I welcome the following from the Carers Association: Mr. Enda Egan, chief executive officer; Mr. Frank Goodwin, chairperson; Mr. Frank Lahiffe, advocacy researcher; Ms Clare Duffy, social policy officer; and Mr. Tom Curran, Mr. Martin Cullen and Ms Susan Byrne, family carers. I extend a warm welcome to our guests. I state the obvious in pointing out that I am not Deputy Jackie Healy-Rae, the Chairman of the joint committee who, unfortunately, has other commitments.
Post-Budget Analysis: Discussion with Carers Association of Ireland.
Where is the Chairman?
He informed me he had another engagement and asked me to take the Chair.
Again.
Before Mr. Egan commences his presentation, I draw attention to the fact that members of the committee have absolute privilege but the same privilege does not apply to witnesses appearing before the committee. Members are reminded of the long-standing parliamentary practice to the effect that they should not comment on, criticise or make charges against a person outside the House or an official by name or in such a way as to make him or her identifiable.
It is understood a division will take place on the Order of Business, at which point it will be necessary to suspend proceedings. I invite Mr. Egan to make his presentation after which members will contribute and ask questions.
Mr. Enda Egan
I thank the joint committee for inviting representatives of the Carers Association to appear before it. It is important that we have an opportunity to come before it to discuss the effects of the budget on our members, family carers across the country.
I shall quickly go through the key social welfare items we looked for in last year's budget and say what actually happened. Then I shall call on Mr. Martin Cullen, Mr. Tom Curran and Ms Susan Byrne, who are family carers, and they can tell the committee how budget 2010 has affected them, their families and the persons they care for. That is a brief outline of how we intend to make the presentation.
I take this opportunity to thank the committee for its support pre-budget 2010, in terms of lobbying the Minister and other key members of the Government. That support has been very helpful and we hope to continue to enjoy it in the future. Most people here, it is fair to say, have a fairly good idea of what caring is about, but it is nonetheless important to give a brief overview. I shall start by stating that caring is not an issue which discriminates on racial grounds. It does not discriminate against colour, rich or poor, man or woman, child or adult. It takes place right across the life cycle and is relevant for all socio-economic groups. Obviously there may be differences as to how the caring situation manifests itself across the different socio-economic groups, but it is well recognised that everybody will at some time be faced with a decision in terms of either caring for somebody or being cared for. It is also well recognised that everybody would prefer to be cared for in his or her own home.
There are 161,000 family carers in Ireland, of which just over 40,000 are full-time, according to the last census of population. It should be noted, too, that there are approximately 39,000 nurses in Ireland. That is 39,000 who wear uniforms, work in hospitals and are easily identifiable around the country. Family carers tend to be a forgotten group and are not easily identified. They tend to find it difficult because of their caring role to get outside the house. Our carers can explain to the committee later that the effort involved in coming to an event such as today's requires a considerable military style operation and entails many jigsaw pieces being put in place.
On a full-time basis there are more than 40,000 family carers in Ireland. We estimate that carers save the State about €2.5 billion per year, when one considers the amount of hours they work, equivalent to about 3 million per week. It is worth repeating that some 3 million hours per week are chalked up by carers in the social economy, propping up the health services. That means we have a group of people numerically greater than the number of nurses working in the health services.
I shall briefly address the issues as regards budget 2010, dealing with the various initiatives we asked the Government to implement and what happened in the event. I shall start with the half-rate allowance. Prior to budget 2010 our number one priority was to ensure the half-rate carer's allowance was not removed. This allowance needs no explaining in the present forum. It is, as the committee knows, a payment to a carer who is providing full-time care and attention, but who is also in receipt of another social welfare payment. It was introduced by the late Deputy Seamus Brennan when he was Minister for Social and Family Affairs to give recognition to the fact that such people were providing care. The half-rate was about €110 prior to the last budget. Our major concern was that it was going to be removed. The present Minister, Deputy Mary Hanafin, is on record in the Sunday Business Post last February as saying the half-rate allowance was something that would be seriously considered for removal. There are about 18,000 members of our organisation in receipt of the half-rate carer’s allowance. Had it been removed from those people, it would have meant absolute devastation.
I am sure it would have been easy for the Government to consider its phasing out for new applicants. In other words, it would have been easy to stop the allowance from being available to new applicants post-budget 2010. We were delighted the Minister for Finance took the decision to leave it in place, while obviously we are disappointed that there was a mandatory 3.9% cut in the allowance. Nonetheless, the fact the half-rate allowance was kept is very important, because its removal would have created a two-tier system. Some people would have ended up getting the half-rate allowance while anybody who became a carer a day or two after the budget might not have been entitled to it. That would have made a mockery of the principle behind the introduction of the half-rate carer's allowance.
We also asked the Government to safeguard family carers from the proposed social welfare cuts in the budget and were very disappointed this did not happen. While we were quite pleased the Government protected those over 66, we believed that people on disability payments and family carers should have been included in that category, in effect. It should have applied to carers from our viewpoint, given the number of hours they work per week propping up an ailing health service, along with the fact that they save the State in excess of €2.5 billion per annum.
