands until they do the job or have somebody close to them doing it what enormous sacrifices carers make. They are completely undervalued. We need to care for our carers.

I am delighted to be able to come into the House and support the motion tabled by Sinn Féin. It is very important that we put in place measures for family carers once and for all. Carers will tell one that this is not about them but about the people for whom they are caring. Carers are not selfish people. They are not seeking sympathy. They are not seeking platitudes and soft talk about how good they are. They are quiet, loyal and loving. They care for people and they believe that they are being neglected and left alone.

Figures of between €10 million and €20 million have been bandied about in terms of what this support means to the State. It does not matter because the State is saving an enormous amount of money and a major service is being provided on its behalf.

We have to do some very simple things to help family carers. I am sure the Minister and the Minister of State who are present have received many queries about people who applied for carer's allowance but who have had to wait 15 to 18 weeks for decisions on their applications. If the decision is to refuse an application for carer's allowance, there is a review and an appeals process. The person spends approximately six months without any income wondering whether he or she will get one. Meanwhile, he or she provides the service. That is wrong. If there is one action we must take after this debate it is to make it binding that the process of evaluating an application for carer's allowance is concluded within four weeks. If we did that, we would be doing a service to family carers. There is no excuse for the process to which I refer. It is just one that has built up.

The other issue that has come to my attention relates to parents who are caring for children and the fact that there are no overnight respite services in County Galway. If a family member or parents need to get a break away for one night, they might have to bring their child to Limerick for the night and then take the rest of the night off. However, there is no respite in having to drive down, get everything sorted out and drive back again. I am aware that the HSE is looking at this matter. I urge the Ministers to make sure that it is not just looked at but that we put in place overnight respite services for children in Galway as a matter of urgency.

Last night's announcement in respect of vaccinations was probably a kick in the teeth to family carers. Without any warning or consultation, their entire vaccination process was taken away under them. No more than that relating to teachers or gardaí, this issue has been dealt with in a poor way. It should have been communicated to those people and to Family Carers Ireland before journalists put the news out and informed them. I do not agree with it. What was being done for those cohorts needed to be done, and still needs to be done.

I wish to refer briefly to the "RTE Investigates" programme . There is a bad smell from all of that. I believe that what was shown reflects the attitude that prevails within Departments about children with autism. I deplore what is going on because it breaks the confidentiality aspect and wrecks the GP code of ethics and the professional nature in which they are supposed to work. It should not be tolerated. We should not have to defend it. We should stop it and apologise for it immediately.

Family carers are at the heart of our discussion but if we simply talk about them, we are not doing anything other than offering soft talk. As politicians, there is an onus on us to make sure that we leave a legacy to family carers by treating them with the respect that they, and the people they are caring for, deserve.

Family carers across Tipperary and the country in general are one of the greatest assets to healthcare. They are undervalued, unappreciated and all too often overlooked. Despite the service they provide, they consistently remain on the bottom rung of the ladder when it comes to recognition. We can never hope to pay family carers their true worth. No price can be placed on love, compassion and selflessness. However, we can grant these people the recognition they deserve.

The decision not to prioritise carers in the vaccination roll-out has been the ultimate snub. Carers are the Cinderella of front-line workers. Family carers across Ireland save the State an average of €10 billion every year. By giving their time to care for a loved one, they keep hospital beds free for others and reduce the need for State-funded care facilities. The actual work that family carers do is not reflected in this figure. The truth is that their work is priceless. One cannot put a value on the love and dedication that carers give. Equally, it cannot be forgotten or go unnoticed.

Since this pandemic began, family carers have been left in absolutely no doubt that their contribution to healthcare is not fully appreciated. Their plight has been raised on numerous occasions. I have raised it myself. There have been compassionate responses but nothing has changed. A small increase to the carer's support grant and a commitment to review and update The National Carers' Strategy does not address the needs of people who give their lives to caring for the needs of a vulnerable loved one. Some 10% of Irish adults are family carers, who provide 18 million support hours annually. Some 86% of family carers care for an ageing parent or a child with high dependency. A mere 6% of the overall Department budget is spent on income support for carers. The Trojan work of 10% of Irish adults is valued at this paltry amount.

