I welcome the Minister of State, Deputy Madigan. The motion is on the delivery of a rights-based care economy based on the recommendations of the Irish Women's Parliamentary Caucus. I call on Senator O'Loughlin to move the motion.
Rights-Based Care Economy: Motion
I move:
That Seanad Éireann, in accordance with the recommendation of the Women’s Parliamentary Caucus:
acknowledges that:
- the UN Convention for the Rights of Persons with Disabilities (UNCRPD) requires a significant social transformation from a medical approach to disability, where economic development, health, and care economies can sustain the violation of human rights through a lack of rights-based care, and where people are institutionalised in residential care settings, or in their own homes without access to the community, to a social or human rights approach where individuals receive rights-based care in the community, and are supported to live with their families, or independently in the community, and have a better quality of life;
- the report ‘The Care Economy, Covid-19 Recovery and Gender Equality’ highlights how the care economy in Ireland relies heavily on the private marketplace and informal family and community networks to access care, and while the State funds a significant amount of formal child and long-term care, it is delivered mainly by private-for-profit services; in contrast to paid work, participation and the time people spend in informal care activities is rarely measured;
- as highlighted in the Joint Committee on Disability Matters recent report ‘Aligning Disability Funding with the UNCRPD Budget 2024 Pre-Budget Submission’, there are concerns regarding a lack of co-ordination, organisation, and oversight, as well as policy implementation with regard voluntary services who are delivering disability services in the community in Ireland; this has significantly impacted the development of community infrastructure, planning and services, to provide people with adequate support to live with their families or independently, and fulfil requirements of the UNCRPD;
- homecare services in Ireland, which allows people to receive health, social and personal care within their home, also needs urgent reform, regulation, and standardisation to establish equity in service provision, and ensure their quality and safety, while ensuring that the services facilitate rights-based care;
- Ireland is undergoing a major demographic shift to an ageing and disabled population which is significantly increasing levels of caring responsibilities, while adding significant pressure on informal family and community networks;
- as highlighted in Family Carers Ireland report ‘State of Caring 2022’, the lived experience of those providing informal care in Ireland reflects a stark reality where carers are experiencing significant poverty, loneliness, social exclusion and reduced physical and mental health, without access to essential supports;
- there are other carers, outside family carers, who are caring for someone, including foster carers, who need additional support to provide rights-based care;
- UK research ‘Developing a clearer understanding of the Carer’s Allowance claimant group’, highlights that because of the diversity of carers’ circumstances and characteristics, for example, the level of care an individual carer provides varies according to the needs of the person they care for, the extent to which they have other support with their caring role as some have to give up work, or some carers may be younger, while others are older and need more support, there is a need to adapt benefits systems to make them more responsive to individual carers’ needs;
- there is a need to develop Ireland’s Care Economy in line with the UNCRPD to realise rights-based care, while redistributing funding to support informal family and community care networks to deliver equity in access to services and better outcomes for the people that receive care, along with ensuring effective early intervention, supported independent living, adequate carers welfare supports, and in-home and community supports for those who are being cared for, to live at home;
- both the deeply gendered division of caring responsibilities in society, and the need to ensure that a higher value is placed on care and caring roles, both of which issues are recognised and addressed in the recommendations of the Citizens’ Assembly on Gender Equality and in the set of actions proposed to progress those recommendations as contained in the December 2022 report of the Joint Committee on Gender Equality, ‘Unfinished Democracy: Achieving Gender Equality.’
further acknowledges:
- delivery of the ‘Carers’ Guarantee’ proposal will allow Family Carers Ireland to deliver a core basket of services to family carers across the country, regardless of where they live;
- Government spending on social protection schemes, public services and taxation which broadly contribute to the Care Economy has increased significantly in recent years from €8.8 billion in 2019, to a projected spend of €10.6 billion in 2023, which equates to an increase of 21%;
- the National Carers’ Strategy 2012 was instrumental in raising the profile of carers and unpaid care, recognising the significant contribution carers provide to the State, and highlighting the model and framework for positive collaboration between Government and the care sector;
- the National Carers’ Strategy 2012 was developed before Ireland ratified the UNCRPD and at a time of significant economic challenges and public financial constraints which led to limited progress, developing longer-term commitments for carers and implementation of the forty-two actions it contains on a cost-neutral basis;
- the UNCRPD Implementation Plan, which will outline how the Convention will be implemented, along with right-based supports for family and home life, has not yet been published;
notes that:
- there is a need to acknowledge and meaningfully support carers, who are fulfilling Article 23 of the UNCRPD, by caring for their loved ones in the family home and in the community, as opposed to that individual being placed in a long-term residential care setting, which through a lack of support, may become the only option;
- there is also a need to significantly increase residential places for people in disability residential care/supported housing to address a substantial backlog of need for the significant number of people with extremely high support needs, whose current living arrangements with their families are no longer sustainable;
- individuals’ rights must be upheld in these residential care settings and housing must be made available in the community in line with Article 19 of the UNCRPD;
- respite is identified by carers as crucial for their wellbeing and quality of life and is a key support to families to care for their loved ones in the family home as opposed to placing them in long-term residential care;
- the Government has committed to develop a new centre-based respite facility in each CHO; however, access to respite care is inconsistent throughout the State and rather than increase over recent years, respite provision has fallen and does not address the latent unmet need which the Disability Capacity Review to 2032 suggests requires an investment of €16 to €20m annually;
- the Disability Capacity Review to 2032 also estimates up to 3,900 extra residential places are needed by 2032, costing €550 million annually; however, because of the crisis management in the residential care placement process, respite capacity can be used to fill the demand for residential care, which limits families access to respite as a resource to maintain resilience;
- the Programme for Government 2020 has committed to introducing a statutory scheme to support people to live in their own homes; however, homecare providers across Ireland have for many years faced a staffing crisis, whereby people who are medically assessed by the HSE as needing homecare are not able to access home supports due to a shortage of staff;
- over one-third of those currently on a waiting list for homecare supports or a homecare package are waiting over two years for the service;
- the Government has committed to holding a Referendum in 2023 to implement the recommendations of the Citizens’ Assembly and the Joint Committee on Gender Equality, in order to insert a specific provision into Article 41 of the Constitution to recognise and acknowledge the value of care in Irish society;
in the absence of a new strategy for carers, with regard to progress on relevant measures to date, and to ensure transition to a rights-based approach to care, calls on the Government to immediately deliver on commitments that support carers as outlined in the Programme for Government 2020 and to consider additional measures where appropriate, including:
- the establishment of the Commission on Care immediately and the extension of its remit to include all types of care, including disability and delivery of rights-based care in line with the UNCRPD;
- ensuring that elderly carers who are providing informal care in the home can access support as a priority and increase residential places to address the substantial backlog of need for the significant number of young people with very high support needs, whose current living arrangements with their families are no longer sustainable, while ensuring that individuals rights are upheld in these settings;
- providing access to the State Contributory Pension to those in receipt of the Carer’s Allowance, to include a pension solution for foster carers;
- ensuring implementation of the Programme for Government 2020 commitment to the delivery of a ‘Carer’s Guarantee’ proposal to allow Family Carers Ireland to deliver a core basket of services to family carers across the country, regardless of where they live;
