I wish to share my time with Deputy Tunney and we may try to fit in Deputy De Rossa as well.
Adjournment Debate. - Ballymun Home Help Service Funding.
Is that agreed? Agreed.
I and other public representatives from the area were recently invited to attend a meeting to consider the crisis being faced by the Ballymun Home Help Service. The service can take no new referrals unless they can remove an existing client from their list. If their indebtedness continues at the current rate they will not be able to get facilities from the banks to overdraw any further by October or November next.
The Ballymun Home Help Service provides home care facilities or support to 184 clients. Many of these clients are aged. Unusually in the Ballymun area the aged group are not the dominant group. The case load of the service also includes families in stress, in respect of whom they do vital work. They also care for the disabled, a small but very important group. In Ballymun there is a substantial need for the psychiatric back-up service which they provide. Home-making is another valuable service provided at minimal cost to the State.
I was horrified to find that not only in Ballymun but throughout the home help service in Dublin people in need of support cannot be accepted unless existing clients are crossed off the list. In the past one could always rely on being able to offer the home help service to support, say, an elderly person looking after a spouse at home. One can no longer guarantee that service.
The financial problems of the Ballymun Home Help Service began last year when for the first time they received insufficient funds to meet the budget they provided to the health board. They were unaware until December that they were being given a limited amount of money. Some form of breakdown in communications seems to have occurred at local level. As a result they had a substantial deficit at the end of last year which they understood was to be cleared by the Eastern Health Board. It was paid but they were told that the payment was made by withholding their running costs for January and February of this year. They have an ongoing inadequacy of funding running at about £1,000 a month. Their major problem is the deficit and the fact that the situation in relation to PRSI payments for part-timers is unclear. I know my other colleagues will wish to raise that point and will support my case that this minimal service should be funded adequately. It is a particular attack on women with low incomes who have the opportunity of assisting themselves and their community through this service.
Following an enlightened and convincing visit and discussion yesterday with Sister Catherine and her esteemed assistants in Ballymun I did have, as promised, a discussion with the Minister for Health, Deputy O'Connell, this morning to plead the merits of this vital service catering for a total of 184 people including the aged, the handicapped, the invalided, and psychiatric and stressed persons. Accordingly, I welcome the opportunity of going public to endorse everything that has been said by Deputy Flaherty, and which will be added to by the other representatives, so that a sufficient amount of money will be made available for the survival of this vital service. I hope to make possible the development of such a special service in this area. It did strike me yesterday when speaking with those people that what they had been allocated approximated to slightly less than that which was given to members of respected professions recently for one week's work. If this House cannot make available the amount of money required for these special services we should be looking at other areas where we can effect economies so that a service like this could be better looked after.
I thank Deputy Flaherty for sharing her time with me on this issue. I do not want to cover the ground already dealt with by both of my colleagues in Dublin North-West except to emphasise that our social services and our health services depend to an extraordinary extent on voluntary organisations. It is time we established some formal way of ensuring that these organisations which are providing essential services are budgeted for in a more comprehensive and organised way. There is a constant stream of people — I am sure all Deputies will confirm this — whose budgets are running out of money and who are up against deadlines. They spend much time either trying to raise funds or to obtain money from Departments. I appeal to the Minister to provide adequate funding for the Eastern Health Board to maintain the home help service. In this I would include also Aoibhneas Women's Refuge, located in Ballymun, who are also in serious financial difficulties. There is a general issue here which needs to be addressed by the Minister.
With your permission and that of the House, I wish to share my time with that of my colleague, Deputy Michael Barrett by giving him the first minute of my time.
Is that satisfactory? Agreed.
I thank the Minister of State for allowing me one minute of his time. Like Deputy Flaherty, I, too, represent the Ballymun area and I should like to be associated with and support Deputy Flaherty's motion. I am concerned about the lack of finance, finance without which this service cannot be continued. I am aware of the excellent service provided by the home help workers and I am aware too of the increasing demand for this service. As a member of the Eastern Health Board I can assure the House I have pursued this matter to the utmost. I hope the Minister will do whatever is possible to provide additional finance for the continuation of this excellent service.
Under section 61 of the Health Act, 1970, health boards may make arrangements to assist in the maintenance at home of persons who, but for the provision of such a service, would require to be maintained otherwise than at home. This section empowers, without obliging, health boards to provide or support services such as home help, laundry and meals.
Health boards are not limited in the categories of persons they can assist at home and may charge for the service. The health boards consider individual cases on the basis of need and in the light of resources available to the scheme. In practice, about half of the home helps and the vast majority of meals are provided by voluntary organisations with funding from health boards. The remaining home helps are employed directly by health boards. The balance between voluntary and health board input to the home help service varies from health board to health board. Home helps are predominantly part-time, though a number of full-time home helps and home help co-ordinators are employed by some boards.
The role of the voluntary committee in the home help service is to provide a service, on the health board's behalf, to those persons requiring care and assistance at home so that they can continue to live independently within the community. To this end, the committee act as the employer of the home help organiser and her staff. The committee must also maintain an overview of the service within their area, ensuring that the service is effective, flexible and responsive to the needs of the community.
In addition to ensuring that a high quality service is provided, the committee must ensure that adequate systems of financial control exist for receipt and disbursement of funds, and that an annual audit of the committee's financial affairs is carried out.
I would like to inform Deputies that the overall percentage increase in the amount allocated by the Eastern Health Board to the home help service in recent years has been considerably greater than the percentage increases in allocations to other services or, indeed, to the board's own allocation generally. Every year an allocation is made to each community care area from the programme's total allocation. The director of community care and administrator then allocate this to the organisations in the area having regard to a number of factors.
The Eastern Health Board endeavour to inform organisations of their allocation as early as possible in the year so that they can budget for their service. The Ballymun home help service were advised of their allocation in early March this year. In allocating the funds for 1992 every effort was made to maintain the 1991 level of expenditure.
In 1991 the Ballymun home help service was allocated £101,000. The 1992 allocation is £115,000. I would like to emphasise that Community Care Area 7, in which Ballymun is situated, is receiving a very high proportion, 19 per cent, of the overall sum of £3.7 million which the Eastern Health Board have allocated to the home help service this year. I should add that the number of elderly people or families being assisted by the Ballymun home help scheme increased from 135 in January 1991 to 177 in December 1991 and to 184 in March 1992. I am informed by the Eastern Health Board, that the area director of community care and area administrator are still in discussion with the home help organiser in Ballymun concerning this year's financial allocation and, in fact, a further meeting will take place within the next few weeks.
If you bear with me for one second, in the matter of trying to tailor my thoughts to a half a minute I omitted, and this would be uncharacteristic of me, to express my great thanks to Deputy Flaherty who gave me the opportunity of addressing the House.