Prior to the pandemic, 68% of carers reported that they felt their own health had suffered as a result of caring, 48% had been diagnosed with ill mental health and there was a shocking 70% increase in the number of carers diagnosed with depression. This was before Covid struck, which has added significantly to an already serious situation. Statistics on the mental health impact of the pandemic on family carers are not available. However, there is sufficient information in the public domain to prove that it has had a devastating impact. The primary concerns are that the carers themselves will contract Covid and will be unable to care for the people who depends on them. There is an ongoing fear that the vulnerable person would contract Covid and end up in hospital. In that situation, the carer is not permitted to visit to offer reassurance or support.

The Covid pandemic has led to the almost total isolation of carers and their dependants. It is far too risky to allow anyone into the house and equally dangerous for the family carer to leave the house. Some family carers who had the back-up of hired carers contracted by the HSE to provide assistance lost this support during the early months of the pandemic when the contracted carers were redeployed. They were simply abandoned for weeks on end. The majority lost respite services, which provided their only break from caring. Family carers continued to carry out their work. They continue to do so every day, every night and every week. They struggle on to do their very best. They suffer their worries and fears in silence. Most learned a long time ago that a listening ear is hard to find.

I support the content of this motion. In particular, I wholeheartedly support the call to vaccinate family carers without delay. There is nobody who could honestly deny them that peace of mind for themselves and for those to whom they dedicate their lives. Knowing that their risk of contracting Covid is reduced would mean more to carers than anything else. I support the call from carers to increase carer's allowance, carer's benefit and to further increase the carer's support grant. Family carers can be on call 24 hours a day. They seldom know the day or the hour when a crisis may occur. No other healthcare worker in the country is expected to be on call all day, 365 days a year. If they were, they would demand and deserve to be compensated for it.

Despite saving the State €10 billion annually, carers ask for very little in return. It falls on us, as Members of this House, to identify and recognise their needs and to be their advocate in ensuring that they are treated fairly and equally. It falls on us to be their voice and to ensure that they are treated with dignity and respect.

I welcome this motion about carers. I have been vocal in my support for carers in west Cork, especially in the times that we live in with Covid-19. Carers are unsung heroes. Many carers give up their everyday lives so that they can care for their family members. This often means leaving them with no time for themselves. The very least that we can do is support them in every way possible.

The Government has failed to prioritise carers in the roll-out of the vaccine. Last night, it changed the goalposts yet again. Income supports that are available for family carers are simply not good enough. Some of those being cared for are over the age of 80 and are not able to go to their doctors for their vaccines. This was meant to be rolled out by the National Ambulance Service. We have been left with elderly people stuck inside their homes and in no way able to get their vaccines. More than 2,000 housebound people in Cork and Kerry should have been vaccinated. This was meant to be carried out by the National Ambulance Service. However, only 5% of these people have been vaccinated. Some of them are in their 80s and 90s and they or their families have been in contact with me. They have not been vaccinated. It is not good enough. We lost enough of our elderly generation during the initial stages of the Covid pandemic and we are still losing them.

Our family carers should be given more credit and more financial support. We need to focus seriously on what payments are made to carers. These payments need to be significantly increased. The way we are working is penny wise and pound foolish. If many of these elderly people had their loved ones to care for them, they would be at home and maybe not in nursing homes or community hospitals, costing far more money. We need to give more serious consideration to giving more decent contributions to carers, because it is a 24-7 matter. The way that elderly people are being treated is shambolic, including how the fair deal scheme has been dragged out, bleeding people of their bit of savings that they worked hard for over the years.

We have had the longest lockdown in Europe and it looks like it is set to continue. It is due to years of mismanagement by the HSE, failure to add ICU capacity in the pandemic and the vaccine roll-out being a shambles. Now, newly-trained doctors are being let go. The Government needs to work with family carers to deliver supports and services to their loved ones and it needs to prioritise family carers for vaccination.

I thank Sinn Féin, especially Deputy Cullinane, who is an excellent public representative and spokesperson on health issues for Sinn Féin. This is a timely motion. The one thing that people who provide care for older and vulnerable people in their homes do not want is lip service from the Government. The most frightening statistic is that over the past three years, there have been 52,000 applications for carer's allowance with 24,000 of them being refused. This means that almost one in every two applications is refused.