further calls on the Government to immediately implement provisions that support carers under other sectoral policies and consider additional provisions where applicable, including:
- ensuring carers’ needs are reflected in the UNCRPD Implementation Plan as well as providing standard training for all carers on the provision of rights-based care in line with the Assisted Decision-Making Act;
- continuing to develop carer prevalence data to inform policy, service planning and delivery;
- ensuring equality-proofing of budgetary policy and consideration of whether welfare changes disproportionally impact households affected by disabilities;
- the prompt national rollout of the interRAI Single Assessment Tool as the standard assessment tool for care-needs and ensuring that individuals with disabilities of any age can access the new home support scheme;
- ensuring additional funding for the National Treatment Purchase Fund to enable it to be extended to include clearing the waiting lists for paediatric interventions and essential therapies by treating these children through the private system;
- ensuring the accessibility and availability of in-home and community-based services for families with a member with disability, including biological and foster families of children with disabilities, and, in particular, families of children with autism or who are caring for individuals with dementia, for example, personal assistant services and additional access to homecare services, to guarantee enjoyment of the right to family on an equal basis with others;
- collecting and reporting disaggregated data on the availability of community-based supports for families of children with disabilities, and the number of families who access those services;
- developing resource networks of support at local levels, i.e., parent’s groups;
- within the statutory home support scheme, the introduction of a provision for a right to a minimum 20 days per year of respite and the right to a Family Carer Needs Assessment, including foster carers; - the immediate alleviation of waiting list for respite provision;
- increasing the maximum grant limits, income thresholds and disregards under the Housing Adaptation Scheme and removing the need for assessment of the income of other adults living in the household not in full-time education;
further calls on the Government to consider and fund additional measures to support carers in Budget 2024, to:
- ensure the inclusion of carers’ needs in legislation which will extend and enhance the rights of carers aligned with the UNCRPD, with the purpose of better supporting carers on a more consistent basis so that they can continue to care, if they so wish, in good health and to have a life alongside caring;
- undertake a review of the cost of caring and assess how current social insurance schemes for illness, disability and carers can be efficiently used to provide income supplements to carers in Ireland to address rising costs of caring, and in the interim to increase thresholds from 18.5 to 22.5 hours per week if an individual receives Carer’s Allowance, Carer’s Benefit or the Carer Support Grant; this review must be completed before the cessation of this Seanad session and consider:
(a) the impact on education and employment;
(b) full removal of ceilings on number of hours in paid work outside of the home for those in receipt of Carer’s Allowance;
(c) developing access for carers to avail of Back to Education, INTREO schemes etc., and ensure that the Carer’s Allowance is a qualifying scheme for training supports;
(d) enabling access to the SUSI grant for carers undertaking part-time study as well as providing direct funding/subsidisation to enable the undertaking of QQI level 5 health care courses;
- develop individualised means-testing for Carer’s Allowance and increase thresholds to include the costs of caring and to reflect a more needs-led payment including, how to provide additional access for full-time family carers to the Back to School and fuel allowance; in the interim, to introduce a living wage/basic income for carers by increasing the Carer’s Allowance to the equivalent amount of the artists basic income at €325;
- introduce ‘care credits’ for people who do not qualify for Carer’s Allowance but should still accrue credits in order to remain within the social protection system;
- develop a central database of individuals who have applied for, or who are actively aware of, individuals who need a disability service, such as a residential service, enhanced support in an existing residential place, or other non-residential services such as respite or home support that fully captures the level of unmet need in the system;
- introduce care coordinators within local health areas;
- introduce a mechanism under the fair deal scheme to develop an equitable system for community / long-term care as well as developing discharge planning;
- ensure that the promised Referendum to amend Article 41 of the Constitution to provide for the value of care in society is held in 2023.”
I will share time with Senator Clifford-Lee. I am very pleased to propose this motion in the Seanad. It arises from discussions among members of the Irish Women's Parliamentary Caucus. Within the caucus, which includes members of all parties and none, we were very keen to have a discussion on the care economy and to see how the caucus could contribute to that. The care economy is a broad topic and we need to have many national conversations about it.
I thank Zoe Hughes, policy adviser with Care Alliance Ireland, who spoke to the caucus about different areas we could look at. The term "care economy" refers to all paid and unpaid labour provided in support of caregiving. Ireland's social care system has a complex mix of public and private delivery and financing. We could spend from now until next month without a break speaking about all the different aspects of care and the care economy. As a caucus, we decided to focus on the review and renewal of the current national carers strategy, which has been in existence since 2012. We decided to do so against the background of the Covid-19 pandemic, which brought significant care deficits into focus. The lockdowns highlighted in particular the ongoing gendered nature of care. It exposed gaps in care provision and revealed an increasing reliance on a migrant care workforce and privatised care services.
The caucus sought submissions from care organisations and those with lived experience because there is nothing like sitting down to talk and listen, particularly to a family caregiver who cares passionately and compassionately for a loved one. We acknowledge the many challenges that are there. We set aside one day to meet a number of different groups, including Family Carers Ireland which published a report, Caring Through Covid: Life in Lockdown, which documented an online survey of 1,300 family carers. Many of the carers outlined their worries about becoming ill during that time and being unable to continue caring, as well as their fears that normal services would not resume after Covid-19. I know we can look back on it now, but while we were in the eye of the storm, there was a huge fear among parents about schools reopening. We can imagine the real fear that care services would not resume and that those with special needs would regress during that time.
Following a request for submissions, we received 38 submissions. We brought together ten different organisations, namely, Shine, Family Carers Ireland, Care Alliance Ireland, Westcare Homecare, Acquired Brain Injury Ireland, Diabetes Ireland, Inclusion Ireland, Sage Advocacy, the Irish Hospice Foundation, special schools and classes and, as I mentioned, individuals who came in to give us information about their lived experiences. I was particularly struck by those who were foster parents, particularly for those who have special needs. I thought they had a very special story to tell. I thank Karina Doorley and Brendan Walsh from the Economic and Social Research Institute, ESRI, who helped us with statistics from the Central Statistics Office, CSO, etc.
Following that, we spent some time drafting a motion that went to all our political parties for feedback. It is important to again emphasise that this motion comes from the women's caucus. It comes from all the women who are elected to the Dáil and Seanad. The existing national carers strategy, which was published in 2012, set out 42 actions to be undertaken by the Government to improve the lives of family carers. Those actions covered the needs of family carers and those for whom they care, including the need for access to home care and respite, adequate financial supports, transport, information, advocacy, housing, training, employment and the right to a life of their own away from their caring role. That came out really strongly. Every year, following the publication of that strategy, the Department of Health has produced an annual progress report since 2012. However, this ceased after 2018 and it was acknowledged that this needed to be revisited. I understand from the Minister of State, Deputy Butler, that work is ongoing on the review.
We felt that as a caucus it was timely for us to contribute to this policy.
One of the areas that was very much reflected in the stakeholder engagement was the very high prevalence of loneliness and social exclusion among carers. The ESRI, when it looked at its statistics, was able to give examples of associations with poor health for carers. These are major challenges for society. Preventing and alleviating loneliness and social exclusion requires a very multipronged and multilevel approach that includes government, individuals, community organisations and society.