The cuts outline the significant impact on the carer's allowance, which in 2009 was €220 per week. It has dropped to €212, an annual reduction of about €442 per annum for anybody in receipt of that allowance. This might not appear to be a great deal of money per year, but when one examines individual incomes, one tends to find that the family carer is looking after somebody who is probably on a disability payment, for example, and this will also have been cut. The cumulative effect is something we are very concerned about. People in receipt of a medical card, for example, have to pay into the drug prescription scheme and the family carers with us can give the committee greater detail as to how this affects them. Cumulatively, when all the cuts are aggregated, it can be seen that very often family carers are losing between €800 and €1,000 per annum as a result. That is a considerable amount of money for a family completely dependent on social welfare and for whom there is no other way of supplementing its income.
On top of this there was the removal of the Christmas bonus which was flagged in the previous budget, in April 2009, equivalent to about 2% or one week's payment per year, another €220 taken away. When all this is added up, it equates to €800 to €1,000 per year being taken from family income, and this is significant.
The Government tried to sell the idea of cutting social welfare payments on the basis of a deflation figure of about 6.5%. Most people would be familiar with "The poor can't pay" campaign, which was run by a number of voluntary organisations. Research done by the campaigners showed quite clearly that the true deflation figure for families predominantly on social welfare was around 2.2% and not 6.5%, which the Government tended to reiterate constantly when it was trying to cut social welfare payments. It is important to appreciate that the 6.5% figure was not relevant for families who do not generally have high mortgages. That higher figure was mainly driven off decreases that were taking place in mortgage repayments – for those who were not on fixed mortgages – while many families on social welfare could be living in public housing and therefore would not be paying mortgages. Therefore "The poor can't pay campaign" argued that instead of being 6.5% the actual decrease was 2.2%.
A major issue for us in the carers association and for family carers is the national carers' strategy. We were quite adamant with two Administrations that the carers' strategy should be put in place, while being aware that the various upheavals in the economy have put the Government into a position whereby it has to find savings. The view of the Minister, Deputy Hanafin, was to the effect that if the national carers' strategy was adopted, it would need to have very clearly outlined key performance indicators, KPIs, in terms of how it could be measured. Key services would have to be plugged into that document. Due to the downturn in the economy, the Government felt it did not have the resources to deliver on new services for family carers.
We see this document as a roadmap. It needs to outline clearly a vision on how family carers should be treated over a period of time. That period of time was the duration of the national agreement, which runs until 2016. Our position has always been that the Government should go ahead and publish that strategy, but come out clearly and state that when economic, social or political indicators are back where they should be, the strategy will then be implemented.
The budget did nothing for the strategy. We are very disappointed with that and if the Government is serious about recognising carers and the role they play in society for our health service, it would put a strategy in place. If one was a CEO of a commercial company but did not have a vision for that company and did not outline where one was to drive services in the future, then one would be put on the CEO scrap heap by the board. In other walks of life we would not get away with this approach.
We should move towards a system where carers are properly recognised for the work they are doing, and they should be on a rate of pay that is analogous to the market rate for similar work. However, we believe that it should start off at the minimum wage. People are realistic that the Government will not introduce a rate of pay tomorrow, but a number of things should happen here. A clear statement should be made that the income disregard should not be applied across the family. The income disregard on the carer's allowance should only be applied to the carer's income. Many carers tell us how demeaning and disrespectful of their position it is to have a means test across the family. We often find scenarios involving a married couple in which the wife is looking after her mother-in-law and her husband's wage is at a level where she does not qualify for the carer's allowance. She may have given up work to take up that position, yet she still does not get the allowance. Everybody will agree this is an unfair position, especially when somebody forgoes an income of her own. Our position is clear. The Government should put the income disregard on to the carer's income only, immediately introduce the minimum wage as the rate for the carer's allowance and over a period of time, move to the rate for the job in that position.
Department officials and Ministers often state it is difficult to do things without having huge resources, but there are some things that do not need such resources. For example, a carer is able to work or study 15 hours per week and still claim the carer's allowance. That is welcome and it has moved from 12 to 15 hours in the last couple of years. However, there are anomalies, such as a carer with a teaching qualification who is looking after a child with special needs may be able to teach a number of hours per week. On a given week, the person might work for 18 to 20 hours, but across the year that might balance out at less than 15 hours. The Department does not take a common sense approach to this. The Government should introduce a system whereby a common sense approach is taken and those hours are added up across the entire year, rather than looking at them week by week. When the whole year is added up, some people are working less than 15 hours per week but they might be working more than that for certain weeks of the year. That is a common sense approach. The Government should also increase the 15 hours per week that carers can work to 19.5 hours. This would allow them to take up positions in community employment and so on.
Another important trend we have noticed in the last few years is the number of people who return from the US or the UK to care for an elderly parent at home. This trend is increasing all the time and it will only get bigger. Everybody is aware that the number of older people will grow from just over 450,000 at the moment to about 1.4 million in the next 20 years. Many people left Ireland in the 1970s and 1980s to go abroad and work, and they are coming home now to provide care. They cannot get carer's allowance because of the habitual residency clause. We feel this should be examined again and that it should have been examined under the carers' strategy. It is a medium-term planning issue that unfortunately was not dealt with. According to The Irish Times, there has been a 75% increase in the number of people turned down for social welfare payments in respect of the habitual residency clause. Perhaps the committee might examine this issue.
