JOINT COMMITTEE ON FINANCE AND THE PUBLIC SERVICE debate -
Wednesday, 31 Mar 2010

Effects of Economic Downturn: Discussion with Carers Association.

Chairman

I welcome, from the Carers Association, Mr. Seán Dillon, head of services, Ms Clare Duffy, social policy officer and Mr. Martin Cullen, family carer. I also welcome Mr. Frank Lahiffe, advocacy consultant for the association. We will have a short opening statement followed by a question and answer session.

I draw attention to the fact that members of this committee have absolute privilege but this same privilege does not apply to witnesses appearing before the committee. The committee cannot guarantee any level of privilege to witnesses appearing before it. Furthermore, under the salient rulings of the Chair, members should not comment on, criticise or make charges against a person outside of the House, or an official by name or in such a way as to make him or her identifiable.

I now call on Mr. Seán Dillon to speak.

Mr. Seán Dillon

Mr. Frank Lahiffe shall make an opening statement.

Mr. Frank Lahiffe

I apologise for the absence of our chief executive, Mr. Enda Egan, and chairman, Mr. Frank Goodwin. Today's meeting clashed with a board meeting of the Carers Association and, like this committee, it has some important budgetary matters to deal with. The team present will adequately represent the association.

I thank the Chairman, Deputy Michael Ahern, and the committee members for the opportunity to present our policy priorities for the year ahead. Our thanks also go to the clerk for making the arrangements.

We commend the committee on recognising the importance of providing a framework through which the Carers Association and the 161,000 family carers we represent have the opportunity to contribute to key decisions being made about carers and to ensure that the strategies are put in place to enable them and those for whom they care to lead healthy and fulfilled lives. The association takes this opportunity to thank the committee for its support of our association and of family carers in the past. We look forward to its continued support. I shall now hand over to Mr. Seán Dillon, head of services, who will deal with the content of our submission.

Mr. Seán Dillon

I understand copies of our submission have been circulated to members. I propose to offer a synopsis of the key points after which my colleague, Mr. Martin Cullen, will speak about his experience as a family carer. Members may then put any questions they have to my colleagues and me.

Family carers are relatives, friends or neighbours who provide unpaid care for adults and children with a disability, mental illness or chronic condition, or for frail older people. Given that carers must be constantly available due to the heavy demands and responsibilities of caring, many are unable to take up employment and are often reliant on Government supports. In addition, there are often significant financial costs associated with caring, such as greater heating costs, special dietary requirements, transport and medical expenses, cost of medical equipment and so on. These must often be borne solely by carers.

The document we have provided offers some key statistics. There are almost 161,000 family carers in Ireland, representing 4.8% of the population. In light of United Kingdom and European figures, that is probably an under-representation, but it is nevertheless a significant number. According to the 2009 figures, approximately 43,000 of these carers are in receipt of carer's allowance. We are eager to highlight the contribution family carers make to the economy, which is of particular relevance to this committee. Family carers provide more than 3.7 million hours of care each week and save the State more than €2.8 billion per year. This means the average full-time carer saves the State approximately €44,000 per annum. At a time when the State is obliged to invest so much money to deal with bad practices in the banking sector, here we have a group of unsung heroes, true citizens of the State who are saving the Exchequer billions of euro.

We expect the committee will receive a plethora of requests for funding this year and we are grateful for the opportunity to make our case. Last year was a difficult one for the State's 161,000 family carers. In March 2009 the Government announced that it would not publish the promised national carer's strategy. Later in the year we had the bord snip nua report and the report of the Commission on Taxation, some of the recommendations of which would be extremely detrimental to family carers. However, the decision in budget 2010 to retain the half-rate carer's allowance was a welcome relief to the 19,000 carers who rely on that payment and to carers who may be eligible for it in the future. We sincerely thank the Government for heeding the views of carers in this regard. As Estimates are prepared in the coming months we appeal to the Government not to attack the half-rate allowance. It is a strong priority for carers.

The decision to impose a blanket reduction in various social welfare payments, including carer's allowance and carer's benefit, to increase the drugs payment scheme threshold to €120 per month and to introduce prescription charges were met with widespread opposition from our own members and from family carers in general. It would be remiss of us not to take this opportunity to highlight the issue. The Carers Association recognises that the current economic situation has obliged the Government to seek out strategies to enable a return to prosperity in future years. We accept that difficult choices must be made in the interim. However, such strategies cannot be at the expense of carers who are already shouldering an unfair level of the caring responsibility and saving the State billions of euro per year.