The motion is quite long. I thank those working for the Oireachtas who helped draft it. The key areas are about how, under the UNCRPD, we require a significant social transformation away from a medical approach to disability to one where economic development, health, and care economies can sustain the human rights approach. I also acknowledge that the report, The Care Economy, Covid-19 Recovery and Gender Equality, highlights how the care economy in Ireland relies heavily on the private marketplace and informal family and community networks. There are a number of key areas. A lot is available already. I note that the Government has committed to developing a new centre-based respite facility in every community healthcare organisation, CHO, but we have not had progress on that. Only this morning, I had a meeting with the Minister for Finance, Deputy Michael McGrath, Deirdre Murphy, the CEO of Kare, and Siobhán Bryan, the CEO of the Muiríosa Foundation regarding where we are in respect of respite care. We are very sadly lacking. It is not down to a lack of money. It is down to being able to put the capital spend in place and making sure that we have the staff to deliver it.
I acknowledge that the Government committed to holding a referendum in 2023, which has now been extended to early 2024, to implement the recommendations of the citizens' assembly and the Oireachtas Joint Committee on Gender Equality. I understand, from a conversation with Clare Duffy from Family Carers Ireland today, that part of the issue seems to be around how we define care. Defining care is about those who need extra care. Care is a very wide area but those who are vulnerable and need extra care are the ones that need to be included.
I acknowledge some of the work that has been done. A HSE pilot of a family carers needs assessment in Community Healthcare West is currently under way, which is one of the areas we spoke about. A commission on care has been committed to and will roll out soon. The Minister of State at the Department of Health, Deputy Butler, established the cross-departmental strategic workforce advisory group in terms of the commission on care. Its recommendations will be important.
I am conscious that my time is running out. I will hand over to Senator Clifford-Lee.
I thank the Senator for all her work.
I thank Senator O'Loughlin, who has plenty more to say on this issue. I appreciate the work she has put into this, and that of the women's caucus. It is a very important motion. It is very long but contains so many facets. It is very important that we have the conversation because, as she outlined and is mentioned in the motion, care is very gender based. There is unpaid and paid care. Both forms of care are rarely mentioned. There is low pay in the paid care sector, which involves predominantly women in very precarious employment situations who are often on zero-hour contracts. It is very important that we have a conversation but also have action following that conversation because we could be going around talking among ourselves. I see it is all female Members who have shown up for the debate. That tells a story as well, unfortunately.
Senator O'Loughlin outlined how, during the Covid pandemic, we saw the impact carers have in society and how the lack of access to care services in the community impacted on families. I have spoken to many families down through the years, particularly during Covid, who were at breaking point. They were at breaking point before Covid but it tipped many of them over the edge. There is no day, or even hour, off in caring. Carers are constantly on edge. I have spoken to families who have struggled to get respite care in order to attend a family wedding, for example. People have talked about only getting respite one weekend every two or three years. That is not good enough. People do not like to complain about it because they love the family member they are caring for and are happy to spend time with them, but they also have to take care of themselves.
Carers are tired and lonely. There is significant social exclusion because people cannot take time off for themselves or take a couple of hours in the evening to join a sports team or other social occasion. We are thankfully living longer. We are an older society, which is a good thing, but we will possibly all need care in the future. If we do not have a proper conversation on it and action arising out of that, we will find ourselves in even more of a crisis situation in the coming years.
I look forward to the Minister of State's contribution. It is to be hoped this is the start of a conversation, and we will be able to lead out from here and put some flesh on the bones of this. The Government has made significant progress. Senator O'Loughlin outlined a number of measures. The time taken to access respite has dropped and many additional services have been put into communities, but it is not enough. We are starting from a very low base. It is fantastic that we have the opportunity to discuss this but I would like to see action following it that we can deliver, so we can say to the carers of Ireland, who are primarily women, that we are listening to them and will deliver some real progress. I second the motion.
I welcome the Minister of State. I thank the Irish Women's Parliamentary Caucus for its very detailed motion, which I support.
I will point out a few issues because it is important that we have some consistency in our approach. That is why I will touch on a few issues. I start by saying "Well done" to the Irish Women's Parliamentary Caucus. It has done a lot and it plans to do a lot more. I very much stand in solidarity with its key objectives, which includes making this Parliament a better place but also bringing the lived experience of many women who try to come through various levels of politics and systems within Irish society. I encourage the women's caucus to branch out and look at best practice and other experiences across the European Union. Other parliaments have done amazing things. It needs encouragement.
Some of us have connections in politics, be they through the political party system or the Independents. I hear so many women in everyone's party, and Independents, who say they will not run in the next local elections. When I ask why, they mention the hassle, the intimidation, the social media bit, and the toll it takes on their family and personal life. People can give anything so much commitment, but there comes a point for all of us when we have to ask what is important to us. What is it about for us personally? Does it impact on our integrity? Does it in some way impact on our ability to be authentic about ourselves? These are challenges that we in politics, every one of us from Minister right down, all face. That is something, therefore, we need to address collectively. It is not just for the women's caucus but all of us. Let us reach out to all. Let us not exclude anyone as regards how we can make politics a better place, although I salute and acknowledge the very important work the women's caucus does.
I welcome the motion, which seeks to ensure that people with disabilities have their rights protected and that people are not deprived of opportunities regardless of their background or orientation. I acknowledge that Ireland is in the process of implementing the UN Convention on the Rights of Persons with Disabilities. I accept that will take time. In Ireland, we sometimes have a problem with being over-reliant on informal care structures, including a reliance on family members to do all the caring.
Family members and loved ones do not have a problem with caring, but when they do all of the caring all of the time, it becomes very difficult. I accept that is acknowledged in Senator O'Loughlin's motion. On the issue of gender equality and helping everyone reach their full potential, ensuring rights for those with disabilities is tied up with ensuring equal rights for all of our citizens. Let us not pigeonhole people. These are about fundamental rights. It is interesting. I was coming in on the DART this morning and I saw the gov.ie campaign stating that "disability issues are human rights issues." I thought that was important. There is a strong campaign on our bus stops, bus shelters and the DART. I have noticed it particularly in the past few days. I say to the Minister of State that whoever is responsible for driving that, it may be an obvious slogan and message, but I think it is no harm that it is being re-endorsed by attractive and professional marketing. That message again is that these are human rights, and they are really important.
I have to flag the concern of my colleague Senator Clonan's Bill. Earlier this year I, with many on this side of the House, supported the Disability (Miscellaneous Provisions) Bill 2023. The Government presented an amendment to delay its introduction, but did not put tellers in place. That was really disappointing and a rare thing to happen in Seanad Éireann. It happened once before in the previous term. It never happened in this term. The Government did not present tellers, so it effectively closed down that Bill and it has been deferred for 12 months. What does that say?
No, it did not.
That is what happened. No tellers were appointed to the Bill.
The Bill went on to the next Stage.
But no tellers were appointed to the division on the amendment to the Bill.
Senator Boyhan, without interruption, thank you.