Respite is a key issue for carers. If one was to stop a carer in the street, there would be two main topics to talk about, namely, income and respite. People need a break from their caring role and just to have a life. The respite grant is something that was extremely important within that. We were fearful that the respite grant would have been taken away prior to the last budget, but we are quite pleased this has not happened, even though it has not been increased. Carers work around the clock and work hours and conditions that would not be allowed in paid employment. We feel that the respite grant could be increased to around €3,000, which would allow the carer to take off the statutory number of days and buy care to fill in for his or her position. It is not unreasonable to request the statutory 21 days leave per year, and carers are no different than any other employee.
We are very concerned about how carers will be able to continue providing care, especially those who are relying on things such as the carer's allowance, the carer's benefit and so on. Carers also depend on things such as child benefit and the qualifying adult allowance. The Christmas bonus is gone, while there is now a carbon tax, prescription charges on the medical card, the drugs payment scheme and so on. When all these were added together, our major concern coming into the last budget was what was referred to in the McCarthy report as the cumulative effect. In other words, officials from the Department of Social and Family Affairs might examine an individual's case and be satisfied that his or her benefits were cut by 3.9%. However, there is also the carbon tax, prescription charges in health, cuts in home help hours and so on. Members are probably well aware of the cuts in home help hours, while the home help service cannot even be obtained in Cork at the moment. We have heard stories where people had their home help hours cut from two hours to 15 minutes. One would hardly say "hello" to a person and shake hands in 15 minutes. Home help is invaluable, but when it is cut down to half an hour per day, it becomes useless. When all these issues are taken into account, we see that the cumulative effect on carers has probably been greater than on any other group in this budget. We would be very concerned about that.
It would be great if the Government clearly acknowledged the fragility of our health system and how much more fragile it would be if family carers were taken out of the equation and the State had to take on their role. People might say that this does not always stack up in practice, and there may be an element of truth in that. Some people might go into nursing homes and so forth, but by and large somebody has to do it. There are 40,000 full-time carers, so somebody or some organisation would have to take over their role. Carers will not be able to keep doing this continuously. The Royal College of Physicians carried out a piece of detailed research which we hope to present to the committee on health later in the year. It clearly shows that carers suffer with mental health problems and other issues related to their well being on account of the stresses and strains imposed by their role, including the fact that they are unable to get out of their house.
Budget 2010 was announced on 9 December and the pre-budget campaigns for budget 2011 began on 10 December. All the issues which arose in budget 2010 are automatically key issues for budget 2011, when I assume the Government will have to find another €4 billion from a smaller menu than that for budget 2010. It is important that this committee and other Deputies and Senators are clued into the fact that carers' issues have not gone away. We might not have been hit as hard as expected in budget 2010 but the issue is still alive. Carers are givers in society, not takers, and that needs to be reflected in budgets and in Government policy.
If possible, I will hand over to the three carers present, who want to talk briefly about how budget 2010 has affected them.
My advice is that we should take some contributions and incorporate the carers into the question and answer session. I will invite the two spokespersons to make brief contributions. I apologise for the absence of Deputy Olwyn Enright, for whom Deputy Seymour Crawford will substitute.
I apologise in advance but I must leave to attend the meeting of the Joint Committee on Justice, Equality, Defence and Women's Rights at 12 noon because I asked for the topic which is being discussed to be raised.
I must go to a launch of the report of another committee at 12.15 p.m. If there is a vote I will not be able to return to this meeting.
I welcome the group and appreciate its frankness and honesty about this major issue. I welcome the fact that some of the suggestions for the last budget were not brought in, in particular the removal of the half-rate carer's allowance. That is an extremely important issue. I tried to bring the allowance in ten years ago and would not like to see it being taken away.
The number of hours carers work is fantastic but a number of issues are creeping in that not everybody will be aware of. The health of the patient who is cared for is being questioned much more than it used to be and very genuine cases are turned down in a way that is impossible to understand. It is a means of curtailing the amount of carer's allowance.
Another issue is the question of whether a person is in receipt of full-time care. I know of a 94-year old who is taken out of bed in the morning. The fire is lit and everything is done for him. His lunch is brought to him at the usual time and at the end of the day he receives his supper and is put to bed. His shopping is done as necessary and he is brought to town once a fortnight. This happens for seven days a week but the inspector has decided it is not to be classified as full-time care. The person caring for him is not employed for ten or 15 hours but is a full-time housewife who is caring for a 94-year old man. He used to get two hours' home care per week, one hour on a Monday and one on a Friday, but this has now been cut to half an hour on each day. There are serious problems that are being initiated through the back door.
I support the stance of the guests on the respite grant but respite care is even more important. The number of people able to get respite care is diminishing but if a person can be put into a proper nursing home for even one or two weeks it is extremely beneficial to the carer. I am also worried about the costs of the carbon tax, and heating oil will increase as a result of the budget. The drugs payment scheme will also have to be taken into account and there will be a significant cutback in income for these people.
I and my colleagues in Fine Gael will follow up the issues raised by the delegates and will do our best to ensure that the allowances currently available are maintained and increased. It is important to ensure a level playing pitch and that we recognise the hidden factors, such as the fact that a person can carry out a medical assessment even though he or she has not seen a patient and can ignore a doctor's letter to say a person is not eligible for a carer or to be regarded as being in full-time care. Let the inspectors in question explain what "full-time" care means and clarify matters such as whether a person has to sleep in the same bed as the patient all the time. Can carers sleep in their own house but still provide seven days' care or will this mean they will be determined as not giving full-time care?
