Ceisteanna—Questions. Oral Answers. - Care of Old People.

8.

asked the Minister for Health if his attention has been drawn to the fact that three old people died from neglect over the Christmas and New Year period in Dublin and that the inquests held into their deaths gave heart failure from cold, starvation and pneumonia as the causes; if he will have steps taken in conjunction with the health authorities to endeavour to prevent such tragedies.

9.

Dr. Browne, Mr. M. O'Leary

andDr. O'Connell asked the Minister for Health if in view of the lack of detailed information on the size and scale of domiciliary services provided under the geriatric section of the Dublin Health Authority he will institute an immediate large scale inquiry into the conditions of old people living alone or together in the city area.

10.

Dr. Browne, Mr. M. O'Leary

andDr. O'Connell asked the Minister for Health if he is satisfied that the optimum use is being made of domiciliary care services such as meals on wheels, nursing, medical, laundry, domestic help and ancillary social workers services as are at present provided by the Dublin Health Authority geriatric service in order to facilitate old persons remaining at home instead of being committed to institutions.

I propose, with your permission, a Cheann Comhairle, to take Questions Nos. 8, 9 and 10 together.

I would not accept that the persons referred to by Deputy Flanagan died from neglect. Two of the persons referred to were a married couple; the wife, the cause of whose death was pneumonia, had been out on the day before her death and had been accompanied home by a neighbour. Her husband, whom she cared for, had been medically advised to go to hospital but had refused to do so. In the third case the woman concerned was regularly visited by a neighbour and by a home help. A relative who visited her in the days before her death wanted to get a doctor but she refused to have one. There was food and fuel in the house at the time. In the circumstances I would deprecate any implication that these deaths were the outcome of neglect.

So far as health services for old people are generally concerned health authorities at present provide domiciliary nursing services for old people living at home and these people, if they are in the lower income group, are also eligible for general practitioner services provided by the district medical officers. District nurses are required, so far as this is possible, to maintain a list of old persons in their areas and to try to keep in touch with them. Apart from the services provided by the health authorities themselves, many voluntary bodies in Dublin and other areas are active in providing services for old people. Health authorities assist these bodies by making grants to meet the cost of some or all of their activities. The extent to which use is made of these services provided by voluntary organisations was the subject of an inquiry sent to health authorities within the past week and I hope to review specially this aspect of health activities when the required information has been furnished.

In addition to the health services made available by health authorities, certain other services, such as public assistance and the free fuel scheme, for which the Minister for Social Welfare is responsible, are also provided for old people.

In order to try to provide more comprehensive and co-ordinated services for old people the existing services have been reviewed by an inter-departmental committee whose report will be published within the next few weeks. I propose to ask health authorities to review critically their services for old people in the light of recommendations contained in that report.

It will be apparent, however, that where people exercise their right to continue to live on their own at an advanced age it would be impossible, no matter how good statutory and voluntary services were, to ensure that incidents of the type mentioned did not occur.

Would the Minister agree that although there may be an individual explanation in the case of this particular tragedy, a review of the incomes available to a great number of old people is overdue? Would the Minister agree that on the incomes available to a large portion of the population they could not possibly provide sufficient heat and nourishment during the winter season? Would part of the Minister's review be an upward increase in such incomes?

Is the Minister aware that the social welfare department of the Dublin Health Authority are deeply concerned, backed by the good Tánaiste, to see that no one in our society should be hungry or in want? Is the Minister further aware that the social welfare department of the Dublin Health Authority have an excellent staff to see that nobody is in want? If there is any individual case that has been missed it is not the fault of the social welfare department of the Dublin Health Authority, nor of the Tánaiste who has directed that this should be done from time to time.

What is the purport of the question?

(Cavan): It is not a question. It is an answer.

I am not going to drag out at great length an elaborate description of the deaths of these unfortunate people. I have read all the reports, every single report available, and I am not convinced that even if domiciliary services of the Dublin Health Authority were markedly improved, and, of course, they can be improved, and will be improved as the years go by——

Deputies

Hear, hear.

I am not convinced that even if they had been improved 100 per cent these three unfortunate people might not actually have died in the same way as they did.

I am not criticising the affairs of Deputy Burke's welfare state under the Dublin Health Authority but what I am saying is that, in general, the incomes for old people in this category are inadequate and they cannot procure sufficient nourishment and heat and so on.

They have a good deal more than they had under the Deputy's party's administration.

It would require a miracle for them to survive on some of their incomes.

There are a great number of State and voluntary services helping people of this kind.

You as Minister have a duty to say that their incomes are inadequate.

Question No. 11.