I have looked at the minutes. I think that was an issue. I am sorry, this is what I researched. This is fact and I was present. No tellers were appointed by the Government. The contents of Senator Clonan's Bill were consistent with everything listed in this motion. So why the deferral? Why the lack of support? Why were no tellers appointed by the Government? That can be checked with the Whips on all sides. I do not want to go back and just say this is what actually happened. It can be checked and validated after this meeting. The Bill was uncontroversial and aimed to create a legal right for the State to provide everything listed in the assessment of need. Everything goes back to this assessment of need, and I am sure the Minister of State has heard this often. Ireland is the only country in the European Union that does not provide this right. I know a lot of work is being done on it, and I know it is a longer process. However, the common issue raised by my colleagues and I is the issue of the assessment of need. I am in full support of the proposal before us. I just want to point out that it would be only right and proper for someone in the opposition to point out that concern, nothing more than that. I hope that we will work together going forward in favour and support and see the rollout of the worthy aspirations the Senator has for this motion. I fully support it.
I join with the Senator in congratulating the Irish Women's Parliamentary Caucus on its important work. A lot of issues are raised in Seanad Éireann because there is a large number of women represented here. The voices of those who often would not be represented in Seanad Éireann are represented by them. I have seen that transformation over the past number of years, which normally would not be happening. Issues are raised that need to be raised, but which often are not because of the lack of voices representing them and their lived experiences as Senator Boyhan has said. I thank them for all their work in that regard. I call Senator Seery Kearney.
First, and with due respect, I want to correct Senator Boyhan. Tellers were not put forward for the Government amendment to the Bill. So the amendment was not voted on, and as a consequence Senator Clonan's Bill went through to the next Stage, and did pass through to the next Stage. It was largely supported by the Government Senators from that perspective, because there could not be a vote and it could go to the next Stage rather than being delayed. That was contrary to Cabinet's decision. A lot of us went out on a long limb to make sure that Senator Clonan's Bill went through, contrary to the instructions we received. I am proud to have led on that. Senator Clonan called me out last week to specifically thank me for leading on that. With due respect to Senator Boyhan, who is now in the Chair, he is wrong in his assertions.
It would be inappropriate for me to comment on that. I am in the chair, so I will not comment.
I am just correcting, the Senator was incorrect-----
Okay. No, that is your view.
It is not my view. It is a fact of what happened in this House.
Senator, you have four minutes-----
Does Senator Boyhan accept that he has put on the record of the House something that is incorrect? It is incorrect. Maybe Senator Clonan would grace us with his presence, so we can ensure that is corrected. Otherwise there would have been no need for him to call me out and thank me for leading on it to make sure that it went through to the next section.
Anyway, there are other important things rather than having to correct misinformation in this House, namely that this is a good motion. I completely support it. When we talk about the care economy, we also need to talk about care economics. As an organisation, Family Carers Ireland is incredible. It is incredible in how it supports its membership. Some of the support they need to provide should not, in fact, be needed. If the HSE was doing its job in every way, in fact it would not be needed. Two weeks ago I participated in Andrea Gilligan's programme on Newstalk. People were phoning in to tell of their plight. One woman could not go to her own mother's funeral because she could not get respite. Another woman rang in, who I found out afterwards happened to be a childhood friend. After ten years of asking for support from the HSE, and being left with little to no support they were left with no choice, in a desperate situation with their precious son, but to decide not to take him home from respite. They could not face another day at home. That was the extent of that woman's story. I have spoken with Ger Harris on a number of occasions since. The HSE is now acting, but where was it for the ten years that family was in a desperate situation? Across the country, parents and family members are at the end of their tether, desperate for the State and the HSE to provide care for their children. If the care were provided in a timely fashion in support of these families, it would be more cost effective, and the care economics would be much better were that the case. We have a situation where section 39 organisations now have to go on strike to finally get equality and parity under the law in their terms and conditions of employment. They are providing the backbone. I work with many of them in my own constituency of Dublin South-Central. Organisations like WALK do extraordinary work, but they cannot retain staff because they cannot offer the same situation as the HSE, or the Section 38 agencies. These situations are not good enough.
We have the peculiarity where we talk about care and we talk about people with disabilities. However, which Department is actually running the show? On the one hand, it is the Department of Health which oversees the HSE. We have the Minister of State at the Department of Children, Equality, Disability, Integration and Youth, with responsibility for disability, who had to get up and walk out of a meeting in order to get something. We have all of the Minister of State, Deputy Madigan's excellent work. That is more easily ringfenced because it is clearly in education, but she does not always get the supports she needs, which need to be provided by the disability network teams in communities. They are just left to flounder in Dublin South-Central. We have had to shut down one of the teams due to lack of resourcing, and the lack of staff actually showing up. None of that is good enough. When we talk about caring and supporting carers, we need to make sure we are delivering the services in a timely fashion, so that there is not just a care economy but good economics around this. By providing supports for children, especially young children, in a timely fashion we are making good investments in the future. We are supporting those children in not bypassing developmental stages without the key supports they deserve.
In another situation I am dealing with at the moment, one social worker and one occupational therapist might affirm a funding stream for a family but following a change of personnel, the next one takes it away. There is no consistency here. Where is the accountability? While I applaud the motion, there is a lot to be done. With due respect to the Minister of State, I think that someone from the Department of Health should have been here to be answerable on this motion. It is not reasonable that the Minister of State is expected to answer on it because the Department of Health is the driver here and it is the HSE that is failing in a great many ways without any accountability.
I commend the Irish Women's Parliamentary Caucus and Senator O'Loughlin on all their work on this comprehensive motion. I welcome the motion on behalf of Sinn Féin and I want to express our support for it. In our view, we really need to move beyond the idea of care as just being a family matter. Carers have long been the backbone of care provision in Ireland but time and again they do not receive the care and support they need and so rightly deserve. I am particularly conscious that the role of carer has traditionally fallen upon women.
The view enshrined in the Constitution belongs to a different era. Ireland has come a very long way and the time is long overdue for the Constitution to reflect that. I welcome that the Government has finally listened to calls to hold a referendum on this clearly outdated clause in the Constitution. I was happy to be a member of the recent Oireachtas Joint Committee on Gender Equality. It is vital that this article is replaced with appropriate wording that promotes gender equality and reflects our status as a modern, progressive state committed to fairness for all our people. Any constitutional change must also oblige the Government to take responsible measures to support care within the home and in the wider community.
It is estimated that family carers save the Exchequer approximately €20 billion per year by caring for their loved ones at home and keeping them from having to be cared for in hospital or a care home. However, carers themselves are left struggling both with their physical and mental health. Caring in Ireland has long been associated with poor health outcomes such as stress, burnout and illness. An already stressful and complex situation with significant health risks also is being exacerbated by financial strain. The cost-of-living crisis and the rising cost of electricity, fuel and food have also compounded the situation. Calls to the Alzheimer Society of Ireland's national helpline that related to financial advice and concerns more than doubled in the first three months of 2023 compared with the previous year.