In my office in County Kerry, I deal with many people who want to care for older people in their homes. They are saving the State, the taxpayer and all of us thousands of euro every week by providing that care and service. Where would any one of us like to be if we were older, incapacitated or in need? The one place that everybody would rather be than in any other place in the world is in their own house, in their own corner of the world and in their own bed at night. Whatever bed we get into in any part of the world, the best bed to get into is one's own, if it is at all possible to do so. We have to acknowledge that. By putting hoops and obstacles in the way of the people who are looking to provide this care, we are doing a great disservice to older people, vulnerable people and to the State. In other words, we are shooting ourselves in the foot.

What is the alternative? I am grateful to the nursing homes in County Kerry, which are excellent. I am grateful to nursing homes because there are cases of people who are beyond being able to be cared for at home and they need a level of care that is only available in a nursing home or perhaps in a long-stay bed in a community hospital. That is more expensive and there are only so many places in those nursing homes, so that is why we have to try to streamline the processing application and grant people the different allowances that they need to achieve what they want, which is to take care of a loved person in their own house, in their own time.

I support this motion. I cannot thank carers enough for the work they do in their own homes and the homes of others in Limerick and around the country.

Since coming into the Dáil, I have continuously spoken about the rural-urban divide and today, I want to highlight the issue again.

Take, for example, the situation in a typical rural setting in which a tender goes out for the care of an elderly man of 82 years of age, who is country-based, 5 km to 10 km away from a rural village, and who requires ten hours of care per week. The provision of care in this situation would amount to a fraction of the cost of the elderly man going to a nursing home and the patient would be happier at home. If the family was to get a carer living nearby in to care for the man for one to two hours per day, this carer's social welfare would automatically be cut off as he or she is only permitted to work three days per week while in receipt of social welfare payments. Common sense would tell us that this could be changed. There are people with different circumstances who are in receipt of social welfare payments but if they work one hour a day over five days, they are cut off. We could change the regulation in order that carers could do two hours a day, which could be worked into two days per week. We would then have local people in local areas who could care for people in their areas.

In the example provided, the care of the elderly man would be the only work that this carer has, yet social welfare schemes make it too complicated for the carer and the provider. This situation needs to be highlighted as a matter of urgency. I understand that there are huge difficulties in getting carers at present Surely, common sense should prevail in a situation such as this.

I am heartened to see that the HSE has undertaken a massive recruitment drive for more carers. This will be of huge benefit. However, were the above example to be borne in mind, it might not be so difficult for carers to care for people in their own homes.

The fact that all carers have been vaccinated has made a huge difference to vulnerable people. I am appealing for the same to apply to family carers. When a parent or a partner is caring for his or her own family member, he or she should also be vaccinated.

I too compliment Deputy Cullinane and Sinn Féin on putting forward this motion. We could not talk about a more sensitive, deserving and needy group of the population. They give all they can to those they care for, who are normally elderly but can also be vulnerable young people. I salute the carers and Councillor Richie Molloy, an independent councillor in Clonmel, and his team who manage the carers in County Tipperary. I also thank Ms Vivienne Kenneally in my office who deals with it as best she can, and the officials in the carers section. However, the guidelines need to be changed. It is the borderline issues. Nearly one out of every two requests for care are refused.

In the main, people do not look for carers unless there is a real need for them. They do the work themselves anyway. There are so many child carers who are not even recognised. The statistics are there to prove it. There are hundreds of children who are caring for adults because of the neglect of the HSE. That is not fair or right. Those children should be enjoying life, ag súgradh agus ag foghlaim. They should be learning and playing, not caring.

The issue must be looked at sensitively. There are a number of Ministers here today. They know about the issue and spoke about it when they were in opposition. These anomalies, guidelines and caps are there. People are being sent trasna na tíre, across the country, to meet others for half an hour here and 20 minutes there. They do not even get time to help the carer even to be in the room long enough to do the things they need to do. Consider the money that has been saved by keeping them at home in their own leaba and house. They are more content there and will recover better and enjoy a better quality of life there, rather than being in hospital. This is particularly the case at this point in time, when hospitals are cruel places because visitors are not allowed because of the lockdown. It is most cruel. People want to be at home, enjoy being at home and have a better standard of health at home, both mental and physical. I salute the army of carers who sign up for this work. I also salute those who are at home and who cannot access carers and the care they give their loved ones because of love and support and family. It is tremendous.