I welcome the group and thank Mr. Egan for his presentation. I will keep my comments short because I would prefer to listen to the carers tell of their experience. The final point made by Mr. Egan, that carers are givers and not takers, is probably the most important. It is critical that we continue to drive that message home because the present climate, whipped up in certain quarters, is very much anti-social welfare recipients. The valuable work by carers throughout the country saves the State billions of euros.
I wonder if research could be carried out on the cumulative effect of the cuts in the last budget. The Government claims that the cuts reflect the reduction in the consumer price index, CPI, but one cannot use the CPI alone and we must be more selective about the costs we examine to identify the charges which are specific to carers. Carers often do not have the same mobility to shop around for bargains and do not have the freedom to try out different supermarkets. The Poor Can't Pay campaign highlighted this issue to a certain extent but some further work could be done to come up with actual figures.
Another issue is the cumulative effect on carers and people being cared for of the increases in the cost of health services generally, including prescriptions, the increase in the drugs refund threshold, reduced optical and dental benefits and so on. Again, we must put figures on those factors. It is all very well for the Minister to claim such changes are in keeping with reductions in the consumer price index, but when one drills down there is a strong case to be made on the basis of those figures. I do not know whether the delegates have the capacity to obtain those specifics but it is an exercise that must be undertaken.
An issue often raised by carers is the cost of caring, an issue to which the delegates referred. We must obtain those figures too, including the additional heating and other utility costs and so on. There is a view abroad that if a person is in receipt of a social welfare allowance and another half payment on top of it, then he or she must be well off. The McCarthy report put the message across that nobody should receive more than one payment. That is a simplistic view. We must be able to provide the figures to defend existing entitlements and to make the case that the current treatment of carers is inadequate. In most cases, the half-rate carer's allowance is absolutely necessary to meet the additional cost of caring, including expenses related to heating, special foods, additional aids and so on.
The committee certainly supports the point made by the delegates that even if it is not possible to implement the national carer's strategy in full, we should at least have a strategy and a target for the future. Do the delegates meet departmental officials on a regular basis and what type of hearing do they get on this matter?
I may not be able to return after the vote but perhaps the delegates could get back to the committee with specific information on the difficulties carers encounter as a consequence of the habitual residence clause. When we have raised that issue with the Minister she has assured us there is no issue in the case of people returning to Ireland to care for elderly relatives. If the delegates claim the opposite it is essential that they provide us with the details. It is an important issue and one we would like to pursue.
Will the Vice Chairman allow me to make a few points from the other perspective?
I would like to facilitate the Deputy but it takes me a few minutes longer than it takes him to reach the Chamber.
I will be brief. The Labour Party has told public sector workers for several months that everybody hates them. Now they are saying that social welfare recipients are also the subjects of the public's ire. The party must get out of that mind set. The Fianna Fáil Party is proud to have introduced the half-rate carer's payment and we are committed to retaining it. We have maintained it under pressure from the McCarthy report and other sources. My colleague, Deputy Mattie McGrath and I have been to the fore in ensuring it is maintained.
I agree that more could be done to ensure the habitual residence clause does not pose a problem for people returning to Ireland to care for relatives. That is an achievable and concrete proposal. While I am of the view that in certain circumstances there is an argument to make the clause more stringent, I accept that it should not pose an obstacle in this instance. We have said all along that it should not be an issue. I join Deputy Shortall in asking the delegates to outline the issues that arise and to offer examples of how the provision is preventing people from qualifying for the carer's allowance.
Organisations such as the Carers Association have a responsibility to be realistic in their demands. Yesterday the Government borrowed €1.5 billion, the equivalent to the social welfare budget for one month. Ministers are awake at night worrying about those realities. The policies the Government has implemented are necessary so that we can make those borrowings and so we do not arrive at the beginning of the month to find, like the Greek Government, that those payments cannot be made. However much we dislike the cuts in expenditure, they have been absolutely necessary in ensuring the entire system does not collapse.
The Government had choices; it did not have to reduce welfare rates.
We made good choices.
That is Deputy Byrne's opinion.
I apologise to the visitors but we must suspend the sitting until after the Dáil vote. We will return as quickly as possible.
Sitting suspended at 11.55 a.m. and resumed at 12.10 p.m.
I apologise to the witnesses for the manner in which the day has developed. They will understand that we had no control over that. As George Bernard Shaw used to say, that is democracy. I invite Mr. Egan to introduce his colleagues prior to them making their contributions.
Mr. Enda Egan
I wish to introduce Mr. Tom Curran, Mr. Martin Cullen and Ms Susan Byrne, who are carers. They will speak in that order.
Mr. Tom Curran
I am a full-time carer and have been for approximately ten years. I look after my partner who is in an advanced stage of MS, which means that the caring is full-time. She is very high-dependency in that she is wheelchair-bound and none of her limbs work. That means she has to be fed. She has a supra-pubic catheter and has very little control over her bowels. It is a full-time job that requires working at night as well as during the day.
The total income to our house is the carer's allowance plus disability benefit, both of which were hit. One of the difficulties with Marie is that she requires constant heat. She is cold all the time, so even in the summer we have the heat on in the house. The carbon tax has affected us dramatically. Given her condition, we also have to have our own transport. We have modified transport to allow the wheelchair to go into it, which means that we have to pay for our own fuel. It is impossible to use public transport. Again, the carbon tax hits us in that regard.
