I propose to take Questions Nos. 96, 102, 103, 123, 135, 143, 302, 308 and 311 together.
The Central Statistics Office, CSO, included a question in the 2002 census to identify the number of persons providing unpaid personal care for a friend or family member with a long-term illness, health problem or disability. The analysis of this portion of the census, which became available on 15 October 2003, found that 40,500 people provide 43 hours or more unpaid personal help per week, or over six hours per day; 23,400 people provide 15 to 42 hours unpaid personal help per week, or between two and six hours per day; and 84,900 people provide one to four hours unpaid personal help per week, or up to two hours per day.
There are currently approximately 22,000 carers in receipt of carer's allowance or carer's benefit. This means that over 34% of the 64,000 carers, as estimated by the CSO to be caring for more than two hours per day, are in receipt of a specific carer's payment from the Department of Social and Family Affairs. People providing lower levels of care would not necessarily meet all the qualifying conditions for receipt of a carer's allowance.
Carers of more than one incapacitated person are currently entitled to an additional 50% of their rate of payment. This is an acknowledgement of the particular difficulties, both financial and personal, which are faced by these carers. These recipients also receive a double respite care grant of €1,670 in June each year. The introduction of further improvements for this group of carers would have to be considered in a budgetary context.
The respite care grant is paid to carers who are in receipt of a carer's allowance and to carers who are caring for recipients of a constant attendance or prescribed relative's allowance. It is not payable with other social welfare payments. All other matters relating to the provision and availability of respite care generally are the responsibility of my colleague, the Minister for Health and Children.
On the question of paying carer's allowance concurrently with another social welfare payment, such as widow's pension, the primary objective of the social welfare system is to provide income support and, as a general rule, only one social welfare payment is payable to an individual. Persons qualifying for two social welfare payments always receive the higher payment to which they are entitled.
With regard to the definition of full-time care, one of the principal conditions for receipt of the carer's allowance is that full-time care and attention is required and being provided by the carer. Under the legislative provisions, full-time care and attention means that the care recipient must be so disabled as to require continuous supervision and frequent assistance throughout the day in connection with their normal personal needs. In addition, the care recipient must be so disabled as to be likely to require this care for at least 12 months.
My Department takes the view that full-time care and attention does not necessarily mean 24 hours in each day. Full-time care and attention can be considered to apply where there is an ongoing and daily commitment by the carer, and which also generally results in the carer not being able to support him/herself through normal full-time employment. Carer's allowance applications are assessed on an individual basis having regard to the medical and other related evidence supplied by the applicant.
I am aware of the report, The Position of Full Time Carers, which was published by the Joint Committee on Social and Family Affairs in November 2003, and I have examined its recommendations. In relation specifically to the proposal to abolish the means test for carer's allowance, it is estimated that abolition of the means test could cost in the region of €180 million per annum. It is debatable whether abolition of the means test could be considered to be the best way to support carers or the best use of these resources.
The committee's recommendations are broad in scope and cover the responsibilities of several Departments. With regard to the responsibilities of my own Department, the committee proposes expanding the carer's allowance scheme. Those recommendations would involve additional expenditure and could only be considered in a budgetary context. They would need to be examined in the context of current Government policy in this area.
With regard to the introduction of a non-means tested payment to all carers, the review of the carer's allowance, which was published in 1998, considered the introduction of a non-means tested ‘continual care' payment to be given, following a needs assessment, to carers caring for those who are in the highest category of dependency.
More recently, in 2003, I launched a study on the future financing of long-term care. The study considers a range of benefit delivery mechanisms, including the ‘continual care' payment, as well as the issue of a needs assessment. It suggests that consideration be given to a flexible system whereby, following needs assessment, the person in need of care and their carer would select in kind services or a cash payment or a mix of both.
As there are significant issues discussed in the study, including those relating to benefit design, cost and financing of long-term care, my officials are currently preparing a consultation document to accompany the study. This document will focus all interested parties on the specific issues we need to address. I expect that this document will be ready for circulation by the end of this month.
On completion of this consultation process, a working group, which will include all relevant parties, will examine the strategic policy, cost and service delivery issues associated with the care of older people. The issue of a continual care payment will be considered, as will other proposals, in the course of the consultation process.
With regard to the amount of money saved in nursing home subventions, home helps and other services as a direct result of the work of family carers, research suggests that community care can be as costly, if not more costly, than institutional care where a proper and adequate range of community services are provided. This is because the medical professionals involved are mainly dealing with people on a one to one basis, and it is also the case that many people who are being cared for at home also spend a certain amount of time in hospitals.
Government policy is strongly in favour of supporting care in the community and enabling people to remain in their own homes for as long as possible. However, the State cannot, and would not wish to, replace the personal support and care provided within the family and the community. Its primary role, therefore, is to provide adequate support to carers and to those for whom they are caring to enable them remain in their own communities for as long aspossible.
The development of the range of supports for carers will continue to be a priority for this Government and, building on the foundations now in place, we will continue to develop the types of services which recognise the value of the caring ethos and which provide real support and practical assistance to people who devote their time to improving the quality of life forothers.