Léim ar aghaidh chuig an bpríomhábhar
Gnáthamharc

Dáil Éireann díospóireacht -
Wednesday, 18 Nov 1998

Vol. 496 No. 7

Adjournment Debate. - Services for Carers.

I welcome the opportunity to raise this important issue relating to carers in advance of the budget in December. Every Deputy in the House knows the sacrifice thousands of carers make every day of the week for their loved ones. Over the years, we have developed an ad hoc system of support for carers in our society. That system has not received the priority or the funding it deserves. Now that the strong economic performance of recent years has produced significant Exchequer returns, it is time to acknowledge the role of carers in our society.

There is a perception that the problems of carers do not affect us. That is a serious misunderstanding. We are all potential carers. Who is to say when or if we will experience the emotional, physical and financial effects of caring for a loved one struck down by accident, illness or the effects of old age? This sacrifice is the reality of life for approximately 100,000 people throughout the country. However, at present only approximately 11,000 people receive the carer's allowance of a miserly £73.50 per week. The forthcoming budget must address the legitimate demands of carers. There must be a substantial increase in the carer's allowance and a commitment to improve the whole area of community care. This would entail the provision of more professional workers such as public health nurses and occupational therapists. To co-ordinate the delivery of these services a liaison person within each community care area, who would assess the needs of carers and liaise with them and the statutory services, should also be appointed.

There is a consensus of opinion in the House that the means test discriminates against people caring for an elderly family member. Extension of the carer's allowance to people who do not come within the means test limit is essential and must be a priority in the budget. The carer's allowance should be a realistic attempt to provide carers with the means to care effectively for their loved ones. Carers often give up paid employment or their potential to engage in paid employment to care for family members in the home. Many daughters give up the prospect of marriage to care for a loved one. There should also be a new non-means tested cost-of-care allowance to cover the hidden costs of caring, such as heating, laundry, special dietary requirements and so on.

In addition to reform of the carer's allowance, it is essential that we develop an adequate system of respite care. The importance of this facility for people with a mental handicap received a full airing in the House last week. A carer's ability to continue caring, thereby saving the State thousands of pounds in residential care costs, depends on the carer having a life and interests apart from caring. Time off is vital to enable a carer to develop outside interests and to devote time to other members of the family circle. Breaks from the ongoing pressures are a basic necessity and resources must be invested in these facilities to ensure every carer is offered a break at regular and planned intervals. The Minister for Health and Children and Minster of State with responsibility for older people have given commitments over the past 18 months to radically improve the position of carers in Irish society. Now is the time for the Government to honour these commitments. Actions speak louder than words. Now that finance is available, there is a moral and political obligation on the State to establish a humane and adequate care system for people who are ill and infirm and for those who dedicate their lives to looking after them.

I look forward to the Minister's reply and to monitoring developments in this area during the lifetime of the Government.

I thank Deputy Ryan for raising this issue on the Adjournment. The extremely important role played by carers in supporting people at home is widely recognised.

A significant proportion of dependent people who are looked after by carers are in the older age category. Current policy towards the care of older people is guided by Years Ahead — A Policy for the Elderly, published in 1988. It provides a framework for the development of health, personal social services and housing to assist older people. The cornerstone of policy towards older people is to support older people at home in dignity and independence and when this is no longer possible to ensure ill and dependent older people have access to the highest quality hospital and residential care when they require it.

The primary responsibility of the Department of Health and Children lies in the provision of front line health services. The health services which impact most on carers are respite and day care together with community nursing and paramedical services and home help services.

In recent years additional resources have been provided to develop community support services. For example, professional support staff have been appointed by the Eastern Health Board to work with older people in their homes. These are known as community ward teams and they facilitate the early planned discharge of older people from acute general hospitals by the provision of rehabilitation and care in the person's home. They also prevent or delay the admission of older people to long stay care and enhance other service supports, including public health nursing, day care, carer support and respite services.

On the mental handicap side, home support services were initiated in 1992 with the purpose of providing additional support to carers where persons with a mental handicap were either waiting for placement in day or residential services or wished to continue to live with their families. The response to the services from both carers and agencies has been very positive and the services have been enhanced and expanded annually. The home support services enable agencies to respond to the needs of individual families in a flexible manner and with a package of care which is designed in consultation with the carers. During 1997 more than 2,200 people benefited from these services.

In summary, the Department of Health and Children's responsibility towards carers lies in the area of provision of mainstream health services and, in particular, the provision of relief care of various kinds, that is day centres, short-term and holiday relief care, night-sitting — freeing the carer for a number of hours — and domiciliary relief care. I accept there is some distance to go in developing such a network. It is my intention to develop a comprehensive range of services, both institutional and community based, for older people including specialist geriatric units, extended care, home nursing, home helps, paramedical services, day care and respite care on a phased basis over the next few years. These would all have a positive impact on carers. This process has already commenced. In 1998 the capital programme for older people has more than doubled. This will result in the provision of an additional 200 day care places and 30 respite places.

I accept the need to provide greater support for carers and this is being actively considered in terms of the availability of additional resources in 1999.

The Dáil adjourned at 9.30 p.m. until 10.30 a.m. on Thursday, 19 November 1998.

Barr
Roinn