In order to assist the committee, we have identified four priorities for the year ahead. It will come as no surprise that our first priority is remuneration for carers. We gratefully acknowledge the Government's decision to protect those aged over 66 from welfare cuts in budget 2010. However, we were greatly disappointed with the reduction of 3.8% in the carer's allowance and of 3.7% in carer's benefit. These reductions are in addition to the 2% cut already experienced by carers through the suspension of the Christmas bonus announced in April 2009. While many arguments have been advanced in regard to the cost of living and how it has decreased substantially during 2009, research published in 2010 by The Poor Can't Pay coalition shows that the fall in prices for items bought by low-income households was closer to 2.2% and not the generally accepted figure of 6.5% used by the Government when justifying reductions in social welfare. Experience has shown us, and this is supported by independent research, that income received through welfare payments by carers, who are among the most vulnerable in society, is often used to cover the additional costs associated with caring. It is the accumulation of these additional costs, which Mr. Cullen will describe presently, which poses a great difficulty for carers and their families.

Our second priority is the provision of tax breaks for the purchase of care equipment. Family carers continue to experience lengthy delays in accessing essential services such as occupational therapy, care equipment and housing adaptation grants. Qualifying requirements mean that if carers go ahead and purchase these services privately any grant is forfeited. Carers who need additional space in their bathroom or a downstairs bedroom for their loved ones cannot wait for bureaucracy to catch up with their requirements. Many people in that situation will meet the outlay themselves through a credit union loan or some other means, which has a further detrimental impact on their income. We also request that tax relief be given to carers for predetermined categories of expenses associated with their caring commitments, including technical aids, hoists, medical care, care products, home renovations and private home care. Given that the State cannot always provide the necessary level of in-home respite care, there may be a need for families to employ private home care. That should be facilitated by tax breaks.

Our third priority is pension entitlements for family carers. The Carers Association welcomes the publication of the national pensions framework and the Government's decision to reform the pensions system. However, while the framework sets out numerous reforms that will assist in making the pensions system both more equitable and more efficient, it does little to address the inequalities currently faced by family carers in regard to pension entitlements. This is a complex area and we have gone into considerable detail in our submission. Members are welcome to quiz us on any aspect of our proposal.

Our fourth priority is the national carers' strategy. No commitments were made in budget 2010 to advance the publication of the strategy. Family carers are already denied many basic supports and the strategy, which was committed to in Towards 2016 and in the programme for Government, is fundamental to providing a roadmap for the development of support services for family carers over the terms of the national agreement. The Carers Associations calls again on the Government to publish the national carers' strategy in full, setting out commitments in regard to income supports, health care, training, the labour market, transport, housing and information services, with an implementation policy across several years when economic, social and political indicators permit. It is important to understand that, for family carers, the strategy was a very important roadmap. It set out a vision for family carers and it enshrined, in the view of family carers, recognition by the State of the essential work they do in assisting the State.

Not all parts of the strategy require additional funding. Those parts included in the proposal we made last year could be pushed later into the period whereby, if funding was required, it could be spent at that stage, depending on the economic conditions at the time. In essence, there is a requirement in any strategy for new and additional funding. We will absolutely concede to that and accept funding is not available at this point, and we concede this was only a fair representation of the economic climate we found at the time. However, not everything in a strategy requires investment and funding. There are vision and recognition parts to the strategy. We propose a certain number of revenue-neutral propositions within it but it is hard to understate how important that strategy was to having family carers feel they were being recognised by the State. Coming not long after the publication of the drugs strategy, and given the early stages of the national positive ageing strategy are under way, it was a very difficult issue for us to talk to our members and carers about. We would again appeal to Government to reconsider the decision and publish the national carers' strategy.

These are the priority action points. I will conclude and then hand over to Mr. Cullen. The Carers Association is very concerned that carers will simply be unable to cope as the reduction in benefits and services they rely on, such as carer's allowance, carer's benefit, child benefit, qualified adult allowance, the loss of the Christmas bonus, the introduction of a carbon tax, prescription charges on medical card holders and the increase to €120 in the monthly drug payment, all begin to take their toll. Given the need to address public expenditure, we are very concerned that, while it was not any single charge, a family carer probably comes into contact with multiple benefits and it is the culmination of cutbacks that has a very detrimental effect on the income of a family carer.