It is clear that our neglect of carers is having a real impact, not only on carers and their loved ones but also on the health service. Successive Governments have spent years expecting carers to almost pop out of thin air but we have reached a point now where almost 10% of all older people who are approved for home care support do not have a carer. The Government's failure to address shortcomings in care means that many people who can and should be cared for in their own homes are pushed into the health service, into hospitals and into nursing homes. We all signed up several years ago to the policy of the right care, in the right place at the right time. Yet even in the midst of a hospital bed emergency, we have people in beds who should be at home and we have people on trolleys waiting for the beds. While the crisis is bad now, I do not need to tell this House that the demographics are also changing. There is no doubt that the proposed referendum represents a clear opportunity for change. However, as this motion makes clear, the issues faced by carers are both wide-ranging and very deep-rooted. If we are sincere in transforming the experience of carers in Ireland, then the Government must ensure that carers themselves receive the care and support they need and greatly deserve. I am happy to support the motion today. I commend Senator O'Loughlin and all the members of the caucus on their work on it.
I too am very pleased to support this motion on behalf of the Civil Engagement Group. I am grateful to Senator O'Loughlin and the Irish Women's Parliamentary Caucus for producing such an expansive and detailed motion about such a timely and important set of interlocking issues. There is no doubt but that this motion addresses gender equality, social justice, disability rights, the politics of ageing and much more. It would be impossible to address everything in just a few minutes so I will limit my remarks to just a few issues raised in the motion.
We are an ageing and increasingly disabled population. We are also tasked with reshaping the economy in a way that provides high-quality, low-carbon employment, that can generate better public services that reduce inequality and promote social solidarity. That is a real challenge but it is also an opportunity. Ireland is a very wealthy country, one of the wealthiest in the world, and with sufficient political will a rights-based care economy is in our reach. I know this is not in this Minister of State's particular area but to achieve it would mean radically transforming the way we have previously conceptualised care.
Let us face it, Ireland's paternalistic and patriarchal form of care has placed huge burdens on family and kinship networks to take on unpaid work in the absence of adequate State provision. When you think about it, the work done by carers in the home saves the State billions and prevents the inadequately resourced long-term care system from collapse. Successive Governments have heaped praise on carers and have acknowledged the love they give and the sacrifices they make but they have not adequately compensated and supported them. This motion outlines important measures that can be taken in this respect, which is brilliant. It also endorses efforts to enshrine gender equality, as well as the rights of caregivers in the Constitution.
Government policy has created a situation where paid care workers, who are disproportionately women and migrants, are underpaid and poorly treated. I do not think traditionally feminised work has been given the respect and compensation it deserves. The increasing reliance on private agencies to provide nursing and social care services is driving down standards, pay and conditions. This helps to explain the staffing shortages in many different services. We can see the devastating results of this low-wage care economy in the huge waiting lists, for example, for crèche places and home help services. The recent announcement that section 39 health and social care workers in a range of voluntary sector care providers will take indefinite strike action from next month demonstrates that the status quo is simply unsustainable. I support those workers taking industrial action. The efforts to unionise care workers and to collectively bargain will be an important driver of reform in this sector that will benefit both workers and the people those workers support and care for.
The motion has several references to Ireland's obligations under the UN Convention on the Rights of Persons with Disabilities and Ireland's ratification of the UNCRPD was a huge step forward. I give great credit to the activists who fought for years to make it happen. Unfortunately, despite the ratification of the convention, there continues to be new legislation produced and enacted that is not compliant with the UNCRPD. This was the case with the assisted decision-making legislation, which was progressive and long overdue but still flawed in crucial areas. More needs to be done to align our laws with our international human rights obligations.
I also want to highlight an issue that has been raised by Senator Boyhan. The Government is currently running a very powerful advertising campaign with the message that disability rights are human rights. It is a very noble message but I wonder how disabled people feel when they see those advertisements. Do they feel vindicated or does it underscore how badly they are being let down? We must face that. Despite the positive rhetoric from the Government, young people are being forced into nursing homes because they cannot get the care they need to live independently. Parents watch helplessly as their disabled children's conditions worsen over time due to long waiting lists for essential surgeries. Disabled artists are prevented from accessing creative funding because it would interfere with their disability allowance. It is heartbreaking. I could go on. The time has come for Ireland to ratify the optional protocol to the UNCRPD. This would give disabled people the ability to litigate violations of their UNCRPD rights. It is crucial to ensure that people can highlight gaps in the care system and vindicate their rights. Building a rights-based care economy means treating every human being in society with the dignity and respect that they deserve.
It means valuing the paid and unpaid care work that people, mostly women, are doing and making sure they are adequately supported and compensated. It means building a society and an economy based on solidarity and co-operation rather than greed and speculation. It would be a radical transformation that would benefit workers, communities and the environment. We need to work to make sure disability rights are tangible and actionable, not just rhetorical. That means strong public services that workers and service users can rely on and legal rights that can be litigated through the courts, if necessary, with the provision of civil legal aid.
I again thank members of the Irish Women's Parliamentary Caucus for all their work on this motion and on behalf of the Civil Engagement Group, I wholeheartedly support it.
I welcome the Minister of State, Deputy Madigan, and thank Senator Fiona O'Loughlin for looking after us today and for driving forward this motion. I am on the working group and I have been involved in this, so I know the work that has gone into it.
I was expecting somebody from the Department of Health today, not that I am not delighted to see the Minister of State, as always. When I was setting out the words that I wanted to say, they really were with health in mind. Coming up to the budget, the carer’s allowance is top of my mind. I and others in the Seanad would share the view that eligibility for carer’s allowance should not be primarily based on means and should not be means tested. It should be based on the needs of the person being cared for and the scale and value of the work that goes into that.
Whatever Family Carers Ireland asks for in the budget, I cannot see anybody disagreeing with it or not supporting it but, at the same time, it is an outdated payment. It was first introduced in 1990 as an income support for people living with and caring for a relevant pensioner and it now refers to caring for someone with an illness, a disability or because of age. When we read about the payment, it nearly sounds transitional or temporary, and it does not reflect the lifelong care and commitment that many carers provide. We need to value and recognise them. It is part of their identity. It is their role in society and they deserve to be visible. I am thinking of the fact that 77% of carers are women and thinking of all of the mothers who have given up their careers and paid jobs to take on the role of caring. They forgo participation in the workplace for a different role that is just as, if not more, important. However, they give up their career aspirations and not only are they at a financial loss, but they become financially dependent. The carer’s payment only goes so far.
As we have seen from the research, caring for a child with a profound intellectual disability is an average weekly additional cost to a household of €244. We are talking about the cost to the State of care but there is the value that these carers are giving to the State in fulfilling those duties. It is also in fighting for their children because not only do they take on a caring role, but, as the Minister of State and I know, they are fighting for services that they desperately need. It is exhausting work. They become advocates. They have nothing but my admiration but these women are invisible. It is not right.
We reduce that recognition to people who have a gross household income of €41,500. When the Minister for Social Protection, Deputy Humphreys, was in the House before the summer, she rightly pointed out that the role of the social welfare system is to provide a basic level of income. The Minister stated:
If we are to pay carers properly for the huge work they do, the Department of Health has a role here. The reality is that if families' carers were not doing the work, a lot of these people would be in State care. No matter where I draw the line in terms of the means test, there will always be some people who will fall down the other side and will not qualify. … I know some of the carers' groups would like to see the means test abolished altogether, but if you go down that road, it will no longer be a social welfare payment. In cases where somebody has to give up their job to care for a person with high dependency who would otherwise be in State care, it is absolutely reasonable that the Department of Health or the HSE would provide a payment once the medical need is satisfied.