I accept it is not within the committee's remit but, by definition, carers look after people with disability or illness. Therefore, we have medical costs. By definition, the prescription charges will hit us. All of those subtle things affect us, apart from the fact that home help has dramatically decreased. When the people who provide help to us go on holidays or are sick they are not replaced. It is impossible to plan around that for me to do the shopping or anything else that is needed. All in all, this year things have taken a dramatic turn for the worse and it does not look as if they will get any better.
Mr. Martin Cullen
I look after my mother, Margaret. She is 87 years of age. She has had a stroke and she has Parkinson's disease. Like Mr. Curran's partner, my mother is in an advanced stage of Parkinson's disease. She also suffers from depression so one has to continually keep her stimulated through the day. In effect, I try to create a sort of Disneyland situation and keep her happy because of her depression. With the cutbacks that have been made I often do not have the help I need to wash her. The agency that sends people out is affected by cutbacks and one or two people have been let go. The people who help me are often delayed because they are looking after other patients and I end up doing the whole job myself which is very difficult at times.
One does it because one loves the person. One does the best one can but the budget cuts have made inroads in that one is just robbing Peter to pay Paul in terms of trying to scrimp and save to do everything and keep everything on the table. When one is looking after someone who is high-dependency, one does not need any extra pressures. One has to look after such a person at night time if he or she is depressed. Often I do not get enough sleep because my mother calls me during the night and I have to put her on the commode or just sit with her and keep her as happy as possible.
As much as carers are grateful for everything that has been given to us in terms of the respite care grant and everything else, we do not get the necessary support from the State, in that when one is looking after someone who is deteriorating before one's eyes, it is very draining emotionally. That weighs very heavily on one because one is trying to do the best job one can for that person and to preserve them because they are the history of who one is. They are one's whole life. It is very taxing all the time.
Members will say I am being parochial if I say Ms Byrne is particularly welcome.
Ms Susan Byrne
I look after my two special needs daughters, one is 15 and the other is nearly 14. I never received any carer's allowance for nearly 14 years because my husband is in full-time employment and we were above the limit when means tested. His wages have fallen 50% in the past 18 months so now we qualify, but not for the full rate. Given that I am classified by the mental health services and health officials as being a good parent, I get no help whatsoever. I have to do it myself. If one is seen to be able to cope and to be a good parent, people step back. They only give help to those who, in their eyes, are in dire need.
We also have two family members with special dietary requirements. They are coeliac. The cost of living has not gone down for us. Each person gets through two little loaves of bread a week, which amounts to four in total. The cost of those four loaves is nearly €20. One can pick up an ordinary loaf of bread for 59 cent. Our mortgage has not gone down. We are tied into a five-year mortgage that costs nearly €2,000 a month. The cost of living has not gone down for us. I do not accept that argument.
I am in receipt of domiciliary care allowance for my girls because they are both under 16, child benefit and partial carer's allowance. We also have to pay for the drugs payment scheme because we do not qualify for a medical card. I have worked it out that we are down €28.43 a week. Given that four loaves of bread cost us €20 that is a lot of money to be down.
I thank Mr. Curran, Mr. Cullen and Ms Byrne. I agree that it is useful for carers to share their experiences with us. Without being patronising, I applaud those efforts. It is good that the witnesses have come before the committee to tell us their story. That is important for the committee. There is a lot of talk about politics but in this committee, apart from minor spats between the parties, all of us work together. We have listened to the groups and we believe it is important that we would engage with those who wish to raise social welfare issues. We will continue to do that.
I will be brief because like me some members have other committees to attend such as the Joint Committee on Agriculture, Fisheries and Food. It was disingenuous of a Deputy on this side of the House to ask where the Chairman was. I just met him. He has a deputation today. We often have deputations with Ministers and other business goes on, as we know. It is not very fair to question where he is. To make it worse, I was wondering whether she had no confidence in the Vice Chairman. I have full confidence in him.
Members
So have we.
They should write that down quickly.
It is on the record. I welcome Mr. Egan and his group this morning, especially the family carers, including Mr. Martin Cullen. I empathise with him because my mother is 87. There were nine of us in the family with seven of us still alive. I do one night a week and it is very difficult and challenging. I cannot imagine how he can do it 24 hours a day seven days a week. I appreciate him sharing his views with us. As my colleague, Deputy Thomas Byrne, and the Vice Chairman said earlier, we lobbied very hard to keep many of the things we kept, including the half-carer's allowance. However, we are in a very difficult budgetary situation. It is good to understand the impact it is having on the ground. From the contribution by the delegation the impact it is having is clear and it is the cumulative effect of all the different small things.
I want to take up the issue of the 75% refusals over the habitual residency. That is a big issue into which we must try to cut our teeth as it is causing considerable trouble. I am delighted to be here and to work closely with members of the delegation. I work with their colleague in south Tipperary, Councillor Richie Molloy, who manages the carers' association there. I have heard first hand from him the challenges he meets every day trying to do more with less and it is not easy.
I thank the delegates for their presentation. I am very sorry that I missed what Mr. Curran had to say when I had to go to vote in the Seanad. I heard Mr. Egan say that without a roadmap it is very hard to achieve. I would consider it somewhat naïve to believe that just by having a strategy the association would achieve all it hopes to achieve. He outlined his hopes that the social and political indicators would improve. I do not share his optimism — I commend him on being optimistic. I do not believe the Government is serious. It does not recognise that many carers if not most are spending time caring for people in their homes as there are nurses employed in the HSE. If it did recognise this, it would not cut the carer's allowance by €450 per year, which is a considerable amount for a person on a tight budget. Ms Byrne pointed out how much a loaf of bread for a coeliac sufferer costs. I am only too well aware of this in my constituency. That amount is equivalent to a fill of oil, or it means being short of food for the table or briquettes for the fire. Carers are being affected by the prescription charges and the increase in the drug payments ceiling not to mention that, as Ms Byrne said, the cost of living has not come down for those who are trying to make ends meet and put food on the table, etc.