Carers are already propping up the Irish health care system and the recent announcement by the HSE highlighted the expanding role they will have to play in the future. It is well known to all of us present that, given the stated goal of the HSE and Professor Brendan Drumm to have fewer patients in our hospitals, shorter hospital stays and an increasing focus on community care, there will inevitably be a further increase in the burden on family carers. It is a policy we do not disagree with. Given the choice, those of us who are in caring situations know full well that our loved ones or family members would, if at all possible, prefer to be in the home and looked after by their families. However, achieving that comes with a requirement around the skill of the individual to provide that care to a loved one, the supports and the ability to take a break and for the carer to have some respite.

It has to be noted again that the contribution made by family carers to the Irish economy has been conservatively estimated at nearly €2.8 billion each year, yet the delivery of this highly valuable service to older people, vulnerable adults and children with special needs does not come without a cost to the carers themselves. Family carers often incur significant financial and well-being costs due to the impact of their caring role. National research projects have consistently identified that carers are an at-risk group for negative well-being as they usually have higher than average rates of depression, chronic illness, injury and poverty due to the physical, emotional and financial demands of caring. Those of us involved in family caring very much empathise with the view with regard to the stress, both physical and mental, caring for a loved one on a continuous basis can place on the individual.

The Carers Association would again urge that, in the interests of responsible Government, priorities for expenditure would be aligned to the evident needs of family carers. Investment in social welfare supports, health services, education and training and strategies to improve the socio-economic well-being of carers, as well as the publication of the national carers' strategy, are the priorities we would like to put to the committee today on behalf of the family carers of this country. I thank the committee members for their attention and I would now like them to hear a contribution from Mr. Martin Cullen, one of our members and a family carer.

Mr. Martin Cullen

I look after my mother who is 87 years of age. She is a stroke and Parkinson's patient and I have been looking after her for over nine years. She is classed as high dependency because she is incontinent and cannot do much for herself — she has to be washed, dressed and so on.

With regard to stress, when the budget was introduced, it created extra worry in terms of making ends meet. When people are on a fixed income and become carers, they are very grateful for any increases they get to help them. Our prime aim is to preserve and look after the person we love — that is the only thing we want to do. It is very difficult when carers are trying to juggle money in every aspect. We understand that things have to be tightened and so on but, speaking with other carers, it seemed that we were devalued.

With regard to facilities, I had horrendous problems trying to get a hoist for my mother. When the services did come out with a hoist for her, it was the wrong type of hoist and I had to wait until I got the right one. When we moved to Clondalkin, where we are at present, I tried to get a grant to have the bathroom converted. I was told by the occupational therapist that it would take possibly six to eight months because it had to be put out to tender to various contractors. I could not wait that long so I had to take out a loan from the credit union, because my job started the next day.

It is a question of all the pressures people go through. Some things are easy and others are not in regard to trying to access services. Organisations such as the Carers Association are the only ones who fight our cause to help us feel we have some sort of self-worth. A person's self-worth goes down when trying to do this job because they are doing it 24-7, particularly when dealing with someone who is high dependency. It is backbreaking. We are trying to do the best we can but in everything we try to do, we are just fighting to try to get entitlements to anything from, for example, chiropody treatment to pads. I went through a period where pads were a big issue, although it is not a big issue where I am living now. All of those pressures mean one would nearly need a secretary to fight one's cause. Carers suffer from sleep deprivation as well as everything else.

The one thing carers do not want to show is that we cannot cope. We are sometimes afraid to say things like this because we are afraid the person will be taken away from the carer. It is a constant battle to try to stay on top of things. My mother has to have heating on all the time, so there is a cost for that — it is all aspects of the situation. When I speak to other carers on the telephone, all we want to do is to have the means to be able to provide. We would work for ever to look after the people we care for. We just want to have it so we can access what we need to access as their condition changes, such as hoists, entitlements to build an extension and so on.

