I welcome the opportunity to address the House on the issues that concern family carers. I thank Senators Mary Seery Kearney and Martin Conway for laying this timely and welcome motion before the House.
Family carers are the backbone of care provision in our country. Whether caring for a child, a parent with a disability or illness, or an elderly family member, carers through their selfless hard work, knowledge and compassion enhance the quality of life of the most vulnerable in our society on a daily basis. Therefore, the Government is not opposing this motion.
The programme for Government aims to prioritise policy actions that protect the most vulnerable, including those in caring roles and those they care for, as our economy returns to growth in the aftermath of the pandemic. There is no doubt the burden on family carers has increased as a result of the pandemic. A survey commissioned by Family Carers Ireland in July 2020 found that one third of respondents were worried about becoming more socially isolated and 60% were concerned about a decline in their own mental health and well-being. Within this context, the programme for Government contains a firm commitment to progressing the review and update of the national carers strategy. This is a priority for the Department of Health. Obviously, the strategy update will involve several Departments, and the Department of Health will work with these Departments as the update progresses.
The programme for Government also commits to developing a carer’s guarantee proposal to ensure a minimum level of support for carers countrywide. To this end, the Government allocated €2 million in budget 2020 to improve equity of access and to support carers in 2021 in tandem with the community and voluntary sector. I take on board Senator Ahearn’s point that this did not go directly to family carers but went to the HSE service plan. That is perhaps something we can look at, and I thank the Senator for raising it.
In addition, a carer’s needs assessment will be piloted in community healthcare organisations this year, which will increase our knowledge of carers' needs. Senator Boylan said that we need to prioritise carers in the vaccine roll-out, which has been an issue. We have all made representations on behalf of carers but it was up to NPHET and NIAC to take those decisions. Hopefully, with the roll-out of the vaccines coming pretty quickly, we will deal with that situation. I appreciate what the Senator has said. Having a better awareness and understanding of the needs of family carers is crucial to ensuring we develop appropriate services to support carers both within and outside their caring role. The Department of Health and other Departments actively engage with carers representative groups and with family carers through the annual carers forum organised by the Department of Social Protection. I know they greatly value the opportunity to interact with family carers and hear their experiences and concerns.
Senator Mark Wall and others spoke about the €20 billion that is saved through the work of the 500,000 carers. It is a huge amount of money that is saved by the State and is something we need to recognise. In recent years, the Government has sought to increase the income supports available to family carers. Senator Mullen also referred to the funding saved by the State. Senator Clifford-Lee said that praise was not enough and that we need to put our money where our mouth is. She also said that this has impacted lives. Senators McGreehan and Craughwell spoke about female carers – mothers, sisters and daughters - as well as the funding that has been saved. It was said that we need to consider the community day care centres which need to be reopened after the pandemic.
Another issue that has come to the fore is the position of carers who came back over the years from places such as the UK, Australia and the United States. These were mostly women who were giving up their careers to take care of their loved ones. If they have fallen between the cracks, we need to address that because it is an issue. We saw this in the 1950s and 1960s, and in the 1980s, and we also had that wave that went ten years ago. That wave of people are now beginning to come home to take care of their parents. While “wave” is probably the wrong word, those people are coming home and we need to ensure they do not fall between the cracks again.
The main income supports to carers provided by the Department of Social Protection are carer's allowance, carer's benefit, domiciliary care allowance and the carer’s support grant. Combined spending on all of these payments to carers in 2021 is expected to exceed €1.4 billion, which will support more than 135,000 carers this year. As part of budget 2021, the Minister for Social Protection increased the carer's support grant from its current rate of €1,700 to €1,850 from June 2021, the highest ever rate for this grant. Senator Joe O'Reilly said holistic recognition is also important for carers. Recent increases in carer's allowance and carer’s benefit highlight the Government's ongoing commitment to maintaining financial support for carers so they can participate as fully as possible in economic and social life. The Department of Social Protection has prepared a comprehensive policy review of carer's allowance, including the means test, which was laid before the Houses of the Oireachtas on 28 August 2019. It committed to keeping the range of supports available to carers under review.
Added to these income supports, a carer whose work ceases as a result of Covid-19, and whose situation qualifies them for the pandemic unemployment payment, can get the payment along with their current care income support, whether carer’s allowance or carer’s benefit.
The Government has extended eligibility for the GP visit card in recent years. Since 2015, all those over 70 have been automatically awarded the GP visit card while, in 2018, free GP visit cards were extended to persons in receipt of the carer's allowance or carer's benefit. This ensures that carers are supported to protect their own physical, mental and emotional well-being. A 10% increase in the income threshold for the GP visit card was also introduced in 2019. The programme for government commits to further extending free GP care to carers in receipt of the carer’s support grant. The Department of Health, in conjunction with the Department of Social Protection, is undertaking an analysis of the policy, legal and financial implications of this commitment.