I accept that the half-rate carer's allowance was left intact, but there is still a reduction of €221 a year plus the loss of the Christmas bonus, which is a considerable amount of money. The poor should not need to pay for the sins, mistakes and abject waste of the Government. I am sorry that the 161,000 people who are saving the State so much money by allowing people the dignity and respect to be able to live comfortably in their homes are not recognised by the Government. There needs to be a wake-up call about the value of carers and to realise how important carers are to the country.
One of the delegates said that people should be assessed on a yearly basis rather than a weekly basis and on a 19.5-hour week rather than on a 15-hour week. I am sorry to say I believe this will not happen because these people have not been acknowledged. I have the same issue in my constituency. I recently met a lady who is caring full time for two elderly aunts. She does not sleep in the house because she has to go home and care for her family, and she has been refused the carer's allowance. One of the ladies has Alzheimer's disease and the other lady has terminal cancer. Although she is caring for these two around the clock she has been refused the carer's allowance, which is a scandal. She goes to their home at 1 a.m. because one of the ladies does not like to go to bed early. She puts her to bed at that hour and is back up at 7 a.m. She does all the washing, cooking and house cleaning. She does everything. The Government does not recognise her at all; she is getting nothing. A Vision for Change is my example of aspirational documents that are left to gather dust and I believe a carers' strategy would be exactly the same. The only way for members of the association to effect change is by lobbying Government Deputies in their constituencies.
First, it is very hard to sit here and not be angry. Deputy Thomas Byrne spoke about the €1.5 billion that needs to be borrowed. I do not know what relevance that has to the delegation being here today; it is a different issue altogether. Nobody should try to lay that on the doorstep of anybody else.
Having experienced what it is like to have a member of the family — my mother — cared for, I see it in a different light. I understand where the delegation is coming from and what it seeks, and I agree with all its points. I want to talk about who cared for the carer at the end of the day. I have seen a major change in my and my brother's family life since my mother passed away last year. Like Mr. Cullen, Ms Byrne and Mr. Curran, he spent the past five years of his life caring for my mother 24 hours a day seven days a week and basically doing everything. He slept on a chair beside her bed. He eventually had to bring his own bed into the room and sleep beside her because she started getting out of bed, falling and doing other crazy things during the night. I can now reflect on how it has changed his life since she passed away. There is a feeling of being lost and not having a daily routine as it was.
When my mother became sick at first one of the big issues was the need to change the bath. The delay in processing an application for a bath or shower was eight or nine months and she could not wait that length of time. It was a cost the family had to bear. As things progressed little things mounted up. There was the extra running of the car and its extra maintenance. On two occasions my brother had to change the bedroom floor covering completely at his own cost. He had to buy a new bed. He recently had to buy a new dryer and washing machine. It was not for his washing but for the amount of washing my mother generated when she was alive. Carers incur extra costs above the money that is given to them which, as Mr. Curran said, is absorbed in fuel and food, including special kinds of food. It comes down to practicalities such as buying a liquidiser so that all my mother's food could be liquidised. These are things one does not think of until one sees it happening.
I am angry that siblings and children who care for their loved ones are not being acknowledged in that when the person cared for dies the carer's entire life is turned upside down again and there is nothing for him or her to fall back on. There is no proper payment even for six months or a year just to help those people regain some kind of place in society and return to some kind of normal life. That is the hardest part of it. Losing the Christmas bonus was a huge loss to my brother just after burying my mother. He has not worked for a number of years due to another disability but that little extra bit at Christmas made a huge difference to him and to others as well.
Today, we are here to listen. We have listened. It is difficult for an Opposition Deputy to overturn Government decisions on the carer's allowance, the fuel allowance or the reduction in the blind pension. We left this meeting to vote in the Chamber. We lost the vote. It is the same in the Seanad. Every time we vote, we lose. It should not come to a vote on whether people have the right to get on with the lives and mind the people they love. Carers are saving this country probably billions every year. I do not have the facts and figures. Carers offer those they love and care for the chance to live out the last weeks, months or years of their lives with dignity and respect. Decisions on such issues should not come down to the action of pushing a button. It takes away from what society is about and how we, as Christian people, should act.
It is not right that we expect carers to devote themselves to family members 24 hours a day, seven days a week and for them to become merely a statistic when that person has passed on. Carers are left to their own means with nowhere to turn. There is no welfare nurse to knock on one's door and ask how one is getting on six months after the death of a loved one. Carers are left to deal with things by themselves. We have failed them not only in terms of pay, but in how we care for them after they have given as much as ten years of their lives to caring for others. The State should be ashamed of that.
I do not have any answers for Mr. Egan. I agree with everything he said. People, especially carers, should be more than statistics. They are human beings and when they have cared for someone who passes on, they should be provided with links and help to cope with their change in circumstances. I am saying the wrong words. People should be facilitated to get on with their lives and to restore some normality. We do not do anything to facilitate carers. We should provide respect for carers and introduce some of the measures raised by Mr. Egan, especially in terms of PRSI contributions. I spoke to Deputy Crawford on the way to the Dáil Chamber about something I have great difficulty pronouncing.