Many examinations need to be carried out in this area. The whole system needs to be examined and dealt with clearly. It must be more compassionate.

I must say that I am shocked at the further change made to the pecking order for carers in respect of the vaccination programme. It is idiotic at this stage. I used to say that it was shambolic but what is going on and the way the carers have been left out of this again is idiotic. It was shocking that they were not even mentioned last night, as if they did not exist. We will pay in pious platitudes but we will not pay them or respect them.

I fully support both this motion and the amendment put forward by me and Deputies Harkin, McNamara, Fitzmaurice and Collins.

Carers are overworked and undervalued and the State is completely over-reliant on the unpaid caring work done by family members around the country. The fear that the Covid-19 pandemic has brought to carers has been palpable in our communities. People caring for vulnerable family members have been terrified that Covid could get into the home and that they themselves could get sick and be unable to continue to provide care. Those lucky enough to have home help have been nervous about staff bringing in Covid, especially because of the lack of PPE at the start of the pandemic.

Since the first announcements of the vaccine roll-out plans, I have been asking for family carers to be prioritised. The Minister's responses to where carers are in the national Covid-19 vaccination programme implementation plan sequencing table has been beyond disappointing and worrying. The national immunisation advisory committee, the Department of Health and the National Public Health Emergency Team approved the roll-out plan. The HSE is responsible for the roll-out of the vaccines. Yet, the Minister cannot wash his hands of his responsibility in all of this. His replies to parliamentary questions I have submitted on the need to vaccinate family carers urgently have consistently stated:

The priority is to first vaccinate and protect directly the most vulnerable amongst us, that is, those most likely to have a poor outcome if they contract the virus ... hence the focus on the over 65-year-old cohort in long term residential care facilities, and healthcare workers in frontline services often caring for the most vulnerable.

The Minister's replies have noted that "Persons being cared for in the home are a diverse group, therefore, each individual will be vaccinated in the group that is appropriate to them." In addition, they have stated:

Frontline healthcare workers (HCWs) in direct patient contact roles will be vaccinated in Group 2. This includes HCWs working in public, private, and voluntary settings. Other HCWs, not in direct patient contact, will be vaccinated in Group 4.

Other replies have noted that "Family carers are a diverse group, therefore, each individual will be vaccinated in the group that is appropriate to them." They are doing the work that hospital workers and other front-line workers do but they are being left behind.

Is caring for a family member at home not front-line work? Carers are that person's lifeline, his or her connection to the outside world, often administering medication, transporting them to and from medical appointments, and all and every other necessary task that comes with being a carer, depending on the needs of the person. Family carers may be part of a diverse group and people receiving care are also in a diverse group but there is a common theme here, namely, vulnerability. Were carers working in hospital settings, they would be classed as front-line healthcare workers and would have been among the first to be vaccinated.

I welcome the motion before us and note the urgent need for the motion.

Last year, between 14 April and 5 May 2020, Family Carers Ireland undertook a national survey on family carers' experience of caring during the Covid-19 pandemic. At that point none of us could have expected the pandemic to have continued for so long. The report was an online survey and was completed by 1,307 family carers. The respondents were from a range of different caring situations, such as parents caring for children with a disability, people caring for an adult, carers of older people and people caring for two or more people. It was open to respondents aged over 18 years. However, we do know that there are many carers under the age of 18 years and probably more since the beginning of the pandemic. In the census of 2016, there were 3,800 children under 15 years of age providing care to others, which at that time constituted 1.9% of all carers. The report is very informative and some of the findings were that the average age of respondents was 46 years, 95% were women and 3% became carers due to the Covid pandemic.

With an estimated 500,000 carers across Ireland, the online survey of 1,307 responses is just a very small snapshot. However, it does provide some evidence around what we have been hearing anecdotally in our constituencies. Family Carers Ireland estimate that carers save the Exchequer around €20 billion and that around 19 million unpaid hours per week are provided by carers.