Family Carers Ireland has provided us with the figures. To abolish the means test and have eligibility depend on strict medical conditions and the need for full-time care, the Department of Social Protection estimates it would cost €1.2 billion whereas Family Carers Ireland estimates it would be more like €400 million. This is something we need to look at.
The Taoiseach said a couple of years ago that women who left work for caring purposes are one of our biggest untapped resources. These women who are caring are also one of our most undervalued and invisible resources. That needs to change.
I thank the Minister of State for coming to the Chamber for this debate. I pay particular tribute to Senator Fiona O'Loughlin, who has shown incredible leadership in the Irish Women's Parliamentary Caucus in looking at a number of issues. In particular, I pay tribute to the Senator and the others involved in the caucus for organising a day of conversations with many groups. It is particularly important that we have the caucus bringing this motion to the House today.
It is a very detailed motion with specific asks that the Labour Party very much supports. As mentioned earlier, it is important to reiterate the context in which this conversation takes place, namely, the Bill that Senator Clonan brought forward in July providing that very powerful but simple right of a person with disabilities to have a legal entitlement to treatment and supports, which they do not currently have in this country. Of course, the Labour Party also had its own motion in July with regard to carers. The abolition of the means test and radical reform of the domiciliary care allowance are among our key asks, as is the very clear statement on the need to recognise carers in this country.
When we look at the motion, we cannot divorce it from the reality of what is happening or will happen over the coming weeks, which is that 18 section 39 care organisations with hundreds of workers are being forced to go on strike to try to win decent pay and conditions. These are workers providing care to the most vulnerable people in the State and, once again, they are being forced to go out on strike following a number of work stoppages last year. The Government has repeatedly said it wants to stand by the section 39 organisations and stand by those workers, but it has turned the other way. There is a real pay cut. That is the offer on the table and it is a derisory one.
If there can be one plea from today's debate, it is that the Government has to get its act together with regard to the section 39 organisations. The State has chosen to devolve responsibility for working with the most vulnerable people to voluntary organisations. It has a responsibility to ensure that those organisations can function. We cannot wring our hands about the need for services and not look at the retention and recruitment crisis that is very real within those organisations. We very much need an appeal from this House that those workers should not be forced to go on strike but that they get a proper pay offer.
I am delighted the Minister of State is in the Chamber because while we are talking about care and the rights of disabled persons, I want to take the opportunity to talk about disability within the education system. We have seen a very welcome push within our communities on the north side of Dublin for an expansion of additional or special needs provision over the past two years. While that is very welcome, my direct appeal to the Minister of State is for greater joined-up thinking, or any sort of joined-up thinking, within her Department, particularly with regard to the issues that I have brought to her in the past and the new one that I want to bring to her today.
I have spoken to the Minister of State in the past about the instance in Stoneybatter, Dublin 7, where we saw children in the access and inclusion model, AIMS programme, in the early years sector, who lost their school places in order to make way for special needs provision at primary school level. When I went to the Department of Education and asked what it was going to do about it, I was told that it was nothing to do with them because this is to do with the Department of Children, Equality, Disability, Integration and Youth. It is simply not good enough. We have to look at the whole spectrum of children from when they are born right up to when they leave the education system, and not have that siloed approach.
The second key issue is that we have a school, St. Peter's National School, Phibsborough, a fantastic school that has approval for two new special classes. They cannot build those classes because they have serious pyrite issues in the school. The Department of Education has told them that the school cannot build the two special classes until the pyrite is dealt with. The Department has said it cannot deal with the pyrite unless the snags from 2007 are dealt with, and yet it has failed to engage with the school on those snags, or on the responsibilities of the Department regarding the completion of building works. I appeal to the Minister of State to ensure that the building section of her Department talks to the additional education needs section to ensure that these two units are built and that the school's issues are resolved.
The last thing I want to say is on the issue of reading schools. This is about disability within the education sector. We have seen a very clear perspective now within the Department of Education that is openly hostile to the existence of reading schools. Yet, when we talk to experts in this area, they talk about the incredible progress made by children who go to reading schools and who are in the first percentile of reading literacy. Yet when we ask for additional reading schools, or additional supports for the existing reading schools, we are constantly met with rejection. I ask the Minister of State for a review of that policy. I know that work on a paper was conducted and that a number of reading schools were extremely upset at the manner in which work on that paper was conducted and that there was a failure to properly engage with those reading schools when the Department of Education put that paper together. There is a serious question now as to how we deal with those particular disabilities within the Department of Education.
The Minister of State is very welcome today. I am delighted to have her in the Chamber, and I wanted to thank the caucus for putting care to the forefront of the activities of our parliamentarians. It is really important and as we have said many times in this Chamber, the Seanad being made up of 40% women, and having women at the table, makes a difference. That is the first thing I wanted to speak about. Before I was involved in politics, I started an organisation to advocate for stay-at-home parents. It was on that basis that I was seen as qualified to run for the Labour Panel. As they are not in employment, people who care in the home have no union they can join, so it is really very difficult to advocate for themselves. They are also quite isolated. That is why I thought it was really important to have people who are elected to speak about this. We all do as parliamentarians but there are a lot of people at home who do not get to advocate for themselves. That is why it is really important.
One group is those with disabilities who are not in employment. They sometimes are in employment but we know that there are higher rates of unemployment among those who are disabled. There are a lot of people, I guess, who have no access to reputation just because of the circumstances in their lives. Senators may have heard one of my party colleagues, Niamh Ní Hoireabhaird, on various news stations, or read her in the paper talking about the fact that she is getting married in December. She is getting married to another lovely member of my party. She is going to run for election for us in Clane next year. I am not trying to lobby for her but I am saying that it is really important to have in politics not just women but lots of different people who are absent from council chambers. There are lots of people who are absent from this Chamber and most definitely, there are a lot of people absent from the Dáil Chamber who do not get to advocate for themselves. Niamh is at risk of losing her disability allowance just because she is getting married, and that is because of the grouped nature of income. Why is it that before one is married, one has all of these costs associated with having a disability but when one is married, suddenly one is seen as not having them? It is completely unfair and archaic. The exact same thing happens when one is a stay-at-home parent, if one is married. We just have to get rid of it. It is not a decent way to treat people. I would love to hear what the Minister of State's thoughts are on that.
I wanted to point out what the Government is doing, and I know it is mentioned in the motion as well. It acknowledges that spending on the care economy has increased by 21% between 2019 and 2023. That is this period of Government that we are in. It is really hard to say that sometimes because when one is really struggling financially, it feels like nobody cares and no money is being put it into it. It actually has increased by 21% but this just goes to show how low it was in the first place. I know that it is being taken really seriously not just in the spending but also the kind of legislation that is being passed. Recommendation 3 of this motion calls on the Government to provide access to the State contributory pension for those in receipt of carers' allowance. Just this morning at the Oireachtas Joint Committee on Social Protection, Community and Rural Development and the Islands, pre-legislative scrutiny began on the heads of the social welfare (amendment) Bill 2023, which is addressing just that. That was a commitment in the programme for Government, and now it is going through.