Habitual residency.
Habitual residency.
I thank Deputy Catherine Byrne. She might find out some day that being a Government backbencher is not that easy either.
I concur with the Vice Chairman. I fully understand and sympathise with Deputy Catherine Byrne, especially on her loss. We are all in the same situation. We would love to be able to do more but, unfortunately, we cannot. Deputy Byrne, like me, is a new backbencher. We are as frustrated as she is. We fully understand the case made by the carers.
Without being patronising, I confirm my support for the work of the Carers Association. Senator McFadden made a point about lobbying. I am always available for lobbying. I pay tribute to Mr. Egan's colleague, Ms Cathy White, who is based in Clondalkin. I would be just as happy if the office was in Tallaght. In fairness to her, she keeps in touch with us in a meaningful way. I and other colleagues are always happy to respond to her calls. I will genuinely continue to do that. Like other colleagues, this is something I feel very strongly about. I said to some of Mr. Egan's colleagues previously that just like Deputy Catherine Byrne and others, I had a family experience of caring involving my father, who is now 14 years deceased. That was a difficult situation. It can be useful to bring one's family and personal experience to politics. I want to do that. I wish the Carers Association well. I genuinely mean that. I invite Mr. Egan to sum up. I am happy to facilitate a contribution by any of his colleagues.
Mr. Enda Egan
I will pass over to my colleague, Ms Duffy, who wishes to make a contribution.
Ms Clare Duffy
I wish to clarify something on the issue of the habitual residency clause because it was raised a few times. I am working from memory but I will check the figures after the meeting. A total of 54 carers were refused a welfare payment because of the habitual residency clause. That was over a three-year period. I take on board what people have said. I will examine the matter further to find out the reasons behind those decisions.
Would it be possible to share that information with the committee? Members on all sides of the House take issue with that clause. It is raised in my clinics fairly regularly. It would be helpful if Ms Duffy could correspond with us through the secretariat.
Ms Clare Duffy
A second point is that carers are experiencing delays of up to four months when they apply for a care-related payment.
It is Government policy to care for the elderly in their own homes for as long as possible, yet many of the decisions and emerging policies are at odds with that. I refer specifically to the HSE service plan for 2010, the aim of which is to try to reduce the number of patients in hospital, decrease the length of hospital stay and focus on community care. There is an inherent assumption that carers will be available to pick up that slack and to do that work. If we do not have the services and supports in place for carers, it is questionable whether we will have the carers available in the future to provide the requisite care.
Mr. Enda Egan
I thank the committee again for the individual support expressed by members. Each committee member has given great support to our organisation and to carers locally in his or her constituency. I thank members for that and I look forward to their continuing support.
It is fair to say that right now in every street, village and town around the country carers have probably got the person who they are caring for out of bed and fed and washed. They might be preparing dinner. That is the reality. They might not see anyone until the weekend, if they are lucky. Full-time carers probably will not be able to leave the house, unless they have someone to cover for them.
Deputy Catherine Byrne is correct. What is wrong in this country is our value system, how we put a value on people and, in this case, on the work they do. Mr. Cullen, Ms Byrne and Mr. Curran outlined the difficulties involved in leaving the house to attend a meeting such as this one, or to any other event. As a result of that, advantage is taken of carers. We cannot have "blue flu" days. We cannot drive tractors down the main streets and cause a big furore, make the "Six One" news, the news at nine o'clock and tomorrow's newspapers. As a result, carers are held over a barrel. Senator McFadden referred to lobbying local Deputies. It is very difficult for carers either to get the time to do that or to have the mental or physical energy to do it. As a result one is left with one's plate at the side of the table picking up the crumbs on budget day.
Senator McFadden is correct. There are strategies lying around every Department but at least if there is a road map one has something at which to fire one's darts. One can at least go to the Departments and point out what the Government has said it would do. Currently, the Government has not said it would do anything. No matter what issue one picks, somebody can try to pick holes in it because it is not representative of a consistent, overall policy. It is a case of choosing between the devil one knows and the devil one does not know. It would be much better if there were a document outlining clearly the policy. In this case, there would be specific line items to lobby for. That is an important point that needs to be made.
It is not just a question of valuing people, as Deputy Byrne stated, in terms of the carer's allowance and services. Of course this is important but there is a life after caring. As carers say, they are left high and dry when their caring role finishes. In many cases, it is difficult to access pensions. The number of credits required for pensions is to double in 2012 and carers may very well be caught in the off-side trap in this scenario.
What does a carer do when his or her caring role finishes? We have put forward many applications associated with putting in place training courses to prepare carers for life after caring. Many carers have many skills that they had when becoming carers. There is much depression among carers. Many find it very difficult to find their way back onto a career path or to begin life after caring. A policy document is required on how the nation should decide to treat and value carers. Carers would put the health service on its knees if they decided to do the equivalent of driving their tractors down the main street or having "blue flu" days. If we could address these concerns, this debate would probably be a little different.
It is well recognised that present and past members of this committee are very committed to this issue. Somewhere along the way at Government level, the penny will need to drop. We have an ageing population and this issue will only become worse. The key point, based on this meeting, future lobbying and Government policy, is that there must be a realistic, common sense approach. Carers cannot continue forever and will not be able to.