At the end of February this year, Family Carers Ireland put out a strongly worded press statement on the exclusion of family carers from the early roll-out of the vaccine. It said that it was "devastating" that carers were once again ignored. It stated:

They were cast aside for PPE, they were ignored for priority testing and now they are being ignored for vaccinations ... The programme for Government clearly states "Family carers are the backbone of care provision in Ireland. They deserve support and recognition from Government". Sadly actions speak louder than words and today our Government has failed family carers.

Gabhaim buíochas leis an gCathaoirleach Gníomhach agus le Sinn Féin as an deis an t-ábhar seo a chur os comhair na Dála chun é a phlé. Tá an t-ábhar seo an-tábhachtach agus tá gá orainn beart a dhéanamh anois ar son na mban agus na bhfear atá ag saothrú ar ár son ar an talamh ionas go bhfuil cúrsaí eacnamaíochta go maith.

I appreciate the opportunity to speak on this motion. I welcome the Minister's statement and look forward to hearing what the Minister of State, Deputy Rabbitte, has to say about the actions she intends to take to address the issues raised.

A number of figures have been referred to this morning and it has been said that we cannot put a value on the work done by carers. However, I understand work is, in fact, in progress by the CSO and local organisations to arrive at such a valuation. The figure of €20 billion has been mentioned repeatedly. It is amazing that we do not have an official valuation and that no Department has seen fit to put a monetary value on the contribution of carers. We put a monetary value on many things but not on this. Can the Minister of State tell us what carers are saving the country? Is it €20 billion, €18 billion or €22 billion? The amount being saved is certainly astronomical but the Minister could not provide an exact figure.

We hear a great deal of talk about having a thriving economy outside of the Covid challenge but there never seems to be a value placed on the work that goes into making that economy thrive. A huge segment of the success in this regard has been achieved primarily on the basis of unpaid work, including that done by carers. I welcome the motion introduced by Sinn Féin and the amendment put forward by a number of Deputies, including one of my colleagues. I will return presently to the "Prime Time" report, which is referred to in the motion.

Will the Minister of State confirm whether it is the case that there is no respite provision, and has been none for more than a year, for people in Galway caring for loved ones? I can think of many such examples throughout the county, as I am sure the Minister of State can in east Galway. One year on, I am asking the same questions. It is beyond my comprehension to understand how NPHET and the other sub-committees have not prioritised respite care. That should have been the first thing they did. We cannot let people struggle on, saving ourselves money while not giving them care and watching them go under. We do not need organisations to tell us this is happening because we can see it with our own eyes. We know what is going on and the Minister of State knows it. Why has respite provision not been top of the list for NPHET and NIAC? Why has it not been a priority to consider how respite services can be made safe? I would love an answer from the Minister of State on that question today or, if not today, in writing.

The Sinn Féin motion refers to the "abhorrent practices" uncovered by RTÉ, a reference I welcome. I do not know whether the Minister of State was shocked by what was shown on that report. I thought I was beyond being shocked before I learned about the abhorrent practice of taking up civil servants' time to build up dossiers on cases that were apparently dormant with a view to doing the families in. I will change the language I have used. It was done with a view to catching the families out when they were at their most vulnerable in the hope of securing a lower settlement and saving costs for the State. All the time that energy was being put into this effort, it was not going into providing services or doing analysis of the cost saved to the State by carers.

I want to say a public thanks to the whistleblower who revealed what was happening. Without his courage to come forward, we would not know the truth. I am sure his life has not been easy since he disclosed what he knew. The Minister of State is nodding and I appreciate that. I appreciate that she is a proactive Minister of State. However, it is unacceptable that we had to rely on a whistleblower to reveal this information and that he has been threatened with the Official Secrets Act, as has RTÉ, as I understand it. What I found most annoying and abhorrent was the reaction from commentators such as the former Attorney General, who did not seem to see too much wrong with what happened and, in fact, noted that it was normal practice to exchange reports. The comment by the head of the body representing psychiatrists in Ireland floored me. I really could not understand what he was saying last Sunday. It is worth listening to his statement again.