Given what the Minister, Deputy Mary Harney, has put forward in regard to the situation if the loved one has to go into a home and the house has to be sold, I cannot understand how, if an extension is needed, it could not be taken at a later stage from the equity of the home when it is sold, which would help. We need the facilities in the here and now when looking after somebody. When carers are looking after somebody and cannot access the things they need, they feel they are failing the loved one, which is a big pressure on any carer I have ever spoken to. It is a constant battle with the State to try to get this, that or the other. My mother often asks me if I would not be better off putting her into a home given that she is such a burden but I do not want to do that because it would represent the end of the road. That thought bears heavily on me. I want to be able to access what I need to do my job.

Chairman

I am afraid I will have to leave the meeting but before doing so, I thank Mr. Dillon and Mr. Cullen for their presentations. I have sympathy for Mr. Cullen's observations as my sister-in-law also gave up her job to look after her parents and through my constituents I have encountered many of the problems he outlined. The carer's allowance has consistently improved since it was introduced many years ago and it would be a disaster were we to go backwards. I believe there would be support across the Houses for continuing to improve the benefits package for carers.

The Money Advice and Budgeting Service, MABS, will make a presentation to the committee at our next meeting. As Mr. Dillon noted, people are facing severe financial pressures and I am sure some are experiencing difficulties in repaying loans. Does the Carers Association maintain a relationship with MABS?

Mr. Seán Dillon

We operate 16 resource drop-in centres but because these are not sufficient to cover the entire country, we co-operate closely with local MABS, Citizens' Information and other services. We are conscious of the importance of collaborating with the agents of the State and charitable organisations in the provision of information. MABS plays a significant role in that regard and our managers on the ground often refer cases to its counsellors. Long may MABS and Citizens' Information continue for that reason.

Deputy Richard Bruton

I thank the witnesses for their submission, which in the context of the billions of euro that have been tossed around freely over the past several days brings the debate back to the reality of the choices available to us. I do not wish to reopen the debate on the budget but it is noticeable that the only savings made were on the public service pay and social welfare bills. A certain level of surprise was expressed that the burden was not shared more fairly.

As a Deputy who works in this city, I am conscious of the invisible cuts which have effectively frozen home care packages and made it more difficult to get home help. Special needs assistants are also being cut and since the middle of last July, Dublin City Council has ceased to offer grants towards home adaptations. These knock-on effects have not received the headlines they deserve.

Chairman

If Deputy Bruton will allow be to interrupt briefly, I propose that Deputy Grealish take the Chair in my absence. Is that agreed? Agreed.

Deputy Noel Grealish took the Chair.

Deputy Richard Bruton

Given that the Government has alluded to a public service spending framework which will involve further cuts, the challenge we all face is to find a way of protecting front-line services while making savings in the back office and administrative structures. That agenda will have to be reopened. It was addressed to a degree by the McCarthy report but while that report investigated savings in back office functions as well as welfare services, only the latter appear to have been implemented. If the savings are repeatedly made in the front line, services will inevitably be eroded.

I was struck by Mr. Cullen's point that an equity release scheme was introduced for nursing home care but there is nothing to support a more preventive policy that would keep people in their homes. It appears to be a feature of our health service that it reacts to acute crises but does not provide well for longer-term preventive measures. Crises leave us with little choice but to spend huge amounts of money.

The complexity of access is a recurring theme. People are confronted with an horrendous array of information, whether in regard to caring or children who get into difficulties. The State does not appear to offer a means of easy access to its services.

Mr. Cullen gave an important insight in this regard which perhaps should inform our policy making. We are a long distance from formulating the next budget but I value the report he provided, based on his immediate experience, of where we are falling short. I hope we can respond to these concerns as we develop public policy. At a time of shortages, any Government would face a huge challenge in responding to the needs of those who totally depend on the State.

Deputy Joan Burton

I welcome the delegation. Several members are under time pressures due to the need to attend other matters arising from yesterday's events pertaining to the banking industry and Quinn Insurance, in which regard we intend to raise Private Notice Questions in the Dáil.

I am in regular contact with Carers Association members in Dublin 15 and I commend it on its work. Having access to information and other people in a similar position can be extraordinarily helpful when somebody is in a caring situation. While the array of leaflets provided by the association in most of its centres is quite daunting, it is also invaluable.