At present, there is a huge disadvantage if one stays at home for a period of time beyond ten years. Lots of people do for various reasons, and they have to. I was the Leas-Chathaoirleach of the Oireachtas Joint Committee on Gender Equality, and at that committee, what we heard really clearly was that when one is a parent of young children and taking time off, or one is working and splitting responsibilities, sometimes one has to rush back home because somebody is ill. However, when one is a woman usually over the age of 50 - but it can be at any age - and if one has elderly parents or if there is a vulnerable adult in one's household, it is mainly down to women, and there are other reasons why one has to take time off work. That is an area that we just do not acknowledge and that needs to be taken into consideration. It is disadvantaging women when it comes to their pension rights.
I know my time is nearly up but I also wanted to mention the referendum. We need to push ahead with the care referendum but we need to get it right because we can lose referendums. It was a real concern for us on the Oireachtas Joint Committee on Gender Equality that if the wording sparks something that actually gets people's backs up, then we could lose a referendum that is designed to help people who are caring. We need to get the wording right.
I want to make a final point about section 39 workers. It is an absolute outrage that we have discrimination against care workers, which is what we have. There are lots of organisation that cannot get people to work for them because they are not paid a decent wage. It is time for that to be addressed.
I thank Senator O'Reilly. As no other Senators are indicating, I would now like to call on the Minister of State, Deputy Madigan.
I thank the Acting Chair, and Senators O'Loughlin and Clifford-Lee for proposing and seconding this motion. I also thank Senators Boyhan, Seery Kearney, Warfield, Black, Currie, Sherlock and Pauline O'Reilly for their various contributions. As Senators know, I am not a Minister or a Minister of State in the Department of Health but I have taken a note.
An official sitting behind me has taken note of all the Senators' contributions. If she needs to come back to the Senators about anything, I am sure that will happen.
I express my gratitude to the Irish Women's Parliamentary Caucus, which does incredible work on gender equality. One of the Senators mentioned that 77% of carers in Ireland are female. That statistic alone is enough for us to table a motion like this.
The Government is strongly committed to ensuring that the rights of everybody with care needs are upheld in accordance with their needs and preferences throughout their lives. Recognising the invaluable contribution that unpaid carers make to caring for the most vulnerable in our society, we are also committed to ensuring that carers are fully supported and empowered.
The UN Convention on the Rights of Persons with Disabilities, UNCRPD, has been mentioned a couple of times this afternoon. Since its ratification in Ireland in 2018, we have taken great strides in the development of services and supports for people with disabilities, their families and their carers to ensure that these are aligned with the principles set out in it. A critical milestone in this regard, also mentioned today, was the commencement of the Assisted Decision-Making (Capacity) Act of 2015 and the amending Act of 2022 on 26 April 2023. This brought wardship to an end in the State. This legislation also provided several key measures for further compliance with the convention previously set out in the Disability (Miscellaneous Provisions) Bill, which lapsed with the last Dáil.
In fulfilment of the programme for Government commitment to develop an implementation plan to co-ordinate the implementation of the UNCRPD, the development of a successor strategy to the national disability inclusion strategy is under way, with targeted stakeholder consultation focusing on disabled persons' organisations. Outlining an ambitious programme of work, the new strategy will support the co-ordination of the body of work already in train across the public service on advancing rights under the UNCRPD.
The disability action plan was approved by the Government in July 2023 and will support the implementation of the disability capacity review, in accordance with the programme for Government commitment. The action plan sets targets for addressing demographic pressures, making significant progress on unmet needs, working to replace remaining congregated and institutional residential care with community-based models, and indeed continuing the reform towards individualised, person-centred models of service while growing service capacity appropriately.
The HSE's progressing disability services, PDS, programme is enhancing the model of service delivery to ensure equitable access to standardised services across the country. The PDS roadmap for service improvement will be launched imminently, reaffirming our commitment to providing high-quality services for children with complex disabilities and their families.
Under the national service plan for 2023, the HSE will deliver an additional 70,370 personal assistant hours to expand and enhance the supports for people to live self-directed lives in the community. Approximately 3.12 million hours of home support services for people with disabilities are also expected to be provided in 2023. In addition, as at the end of July 2023, 8,330 residential places were provided for people with a disability and 84 emergency placements had also been provided.
The forthcoming disability action plan proposes the provision of 900 additional residential care places to tackle unmet needs and ensure supply keeps pace with demographic change.
In budget 2023, approximately €11 million was allocated to address waiting lists for clinical assessments for people with disabilities. A working group on workforce enhancement, focusing on disabilities, has been established to examine, identify and provide solutions to matters that are constraining the supply of health and social care professionals to provide disability services.
Increased investment has impacted positively on the provision of respite services for people with disabilities in successive years. HSE data indicate that, in the first half of this year, 76,994 overnight sessions and 21,947 day-only sessions were accessed by people with a disability. The forthcoming disability action plan commits to increasing this level of respite provision by around a third.
The Department of Children, Equality, Disability, Integration and Youth is supporting the HSE on an ongoing basis to improve the availability and quality of data on disability services. The HSE's disability support application management tool enables community healthcare organisation areas to manage requests for support and ensures that the application process is equitable and transparent. It provides a detailed profile of adults and children who require funded supports outside the current service quantum and supports the HSE in its decision-making processes around the prioritisation of services subject to budgetary constraints.
In addition, the development of an integrated community case management system, which will support the patient journey through disability services, is in train. The HSE is also rolling out a dedicated, single consolidated management information system that will collate and provide meaningful data on the provision of children's development network team services.
The Government is also firmly committed to helping older people to age in place in their communities. With its emphasis on reorientating the model of care towards primary and community care, the ongoing Sláintecare reform of our health and social care system, led by the Department of Health, aims to support people with care needs to live independently in their own homes and communities for as long as possible, which is what we all want.
This ambition is being supported by the expansion of home support services, in which the Government has invested an additional €228 million since budget 2021. This year, the overall budget of €723 million for home support has enabled the delivery of 22 million home support hours – an increase of 4.1 million hours since 2019, during which 17.9 million home support hours were delivered. This increased investment has resulted in a reduction in the number of people waiting for home support from over 9,000 at the start of 2020 to 5,992 by the end of July 2023. Of this number, 3,151 new applicants were approved funding for supports, and 2,841 people were already receiving some level of support.
Expanding the provision of home support services necessitates addressing workforce challenges in the sector, particularly the shortage of care workers. To this end, the implementation of the recommendations in Report of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Healthcare Assistants, 2022, is being advanced as an immediate priority. As recommended by the advisory group, 1,000 employment permits for non-EU and non-EEA home support workers were authorised last year.
The development of a statutory home support scheme, to which the programme for Government commits, is well under way and is advancing at pace within the Department of Health. The preparation of primary legislation for the licensing of home support providers, regulations to underpin the new licensing regime, and national standards to support the ongoing quality enhancement of home support services are all in train. Importantly, the regulation of these services will help to safeguard everyone who uses the service and ensure that all service users receive a uniformly high standard of home support when they need it and wherever they may be.