As a person with limited experience in this area - but some experience, nevertheless - it is obvious to me that it would, of course, be usual practice for medical reports to be exchanged. However, that should be done in an open and accountable way and there are rules guiding such exchanges. Both sides know the rules of the game, so to speak. It may be a game on occasions but it is never a game when one is dealing with a child with a disability. When I talk about a game, I am referring to the law. There were no rules adhered to in this instance. A collection of documents and information was exchanged on a secret basis to build up a dossier and have the advantage if the families ever came to settle the case. There is no need for dormant cases; both sides can bring them to a conclusion. The comments from the former Attorney General were a bit disingenuous in this regard.

I thank all the Deputies who contributed to the debate. I intend to address two issues that are referred to in the motion, namely, day services and respite provision. I will also speak about the "Prime Time" programme and address some of the points raised by Deputy Connolly.

As a Member of this House, I have spoken with numerous carers and, more recently, I have done so as Minister of State with responsibility for disability services. Many of them have told me about the struggles they face in looking after the most vulnerable. The pandemic has worsened the situation for many carers. I take this opportunity to thank them sincerely and to restate the Government's commitment to supporting people with disability and their families and carers at this time. As I said, I want to use my time this morning to address points raised by Deputies regarding respite provision and day services.

I am very aware of the delay in some local health authority areas in the provision of respite services and the stress this is causing for people with disabilities and their families. The HSE regards the provision of disability services as essential to maintaining a response to people with disabilities. I have brought about some changes in this regard since last September. In the first wave of the Covid crisis, disability services were not deemed to be essential services. Disability provision is now deemed to be an essential service for adults. As a consequence of the Covid crisis, centre-based respite facilities are generally providing services at a 40% to 60% occupancy level due to the precautions necessary to maintain physical distancing and adhere to infection prevention and control requirements. The majority of centres are open on a reduced capacity basis due to the physical distancing requirements.

In a very small number of cases, certain centres remain closed or continue to be used for isolation purposes, subject to the prevailing local indices of infection. The HSE continues to work with service providers locally to maximise both centre-based and alternative non-residential respite and support options in order to provide services wherever possible. Targeted, one-to-one home support hours are being offered in lieu of respite in certain circumstances, subject to appropriate risk assessments and in line with the prevailing infection and prevention control guidelines. In 2021, the HSE will provide 214 intensive respite support packages to children and young adults.

We all hope that Covid rates will fall and that improved services can be offered. In budget 2021, I committed to providing funding to the HSE to develop nine additional respite services across the country, which is one for every community healthcare organisation, CHO, in the State. The purpose is to ensure that where we do not have proper respite services, we will, at a minimum, have one functioning respite house in every CHO. That provision is predominantly focused on children's respite but will also provide for adult need. The HSE is engaging as a matter of priority with service providers to develop these services in each CHO and I hope to be in a position to confirm the locations of other facilities in the coming months. Three weeks ago, St. Gabriel's Centre in Limerick was the first of these centres to which funding was allocated and facilities and staff are being commissioned and recruited as we speak.

This time last year, day services had to close due to the unprecedented threat of Covid. In August, we succeed in having them deemed to be essential services. When the services resumed in August, they were coming from a very low base. By September, we had got the quantum of service up to 31%. Today, it stands at 55%. The additional investment in disability services secured under the Covid action plan and budget 2021 will build the capacity of our adult disability services and is enabling us to increase day services provision by one day a week. It will also support approximately 1,700 young people who will leave school and training programmes in 2021. I commend service providers and staff on their commitment and flexibility in maintaining this level of service in very difficult circumstances. Additional guidance has been circulated to all service providers to ensure that they maintain regular contact with service users who are not attending the locations.

I cannot see a clock but I have no doubt the Acting Chairman will tell me when to stop.

There are two other matters, including the important question of a carer needs assessment, CNA, commitment in 2021. There is €180,000 in funding for the roll-out of carer needs assessment as part of the single assessment tool project that has been secured from the dormant accounts fund. The CNA has been done and was due to begin in 2021. It is starting in 2021 in community healthcare organisation, CHO 2 in order to provide a mechanism to assess family carer needs better with a view to linking them to relevant services and support, which is really welcome. We know the tool used for carers to access supports is not very clear.