Furthermore, the Pensions Commission, as part of the programme of work, will consider how people who have provided long-term care for incapacitated dependants can be accommodated within the State’s pension system. The Pensions Commission is due to report to the Minister for Social Protection by 30 June this year. Again, Senators Craughwell and O'Loughlin highlighted the issue of carers giving up their pensions.
There is also an over-reliance on institutional care and the new fair deal scheme. Senators Bacik and Kyne raised issues on different aspects of the scheme. We recognise that waiting lists for accessing therapy services are unacceptably long in some parts of the country. In response, €150 million in new development money was provided in budget 2021 along with additional Sláintecare funding to support the HSE's roll-out of the enhanced community care programme, ECCP. Under the ECCP, more than 2,000 staff will be recruited to community health networks. These will include nursing staff and community therapists such as physiotherapists, occupational therapists and speech and language therapists. The programme is making tangible progress with the establishment of 16 community healthcare networks, the creation of four new community intervention teams, the expansion of three community intervention team, CIT, and outpatient parenteral antimicrobial therapy, OPAT, services and the recruitment of 160 staff, with 250 more in the recruitment process.
With regard to the Assisted Decision-Making (Capacity) Act 2015, the Department of Health, together with the Department of Children, Equality, Disability, Integration and Youth, is continuing with work to address legal and policy issues relating to sections of the Act that have not been commenced. Every effort is being made to progress this work as quickly as possible and the Act aims to maximise a person's right to make his or her own decisions with legally recognised support, whenever possible. It applies to everyone and is relevant across all healthcare disciplines. It will support decision-making and maximise a person's capacity to make decisions.
The issue of training courses for carers who are family members was raised by Senators Byrne and Burke. Having regard to training for family carers to assist them in their caring roles, the HSE and its partner organisations are providing ongoing training, particularly during the Covid-19 pandemic. A range of supports are available including digital partner packs and a carer support webpage with links to information and online training courses, many of which are available free through voluntary organisations such as Family Carers Ireland. The HSE has also temporarily extended access to HSeLanD, its online training portal, to family carers during the Covid-19 pandemic. That is of interest.
With regard to respite care, the HSE has agreed to fund the provision of 27,000 hours of emergency respite through Family Carers Ireland to ensure that the immediate care needs of care recipients will be met in the event that a carer is unable to continue in his or her caring role due to Covid-19 or other reasons. Senator Black mentioned service gaps arising due to Covid-19. The number of home care hours certainly needs to be increased. An additional €100 million in new funding to enhance services and supports for people with disabilities was allocated in budget 2021 to address new developments and to support the resumption of services impacted by Covid-19. Of this funding, €5 million has been provided for the development of nine new centre-based respite care services in 2021. A sum of €30 million has been provided for disability day services to increase capacity in buildings and to provide extra staff. This will ensure that the maximum level of services will continue to be provided safely for those most in need, which will also benefit their family carers.
Home support is vital to support older people to remain in their own homes for as long as possible and to support informal carers. An additional 5 million home support hours are being provided in 2021, including 250,000 hours for persons with dementia. Funding has also been provided to improve community supports for people living with dementia, including a further expansion of the dementia adviser network. The provision of 600 new rehabilitation beds in the community will also further support older people and their family carers. Work is ongoing in the Department of Health to develop a system for the financing and regulation of home support services in addition to the introduction of a reformed model of delivery of services that will ensure the provision of home supports in a transparent, equitable manner based on standard assessments of care needs. The Government has recently given approval for the drafting of a general scheme and the heads of a Bill to establish a licensing framework for publicly funded for-profit and not-for-profit home support providers.
I welcome this step in progressing our work to establish a statutory scheme for the financing and regulation of home support. It is of the utmost importance for all home support users and providers. Senator Pauline O'Reilly mentioned the green aspect, that is, investing in warmer homes. That is very laudable and welcome and I hope it will be included by Government.
More than €1 billion is being allocated for mental health services in 2021. This includes €23 million to commence implementation of many of the short-term recommendations of Sharing the Vision: A Mental Health Policy for Everyone. The Government has therefore provided an unprecedented level of investment in the 2021 budget to improve access to primary care services, services for older people, specialist delivery services and mental health services, all of which support carers in their caring roles.
The motion is right to acknowledge the admiration of Members of the House for family carers. It is also proper that we recognise the contribution of family carers to our healthcare system. Ireland's national carers strategy is designed around a core vision which recognises and respects carers as key partners to be supported in maintaining their own health and well-being and in caring with confidence and to be empowered to participate as fully as possible in economic and social life. Again, the Government recognises carers and thanks them for their vital contribution in supporting loved ones with illness and disabilities. The Government continues to work to implement the commitments made to carers in the programme for Government and to offer a range of supports that will enable them to continue caring with confidence. Unfortunately, I am not in a position to accept Senator Black's amendment. I am sorry.