I regularly encounter issues that arise from the lack of clarity on home care packages. If the committee is to bring recommendations to the Minister for Finance, this information gap should feature among them. Further clarity is needed in regard to applying for the package and the follow-up services available for the home. I have personal and political experience of the problems highlighted by Mr. Cullen in respect of hoists and other issues. The budgetary side of the Department of Finance scrutinises other Departments' expenditure but how can it ensure that when a big promise is made, such as on the home care package, they follow through in a meaningful way so that an elderly person can be reasonably confident of getting the supports he or she needs in the home within a reasonable timeframe? That is important. Now that older people are being brought from acute hospitals to step-down care facilities such as nursing homes for a short period of recuperation, there is time to work out what must be done at home.

The centralisation of the medical card process is another issue. In this regard, I have dealt with people whom I know personally rather than what Deputies often call clinic cases. Perhaps part of this is affected by the current industrial relations difficulties and it may be due to the HSE moving dramatically to a new system. It can be extremely chaotic and very disturbing for people over 75 years to fill in a form and then feel they must talk to somebody about it. It would be better for the HSE to engage in a six-month or 12-month medical card renewal process to sort out the new system rather than bringing suffering on carers and others. There are people who are trying to fill in forms for elderly persons without being sure of the different elements. The framework used could be much simpler.

I was associated with the development of the respite grant when I was Minister of State at the then Department of Social Welfare. It is paid to those caring for adults or children and is a positive and life-enhancing scheme for individuals and families providing care. It should remain a budgetary priority because those who provide care need a break, which is helpful both for the person being cared for and the carer.

I apologise to the committee but I must leave to make a statement on Quinn Insurance.

Acting Chairman (Deputy Noel Grealish)

We will hear replies to the questions put by the two Deputies. We will then call the Senators.

Mr. Seán Dillon

We appreciate the comments of Deputies Bruton and Burton on the role of family carers and our own role in delivering services. We agree that this is a difficult time and that the processing of applications across a plethora of services and methods seems to be getting slower and becoming harder. We are cognisant of the available home care packages which are very important in the delivery of services but they are also very difficult to get a handle on. Having a national presence, we find the position in Wexford could be very different from that in Sligo. How can we explain this in what should be a centralised policy on home care packages?

We are hopeful, on the back of last year's National Economic and Social Forum report and research from the Department of Health and Children, that the recommendations on the provision of home care packages will be followed through. When we met the HSE at corporate level recently, we reiterated the point that we were looking forward to seeing action to standardise the provision of information and the delivery of packages. It is the only area in which we saw an increase last year; some €130 million has been put aside for home care packages. We are curious to see if that will be reflected in additional services on the ground at the end of the year. We will keep a watching brief. We appreciate the support of Deputies in that regard.

Senator Feargal Quinn

I was unaware, to a very large extent, of the work being done and I thank the delegates for their contribution. My mother-in-law was 100 in November; therefore, I recognise the problems being encountered. She has been healthy and well but we are aware of the challenges being faced.

I did not understand two of the points made. It has been mentioned that the home-maker's scheme does not recognise time spent caring prior to 1994 and that this can result in significant gaps in social insurance records. Will the delegates explain that to me? It has also been mentioned that in 2009, 229 claims for carer's allowance were refused because of the habitual residency clause. I did not understand that point either.

Mr. Dillon mentioned the unsung heroes and the figures are significant. I am not sure that the persons concerned are unsung, as they are recognised by those close to them who praise them highly. In general, their work is not recognised, unless a person is close to what is happening.

Senator Dan Boyle

I will ask questions on the national carers' strategy which is a source of ongoing disappointment. My understanding was that the outgoing Minister had decided against its publication because she considered that publishing a document full of aspirations and not linked to resource commitments and a timetable to meet the real needs identified during the process of forming the strategy would not have been useful for carers. What are the views of the Carers Association? There is now a new Minister in the Department who may be open to reconsideration but it is important that when a strategy is published, it is resource-linked and that there is a commitment to provide additional resources in subsequent years within a defined timeframe.

I am also interested in the level of State support, or even local agency or local government support, that would be useful to the Carers Association. Everyone is aware of the need for a greater level of support for carers and knows about the valuable work being done by the association as an umbrella body for carers. In the Cork area I know the local branch organises a regular series of carers' forums, which have the dual purpose of bringing carers together to offer support to each other and informing public representatives of the ongoing needs of carers. I suspect that work is not well supported, financially or otherwise, by State agencies, although it would represent a good use of State resources. I would appreciate the views of the delegation in that regard.