There have been 27,000 hours of emergency respite made available through Family Carers Ireland to ensure the immediate care needs of care recipients could be met in the event that a carer would be no longer able to continue in a role.

There was a question on the "RTÉ Investigates" programme and my understanding is there shall be statements on that tomorrow afternoon. I do not have the full facts to answer all the questions but I will come before the House, perhaps with the Minister, Deputy Donnelly, to answer questions on those matters.

In the concluding stages of this debate it is right to acknowledge the admiration held by all Members of this House for family carers. Every day tens of thousands of people provide care for relatives, friends, neighbours and others. They may come from various walks of life and begin caring responsibilities at different points in their lives but these people share a common love for the person for whom they care. Their noble commitment to provide the best quality of care for their loved ones in the comfortable and familiar surroundings of their home is rightly worthy of our praise and admiration. It is also proper that we recognise the value and contribution made by family carers in our healthcare system.

The national carers strategy 2012 is a whole-of-government strategy containing high level goals and objectives to address a range of priority areas of importance to family carers, including health and personal social services, income support and respite. Progress has been achieved under the strategy but further work remains, as reflected by this Private Members' motion. In budget 2021, the Government increased funding to improve access to health and social care services in the community, which benefits caregivers and those for whom they care.

The Minister of State, Deputy Rabbitte, highlighted significant additional investment in disability services for 2021 and a further area I will mention concerns the ongoing work to improve access to GP care for family carers. GPs are often the first point of contact for carers when seeking advice and information. Since September 2018, individuals in receipt of either a full or half-rate carer's allowance or carer's benefit have been automatically eligible for a GP visit card. This measure was introduced to enable approximately 14,000 people at the time in receipt of carer's allowance or carer's benefit who did not qualify for a medical card or GP visit card on means or age grounds to be eligible for GP services without fees.

The Minister, Deputy Donnelly, has already referred to how we are improving health and social care services for older people and this year an additional 5 million home support hours will be provided to support older people to remain in their homes for as long as possible. This includes an additional 250,000 hours for people with dementia and an additional 27,000 hours in emergency respite to ensure the immediate care needs of care recipients are met where a carer is no longer able to continue in a caring role.

Looking forward, the programme for Government commits to reviewing and updating The National Carers' Strategy, developing a pension solution for carers that recognises their important work and developing a carer's guarantee proposal that will provide a core basket of services to carers across the country, regardless of where they live. There has been a €2 million allocation to the HSE in 2021 to improve equity of access in supports for carers across the country.

It is the duty of the Government to meet the needs of family carers and foster a climate in which they feel valued and supported to continue in caring roles. Our commitment is laid out in an ambitious programme for Government. We will work with family carers and representative organisations to deliver this.

I will be sharing some time with Deputy David Cullinane. At the beginning of this debate the Minister for Health described family carers as the "backbone" of caring in our State. I will put on record some of the words of the backbone of care in our State:

I am so fed up and worn-out from fighting for the basic rights of my daughter.

With so little support, I live in a constant state of distress and worry for my child. I regularly cry myself to sleep at night.

I do not get a break but I am at breaking point. Who will look after my elderly parents if I get Covid?

At the end of the day carers are not part of the old boys network, so we do not get the deals and bonuses that the Government seems happy to hand out to [its] buddies.

These are the words and experiences of family carers who are among the very best and most decent people in our society and yet for far too long they have been abandoned by the State and certainly forgotten during this pandemic.

It has been a very difficult year for everyone but now is the moment to turn the page on how family carers are treated by the State. Our plan, proposed in this motion, is simply designed to give carers a break by ensuring that they are prioritised for vaccination, increasing access to respite and improving supports, including financial supports. The work that family carers do is tough and exhausting. There is no clocking in or out and they are at work every hour of the day. There are no words to describe the importance of the work, which is done with such dignity and love. Behind closed doors they move mountains and perform small miracles every day.

Although the work that family carers do is the work of compassion and kindness, family carers are workers. They are front-line health and social care workers who save the State as estimated €20 billion per year. Nevertheless, they are left behind and ignored. They have much tea and sympathy but when it comes to real respect in the form of support and services, family carers are forgotten by the Government time and again.