As Ms Clare Duffy has pointed out, Professor Drumm, as CEO of the HSE, has been stating over his full term that policy will move towards community care and shorter stays in hospital. It often gave a carer a bit of respite if the person cared for was put in hospital for two or three days before a procedure or for a week after a procedure. One is now admitted the day before and discharged the day after, if possible. Nobody has an issue with the rationalisation of the health services and making them more efficient but there are insufficient supports at community level. If the HSE and Department of Health and Children want to push responsibility back onto the family and carer, they need to put in place sufficient resources to support them. This is not happening and there is no real evidence it will happen without some kind of strategic plan or document to ensure it.
I thank the committee for inviting us. We will be in touch with people throughout the year at local level. There are a few important issues, one of which concerns habitual residency, that we will be working on. We will be taking approximately 15 to 20 case studies of carers to itemise very clearly the moneys they are saving the State and the extra costs of care. As one contributor mentioned today, there are extra costs associated with providing care. Anybody involved in caring realises very quickly that heating must be on all the time. Additional dietary requirements must be met, a greater number of medical bills must be paid and there is extra travel. The costs mount and we will be working to prove this and the fact that carers make a saving for the State. As Deputy Shortall stated on the half-rate carer's allowance, there is a review suggesting that if one is receiving the half rate on top of the other payments, one is not doing too badly. It is seen as a kind of top-up rather than a payment to help nullify the extra costs of care.
I thank Mr. Egan.
I return to the issue raised by Ms Clare Duffy on the winding down of hospital beds. The closure of the hospital in Monaghan, for all intents and purposes, is the first example. Elderly people simply do not want to go to hospital because of the hospital bugs caused by systemic pressure and are putting enormous pressure on their families. It is a real issue for Members, especially those from the Cavan-Monaghan area.
I appreciate the presentation by the delegation. Mr. Curran referred to the cost of the car. Was he able to get the primary certificate for the car?
Mr. Tom Curran
Yes.
A specific problem in the north east is that it takes over 12 months for an application for a primary certificate for a car to even be considered. This is partly because the doctors are addressing the swine flu issue instead.
Mr. Tom Curran
I am lucky to have the primary certificate for approximately eight years. I obtained it before the delays.
Where is Mr. Curran from?
Mr. Tom Curran
Just outside Arklow.
There is a difficulty specific to certain areas. The same criteria are not used everywhere.
The real difficulty I have is the decisions of the assessors. Without ever seeing patients, they are deciding they are not sufficiently in need of care. I have been in some homes and have seen the position of the patients. One or two years ago, the patients would have been accepted without question. A major effort must be made to address this and we need to be very conscious of it.
I fully accept the point made by Deputy Byrne on the overall cost of running the State. We cannot ignore this but surely those at the most difficult end of life requiring care and younger people who are not able to look after themselves should not be the ones to suffer because of the mismanagement of the country. That is not a political statement but a factual one over which we should all stand. This committee, down through the years, has worked under various Chairmen. I assure everyone that while former Minister for Social and Family Affairs, the late Séamus Brennan, introduced the half rate for carers, this committee, along with the Carers Association, has done a great deal of work over many years to bring this about.
Consider the case of two widows widowed in the same week. One, because she did not have to care for anyone, was able to avail of the full contributory pension and take up a job that was vacated, yet the other, who was looking after her mother in law, lost the carer's allowance a couple of weeks after her husband passed away. Although she was free to obtain the contributory pension and work, she could not do so because she was a carer. This was part of the justification for the introduction of the half rate. We must continue fighting in this regard. Irrespective of whether I am a member of the Opposition or Government, a backbencher or otherwise, I will continue lobbying in this regard. Some of my colleagues who are not in politics as long as I am might not realise we still have some power to lobby and put pressure on Ministers.
I welcome the Carers Association and the family carers. I apologise for not hearing all the presentation. There are several meetings taking place in the House and two other committees with which I am involved were meeting at the same time. However, I had a quick scan through the report. No matter on which side of the House a Member sits, we all have an association with carers either through family, neighbours or constituents, making representations on their behalf. With the country's current financial position, I do not believe we will have the perfect scenario. I feel, however, small steps can be made which will make a big difference to the lives of carers.
I propose the committee formally writes to the Minister for a response to the submissions made to the committee this morning.
The committee will do that and also send a copy of the Official Report of the meeting.
That is good. Like other members, I am interested in following up some of the issues raised at this meeting. The association is very fortunate that its researcher has much experience in this field. It will do it no harm. I look forward to working with the Carers Association in the future.
I was reluctant to single out Mr. Frank Lahiffe because I did not want to do him any harm by stating that he knows us.
I thank the association for attending what I believe has been a very good meeting. It is fair enough that people are entitled to make their political points but it has been a good meeting. It has been particularly helpful to hear from Mr. Tom Curran, Mr. Martin Cullen and Ms Susan Byrne. It puts flesh on the bones and members want to hear of these experiences. I hope every member, regardless of political persuasion, will be available to the association. In the Dublin South-West constituency, Cathy White is very helpful and does a great job in attracting us to the various lobbying events she undertakes.
The Carers Association is to be applauded for sharing its experiences with the committee. It is important the committee gives the association the commitment that it will pursue the issues raised this morning
The joint committee adjourned at 12.55 p.m. until 11 a.m. on Wednesday, 3 March 2010.