The Carers Association is a body which provides support through the work of carers. Does it have a policy on squaring the circle? Invariably carers are tied to the people they care for and the households in which they live. There is a need to receive support, learn from the experience of others and receive training but such opportunities may be limited. How is the association addressing this problem?

Deputy Terence Flanagan

I thank the delegation for coming. I specifically thank Mr. Cullen for telling his story about caring for his mother. Such issues highlight the difficulties carers face on a daily basis and the matters which must be addressed by the Government in helping people such as Mr. Cullen in their work.

I have some questions on the carer's allowance and the numbers which reduced by 248 between 2008 and 2009. Why did that happen? Were people refused or did they stop being carers? It has been mentioned that 55,000 carers receive the respite care grant but how many do not receive it? Is the grant sufficient and has it increased in recent years? Does it cover a certain proportion of costs incurred?

It is a shame that the national carers' strategy has still not been published, especially considering the number of carers and the amount of money saved by the State because of their work. Carers are probably underselling themselves, as the lower rate is €14.28. It should probably be much higher. I have no doubt the State is saving more than €3 billion as a result of the work being done by carers.

Out of the five priorities, which are the top three? With all the wealth in the country over the past five years, has the situation improved? Given the current financial situation, things are obviously much tighter. Anyone who is a carer or needs help from the State should receive it no matter what and it should be a priority when it comes to finance. That should be taken into consideration. There should be no more reductions in the allowances and benefits paid to carers in the next budget.

Mr. Seán Dillon

I will answer Senator Boyle's question and Ms Duffy will answer the remaining questions. If we do not answer them sufficiently I ask the committee to revert to us.

On Senator Boyle's question on the carers' strategy, that was the interpretation given to us. The strategy was not published. Our counter-argument was that we fully recognised that parts of the strategy would require funding and we did not want a wishy-washy statement with regard to the strategy. However, there were components of the strategy that we felt were required. The vision was set out in 2008. We were talking about at least eight years and we are now talking of six years. It is still a relatively long period. Our argument at the time to counter the reason given not to publish it was that one does not have to front-load the spending at the start of the strategy. We proposed several measures which, using the current funding, could have been spent in what we thought were better areas and were revenue-neutral from the point of view of costs. We also pointed out that a strategy was not just about some of the key action points but also about enshrining the recognition of family carers by the State and saying that it was a group of people which it thought was important and this would be the road map. We argued that the State may not spend money on key measures with regard to the start of the road map but it would make a commitment to address these matters as the economic cycle improves within the next couple of years, as we have been led to believe. That is what we asked for, that is, to publish it and front-load it with the areas which we could address within the means we currently have, and push out the new spend towards the latter end. Carers felt that first and foremost they wanted recognition. That was why we were disappointed with the strategy. We request that the new Minister review the decision and we will make the same case again. We will again take a local approach. The committee will probably hear from us again but it is very important to the people we represent and we have to keep banging the drum on the issue.

On the point regarding Cork and the value of the forum, the provision of support groups across the country is one of our major services. Up to a couple of years ago people could not say who family carers were. The question was only recently included in the census. It has suddenly grown in people's minds. People look after their mothers, their daughters with special needs or their brothers and realise they are carers. As recognition grew so did the demand for people to talk about it. As Mr. Cullen said, people are often afraid to talk about it. It is like hammering one's head against the wall trying to look after a dear relative, but it is also very stressful. Support groups were recognised by our association more than ten years ago as an important mechanism for people to come together and achieve a sense of release. Everyone did not always release; we liked to vary the content of support groups where people came together.

Sometimes we briefed people on innocuous things such as art or television. Sometimes we discussed very serious issues such as caring in the home, feeding, personal hygiene or how to look after the person for whom one is caring. The people concerned were in a safe space. The support groups come at a cost and in the main we fund them ourselves. We fund-raise; we go out with buckets and do bits and pieces. In some places we get some funding from the HSE which recognises the value of the groups. It is a very important form of health care provision in terms of mental well-being. We see it as a very important part of the care provision for family carers.

The last question is very pertinent. By their very nature family carers are tied to the home. They cannot come out on the streets and protest or down tools. There is a huge demand for training family carers. They are the first call as a nurse or doctor. They administer medication, peg feed, change and dress wounds and lift and handle people in and out of showers and beds. Whether one has a health and safety certificate that still has to be done. We appreciate the Dormant Accounts Fund which has given us approximately €750,000 to train, it is hoped, some 10,000 carers across the country.