This constant neglect comes from a fundamental dysfunction and the cruel way the State treats its most vulnerable people. Instead of the Government prioritising vulnerable citizens and their families, what we get is hostile Departments compiling dossiers on them in an effort to undermine legal cases against the State. When the State has such warped priorities, is it really any wonder people with disabilities and their carers have to fight tooth and nail for proper supports and services? It is no surprise at all.

During the pandemic, when services were either withdrawn or curtailed, as the virus cut off the support of family and friends, family carers were left trapped and isolated in the fight to keep their loved ones safe. As loved ones with additional needs regressed during lockdown, the frustration, worry and fear has been tangible for these families. This sense of abandonment has crystallised around the question of vaccination. After months of hardship, the news of vaccines brought a chink of hope and relief for many family carers. It came as a punch in the gut for family carers that they would not be prioritised for vaccination.

The refusal to afford family carers priority boggled the mind and begged fundamental questions of this Government. Carers asked, very reasonably, who would care for their loved one should they become sick with this virus. Yesterday, we discovered that family carers definitively will not get the priority they deserve. This has been a kick in the teeth to them. They will be joined by childcare workers, special needs assistants, teachers, gardaí and those working in retail and transport, in other words, the front-line heroes who went above and beyond over the past 12 months. The people we have saluted and acknowledged for keeping society on the move and keeping us safe are now to be set aside.

Is cinneadh náireach é. Tá cúramóirí, múinteoirí, cúntóirí riachtanas speisialta agus gardaí go léir fágtha ar gcúl gan aon rannpháirtíocht. Tá ár dtacaíocht tuillte acu. Is laochra túslíne iad. Tá a gcuid déanta acu. Choinnigh siad slán muid go léir. Is slap san aghaidh é do na hoibrithe seo.

This is a slap in the face. The Government changed its vaccination strategy simply because it did not have its work done. The Government and the State failed to provide the correct mechanisms to roll out an effective and safe vaccination strategy. That is the truth of the matter and front-line workers will pay the price for that. Family carers will again be set aside and left aside.

The Minister has indicated that the Government will not oppose the motion we have brought before the House but we ask much more than that. We want the Government to support the motion and go further that again by ensuring all the provisions set out in our plan are realised. It is time to change the present and the future for the hundreds of thousands of family carers in Ireland. If we are prepared to work together, we can do that. We can move from a situation of neglect to one where family carers are truly valued. When somebody asks who cares for the carers, the answer should simply be that all of us do.

I ask every Deputy to back this plan and to ensure it is implemented. I ask Government Deputies, in particular, to show up for family carers by urgently implementing the measures that we as a Dáil will agree this morning.

Covid has shone a spotlight on many sections of society and the vulnerabilities of some of them. Family carers are one of them. This has to be the start of finally delivering a new beginning for carers. I do not have confidence in this Government or any of the main conservative parties in this State to deliver that new beginning. They have been in government for decades. All the carers I have talked to are sick and tired of false promises and of hearing from the same politicians from the same parties, who tell them what they want to hear outside and, when it comes to budgets, resourcing and putting plans in place, it does not happen.

I say to the Minister and, more importantly, to family carers that this will not happen under a Sinn Féin-led Government. We will put carers first and put in place the services and supports they need. We would make sure they were prioritised in the roll-out of the vaccine. We will attempt to clear waiting lists for disability assessments, speech and language therapy, physiotherapy, counselling services and healthcare across the board. We would expand eligibility for carer's benefit and GP visit cards. We would relax the means test for the carer's allowance and establish a discretionary fund for Covid utility bills for carers. We will ensure carers get the support they need and that the big state will not collect data on families of children with special needs, including sensitive and graphic information, to use that information against families to force them to drop dormant cases they took to get their children the supports and education they need.

That is what carers, children with special needs and their families can expect from a Sinn Féin-led Government. I hope it is not the case that the Government will not oppose this motion only to do nothing about it once this session is complete. Carers are watching me and my party and they are watching the Government. The Government must do more than not oppose the motion; it must deliver on what the motion has asked of it today.

Amendment agreed to.
Motion, as amended, agreed to.