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Dáil Éireann díospóireacht -
Tuesday, 18 Feb 2003

Vol. 561 No. 4

Adjournment Debate. - Home Help Service.

I was on my feet in the Chamber for some time last week highlighting the plight of people with disabilities as a result of Government cutbacks. Tonight, I must highlight the difficulties of another group of people who face extreme difficulty, those who depend on home help. I do not know if the Minister is aware of the dire situation in the Southern Health Board region but people in my constituency of Kerry South have been in contact with me about this issue and they are in a dreadful state. The home help service is essential in assisting families who are caring for elderly or ill people. Many families who are trying to keep their lives together while keeping a parent or sibling at home need the home help service. I will not be political about this issue but I appeal to the Minister to use his office to see if anything can be done in the Southern Health Board area for the home help service.

An open letter to the Minister for Health and Children was published in The Examiner today. The correspondent, a woman, said her home help service ceased on 13 November last year. The woman has secondary progressive multiple sclerosis or chronic multiple sclerosis. Her home help was restored on 9 January. She has a husband and two children and her daughter helps her mother with her bodily functions and everything she needs to do. Her daughter has said she doubts that she will ever have children herself because she could not put anybody else through what her mother is enduring.

A family contacted me recently about this matter. Their mother is in the final stages of senile dementia. It is a small family and the members have juggled their lives to keep their mother at home. She had 21 hours of home help but the family received a phone call last week to notify them that this was being reduced by three hours. This might seem small but three hours to this family means they must juggle their lives again, get more hours off work and get their children to mind their mother. I plead with the Minister to ensure that emergency funding is made available for these dire cases so people can keep members of their family at home. If another hour is cut from the home help service for the woman with senile dementia, it will mean she will finish her life in a hospital. The family does not want to put their mother in hospital, they want to keep her at home. The Minister will understand that.

I pay tribute to the local staff of the health board. They are genuine people who work at the coalface. They hear people's grievances. The district nurse recommends the hours but the money is not available to provide the service for those hours. The staff of the health board have to give the bad news. The people giving the bad news are human too and it breaks their hearts to give it. It is unfair of the Minister to put his staff, the patients and their families through such turmoil. The cases I have raised, as well as others, involve people in their final days. I ask that they be given the dignity of staying at home and that their families are assisted in caring for them. I hope I will get a positive response from the Minister of State as to why the Southern Health Board has been instructed to cut home help.

The provision of health-related services for older people and for those with disabilities in County Kerry is a matter, in the first instance, for the Southern Health Board. Since 1997, my Department has allocated significant levels of funding to services for older people and across the disability sector, resulting in substantial advances in the quality and quantity of the health-related services being provided. Additional funding of €27 million has been allocated to services for persons with disabilities in 2003 to meet the full year costs of 2002 developments and to enhance further the services in the sector.

This funding is in addition to the significant revenue investment, amounting to €288 million, which has been made in these services in recent years and which is built into the ongoing budget base. Approximately €100 million in additional ongoing revenue has been provided with regard to the maintenance and development of services to people with physical and sensory disabilities. Such services include, residential, respite, home support services, which includes personal assistants services, therapy services and day care services. A significant proportion of this funding – over €20 million – has been provided specifically for home support services.

In the case of older people, from and including 2000, approximately €230 million of additional funding has been provided to the health boards for a range of services, including the home help service, community support structures, the support of carers, support for the Alzheimer's Society of Ireland and various voluntary groups, improvement in staff ratios and improvements to the nursing home subvention scheme. Government policy in relation to the care of older people is to maintain them in their own homes for as long as possible and the role played by home helps is vital to the success of this policy.

Following the publication of the report entitled The Future Organisation of the Home Help Service in Ireland by the National Council on Ageing and Older People, my Department made available a total of €8 million to the health boards between 1999 and 2002 to expand and develop the home help service and provide appropriate training for home helps as recommended in the report. My Department also made available over €20 million to provide for increased pay rates to home helps. Of the above amounts, the Southern Health Board received over €1 million for expansion of the home help service and over €5 million for the improved pay rates.

The Southern Health Board has informed me that its strategy for older people entitled Ageing with Confidence, which was launched in October 1999, underlines the importance of the home help as part of the community team and the vital role that they play in realising the expressed wish of older people to remain in their homes for as long as possible. The home help service is delivered within the allocated resources of the board and as provided for in its annual service plan. A sum of €30.8 million has been allocated for the provision of the service in 2003. The moneys allocated will enable the board to provide a home help service to 7,000 clients in 2003

The Southern Health Board points out that the levels of home help service within its region have increased significantly over the past number of years, particularly during 2001 and 2002, when an increase of 25 % in service levels was achieved. It should be noted that there has been an increase of 6.2 % in the overall population in the board's area, of which an estimated 5,000 will be over 65, many of whom will require services. In addition, there was an actual increase of 15 % in the population over 85 in the board's area between 1996 and 2000.

The board has indicated that the focus of its service in 2003 will be to make the best use of allocated resources which requires careful targeting of the available resources to those most in need. This will be achieved by regular re-assessment of clients' needs. The home help service, by its nature, is a flexible service and, therefore, the level of service being provided may increase or decrease from time to time, depending on the assessed needs of clients. In the Southern Health Board's letter ofdetermination for 2003 there is provision for an additional €1.2 million to support the home help service. The board has assured me that the number of clients availing of the service will not be cut in 2003.

The Dáil adjourned at 9.05 p.m. until 10.30 a.m. on Wednesday, 19 February 2003.

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