It is very important if a person stays at home to care for someone that he or she gets the respite needed. For that to happen, the family carer must get out of the home and the only way to do that is to put someone else in there. Respite care is a huge component of the services required. Generally speaking a carer needs two, three or four hours to come out of the home, go to a support group, go to the shop or on a course, and do all the little things we take for granted — and, in particular, to get training. We are a small organisation but we do our best. We try to provide respite to release people but it is never enough.

It is very important to recognise the need for adequate funding for respite care because people often picture it as the person cared for going into a hospital for a week to allow the carer some time off. However, it is not just that. It is about the two hours a day to get out of the house, get a cup of coffee, go to the library or buy a newspaper. When one is tied to full-time care, as many of us well know, one cannot do that. We need to release the carer to come out and do that. It is very important to us and I appreciate Senator Boyle's raising of the issue.

Ms Duffy will answer the other questions.

Ms Clare Duffy

On the question regarding the habitual residency clause, it was traditionally known as the two-year rule, that is, one had to be living in Ireland for two years prior to making a claim for a welfare payment. It has changed and there are now five factors on which one is assessed, one of which is one's time living in Ireland. Another is where one's centre of interest is. I cannot remember the other three, unfortunately. Within the past year there has been a huge increase in the number of applications for carer's allowance which have been refused because of the habitual residency clause. I spoke to a man in the Department of Social and Family Affairs in Longford who is responsible for looking at this area. He assured me the increase reflects the rise in the number of applications for welfare payments generally. It has increased threefold in one year.

With regard to pension entitlements for family carers and the home-maker's scheme, it is an area with which I am familiarising myself. The home-maker's scheme was established to make it easier for home-makers and carers to qualify for a contributory pension. It does not recognise time spent caring prior to 1994. The home-maker's scheme disregarded the number of years spent caring by up to 20 years. The new national pensions framework changed that and gives people credits for the years spent caring. It is quite a complicated system. Many submissions made to the pensions consultation raised the issue, along with the inability of women to qualify for a pension because of the marriage bar.

On the question regarding the reduction of 248 between 2008 and 2009 in the number of people in receipt of a carer's allowance, there is no explanation for that. Anecdotally, I have found it is becoming more and more difficult for carers to qualify for carer's allowance. The medical assessment criteria are becoming more difficult. One of the big issues with which I am currently dealing is overpayments where family carers have been deemed by the Department to have been overpaid in recent years. In one case a family in Tipperary have been asked to repay €86,763. When one is in receipt of a carer's allowance, one is allowed to work 15 hours per week. The lady in question worked as a home help and in some weeks she went over the 15 hours allocation. In some cases it was by just an hour a week but in other weeks it was two hours. Whenever her boss asked her to stay behind to do an extra hour, she did. Her case was reviewed back to 2001 and she was asked to repay more than €86,000. She has been in hospital since then.

In the context of the reduction of approximately 248 people in receipt of the carer's allowance, it is becoming more difficult to get a carer's allowance and the Department is reviewing cases where people are in receipt of the payment. In many cases the allowance is being taken away from people. What was Deputy Flanagan's question about the respite care grant?

Deputy Terence Flanagan

One of my questions was whether the grant was sufficient. What are the grounds for refusal in cases where people are refused the grant? Have the criteria changed for that as well?

Ms Clare Duffy

In response to the first question on whether the grant is sufficient, it is a payment of €1,700 per year. We were happy that it was not affected in the budget but I understand that there was a commitment in the programme for Government that it would be increased to €3,000 per year. Not every carer gets the respite care grant. It is not means tested but one must satisfy a number of qualifying conditions in order to get it. Carers who work more than 15 hours a week do not qualify for the respite care grant.

Acting Chairman

All of the questions have been answered. I thank the Carers Association for its excellent presentation. I thank Mr. Martin Cullen, Mr. Sean Dillon and Ms Clare Duffy. I am delighted to see Mr. Frank Lahiffe back in the House again. He was a great help to us in the past. Many issues were raised. We all acknowledge the work done by carers. It is a proven fact that people cared for at home live longer. We will try to address the issues raised.

Sitting suspended at 3.13 p.m. and resumed at 3.15 p.m.