As part of the development of the statutory scheme, a reformed model of service delivery for home support has been piloted across four sites, encompassing the assessment of the care needs of 592 service users with the interRAI single assessment tool. The Government is committed to the national roll-out of interRAI as the standard assessment tool for the care needs of older persons. In furtherance of this objective, the HSE has begun the recruitment of 128 interRAI care needs facilitators.
The Government has also significantly enhanced the benefits available for carers in recent years, with expenditure on income transfers to unpaid carers, who were mentioned this afternoon, having increased by over 50% since 2015.
The number of recipients of the carer's allowance has nearly doubled from 50,577 in 2010 to 94,310 in 2023, and in 2023 over 120,000 carers will receive regular income supports, to the value of about €1.6 billion.
As part of budget 2021, the carer's support grant was increased to its highest-ever rate, €1,850, and in budget 2022 significant improvements were made to supports for carers. The introduction of the long-term carers PRSI contribution provides for a State pension for those who have cared for incapacitated dependants for over 20 years, which is really important.
More broadly, the Government has delivered on the commitment in the programme for Government to introduce a carer's guarantee that will provide a core basket of services to carers across the country regardless of where they live.
Since 2021, the Government has invested €2 million per annum in these services, with additional funding of €950,000 being provided for community supports, and €950,000 being provided for individual supports in 2022. At the same time, a pilot of an interRAI family carer needs assessment tool has been undertaken, funded through the Dormant Accounts Fund, with a view to establishing a standardised mechanism for assessing carers’ needs.
The Government recognises that respite care is a vital part of the toolkit to support carers, and this is reflected in our investment of approximately €62 million in respite beds per annum. In addition, in June 2021, the HSE, in partnership with Family Carers Ireland, launched the home support emergency respite scheme, with funding of €600,000, to provide a total of 27,000 hours of respite care to unpaid carers who require additional emergency respite. In 2023, €4.1 million has been invested in day care services, which are another important source of respite for carers. The Government also allocated €2.1 million in new funding to the Alzheimer Society of Ireland this year to support the resumption of dementia day care services at full capacity following the pandemic.
Recognising that responsibility for caring rests disproportionately with women - and I mentioned that I understand that the statistic is that 77% of carers are women - the Government has announced its intention to hold a referendum on gender equality as recommended by the citizens’ assembly and the Oireachtas Joint Committee on Gender Equality. An interdepartmental group is supporting the development of policy proposals for decision by Government and this work is well progressed. The ongoing enhancement of supports for unpaid carers and the expansion of care in the community under Sláintecare will help address the gender inequality that arises from the fact that the majority of unpaid carers are women.
While we have made tremendous progress in enhancing the provision of care in the community for our older citizens, we recognise that there remain significant challenges which both the Covid-19 pandemic and the scale of ambition of the Sláintecare reform agenda have set in relief. Accordingly, the Government is committed to the establishment of a commission to examine care and supports for older people, as envisaged in the programme for Government. While the scope of the commission has yet to be approved, it is envisaged that its purpose will include the examination of the health and social care services and supports provided to older persons across the continuum of care, and to make recommendations for their strategic development. The work of the commission will be cognisant of the need to ensure continuity of care for persons with disabilities when they turn 65 as well as, more broadly, the need to ensure that the care and support needs of older persons with disabilities are met in accordance with Ireland’s obligations under the UNCRPD. It is expected that the proposal for the commission will be considered by the Government in the coming weeks and that the commission will be formally established by January 2024. I want to again thank the Irish Women’s Parliamentary Caucus, particularly Senators O'Loughlin and Clifford-Lee, the proposers and seconders of this motion, and I thank everybody who contributed. I am grateful for the opportunity to discuss the progress that has been made on all fronts and to discuss the plans to fully deliver on the rights-based care economy, to which we are all committed.
I thank the Minister of State for being here. We appreciate it and I thank her for the points she has brought to us. The introduction of the long-term carer's PRSI contribution for a State pension for those who have cared for incapacitated dependants over a period of time is welcome. There are aspects on which the Minister of State has given detailed information that make a difference to the lives of those with a disability and to those caring for them. I thank all of my colleagues who have spoken on this motion; it is appreciated.
I want to put a few points on the record. First, we agreed that this motion would be heard in both the Seanad and the Dáil, and we are waiting for a time in the Dáil for this to be discussed. I welcome that Senator Boyhan spoke on the motion because it is very important to have men as part of the conversation on the issues the Irish Women's Parliamentary Caucus talk about and bring to the attention of everybody. The Senator raised some general points about women running for election and how difficult it is, particularly in local elections. We have a task, and that is part of what we do. We try to support those who are running, for whatever party or as independents, and we have had engagement with See Her Elected and the Association of Irish Local Government, AILG, on barriers. We have called for and helped secure the security allowance that was announced two weeks ago for councillors, regardless of gender, and we will continue that work.
I want to take Senator Boyhan to task on two issues. One is on Senator Clonan's motion, and Senator Seery Kearney put on the record exactly what happened that day. I would have thought that Senator Clonan would have been happy with the result of that day. There are those of us on the Government side who took a principled decision to make that call because we believed in what that motion was. Trying to politicise it does not do anybody any favours and Senator Boyhan is trying to politicise this motion. I am not here to represent the Government. I a member of a Government party but I am here as the chair of the Irish Women’s Parliamentary Caucus. All of us women, including the Minister of State, are members of the Irish Women’s Parliamentary Caucus. To try to be divisive in it and to call out Government inaction is not appropriate. When we drafted this motion, with the help of Oireachtas Members, it was very important that we tried to not take a party political view but to take a view on what we all felt was important, while taking on board the 38 submissions and the views of the ten different groups that we listened to during our stakeholder engagement. Having said that, we appreciate that the Senator supports the motion and that he was here to speak on it. I also want to acknowledge Senator Currie, who is a member of the working group.
On the section 38 and 39 organisations, I completely agree with Senator Sherlock. Again, the motion was not about that but I had a meeting this morning with the Minister, Deputy Michael McGrath, the CEO of the Muiríosa Foundation and the CEO of Kare, and we spoke about that element. I got the distinct impression that Government is making moves in that direction, and rightly so. It is hugely important that we value the work of caring. I hate talking about section 38 organisations versus section 39 because we are taking away from the value of what people are doing.
We could talk forever about the challenges that people with disabilities face, and we could discuss all of the many things we need to do and put in place, including in the education sector and with the work the Minister of State is doing. We have to come back to who cares about the carer. What we were trying to do in the motion was care about the carer. There should not be a means test of the carer's allowance and we were clear on that in the motion. That was nearly the biggest message in this to successive Government parties. No more than the period poverty motion that the Irish Women’s Parliamentary Caucus moved in a previous mandate, it took until the next mandate to be able to do something about it. It may well take quite a period of time to be able to put everything in train in this.
I thank everybody for their contributions and I look forward to this being debated in the Dáil. I thank the Minister of State for being here and I thank Senator Maria Byrne for chairing the debate.
Question put and agreed to.
Cuireadh an Seanad ar athló ar 6.19 p.m. go dtí 9.30 a.m., Déardaoin, an 28 Meán Fómhair 2023.
The Seanad adjourned at 6.19 p.m. until 9.30 a.m. on Thursday, 28 September 2023.