A number of speakers are offering and each has fourminutes.
Private Members' Business.
Care of the Elderly: Motion (Resumed).
The following motion was moved by Deputy Connolly on Tuesday, 3 February 2004:
That Dáil Éireann notes that:——
— approximately 440,000 people or 11 % of the State's population are over 65 years of age;
— of these, approximately 266,000 are over 70 years, one third of whom live alone;
— 25,000 elderly people are in long-stay beds or nursing homes;
— a further 13,000 elderly people who need high to maximum dependency care continue to live at home;
— it is the wish of a large majority of elderly people to receive care at home or in the local community; — very many families of the elderly make many sacrifices to provide the best possible care for them;
conscious that the inadequacy of the nursing home subvention causes grave hardship for many families;
conscious that cuts in the home help scheme have seriously limited the adequacy of the service;
believing that the failure to abolish the means test for the carer's allowance is a further attack on the most vulnerable in our society;
recognising that day care centres serving the elderly in disadvantaged communities are grossly under-resourced;
alarmed that the failure to mainstream health related community employment schemes has undermined a community-based response to caring for the elderly;
notes with extreme concern the remarks of the Tánaiste and Minister for Enterprise, Trade and Employment that families increase their contribution to supporting the elderly with a consequent reduction in State support;
calls on the Tánaiste and Minister for Enterprise, Trade and Employment to clarify her position; and
demands that the Government immediately put in place adequate resources and comprehensive infrastructure for the care of the elderly.
Debate resumed on amendment No. 1:
To delete all words after "Dáil Éireann" and substitute the following:
"— recognises the importance of addressing the needs of older people, particularly as our population ages;
— restates its policy of supporting older people who wish to continue living at home in the community for as long as possible and acknowledges the role families play in supporting their older relatives in the community;
— acknowledges the significant funding which this Government has committed to the nursing home subvention scheme and to the home help service;
— acknowledges the substantial progress made by this Government in expanding the income limits for the carer's allowance and in implementing significant increases in the value of the respite care grant for carers in line with its commitments in the Programme for Government;
— acknowledges the significant measures being taken by the Government to develop both residential and community based services for older people, including increased day care provision, and the continuing commitment in this regard;
— re-affirms that the primary role of the community employment scheme is that of an active labour market programme, and recognises the need for ongoing restructuring to ensure it continues to meet the specific needs of long-term unemployed persons, together with other vulnerable groups;
— in particular, approves the Government's commitment to put in place an increased level of service provision in line with the Programme for Government; and
— commends the actions taken by this Government and the previous Government since 1997 in meeting this commitment which includes the allocation of substantial additional funding.
—(Minister for Health and Children).
I wish to share my time with Deputies O'Connor, O'Donovan, McGuinness, Fiona O'Malley, Cregan, Kelly and Carty, all of whom have four minutes except the last speaker who has two minutes.
Is that agreed? Agreed.
Who is representing the Minister — is it Deputy Mulcahy?
It is Private Members' time, it does not have to be a Minister.
In fairness, the Minister should be in the House.
I expect the Minister very shortly.
I am very pleased to have an opportunity to speak on issues related to the provision of services for older people and to outline what the Government is doing.
On a point of order, it is ridiculous that a debate should continue in the House in the absence of an appropriate Minister.
I advise the Deputy that we have a Minister as of now.
I am very pleased to have an opportunity——
It is clear that the Minister of State, Deputy Hanafin, had to leave some function or job to come and cover for some other Minister.
I hope I have not been penalised on time. In fairness, my time allocation should start from now. I am pleased to have theopportunity to speak on issues related to the provision of services for older people and to outline what the Government is doing to meet the needs that have been identified for this population group.
Services have been developed in line with the recommendations in The Years Ahead — a Policy for the Elderly, the report of the working party on services for the elderly. Poor quality, older long stay accommodation for the elderly has been upgraded or replaced and there has been a progressive shift from the provision of care in institutions to care in the community in line with the recommendations in the report and in keeping with the wishes of older people. The emphasis now is on providing and developing appropriate community support services to enable older people to live in dignity and independence at home in accordance with their wishes as expressed in numerous research studies.
In my constituency and beyond there are different models of what is excellent new thinking in this area. Examples include Fr. Kitt Court in Crumlin, St. Andrews community centre, Rialto and, outside my own area, an independent living area for senior citizens, Brabazon House, run by Protestant Aid in Sandymount. This is the future of care for the elderly.
Most elderly people want to be independent, if at all possible. The last thing an elderly person wants is to be put in a residential home and forgotten about. The first and best option is help, assistance, care and love in a family home or in their own independent home and, if necessary, in a community and, only as a last resort, in a residential home. The so-called liberal thinking on care of the elderly is that families have to somehow forget their responsibility. Parents look after their children when they are young and children should look after their parents when they are old. There is no getting away from the primary obligation of people to look after their parents. I lost time to the interruptions but I will give way to the next speaker.
I am not going to deal with the hecklers because I do not have the time. I am not going to take lectures because as a member of Fianna Fáil in Government since 1997, we do not have to take lectures from anybody about what we have done for the elderly. Look at the budget figures over the past number of years and compare them with the figures for the years before that. I am glad to see the Minister of State at the Department of Health and Children, Deputy Brian Lenihan, is present but I am sorry that his colleague, the Minister of State, Deputy Callely, is not present because of other Government business. I admire the Minister of State, Deputy Callely, because he has been taking some unfair criticism from the other side of the House in the way in the past week or so. People are saying that he is too busy, that he is sending too many letters. He is doing a great job.
I have known the Minister of State, Deputy Callely, for a long time since he first became chairman of the then Eastern Health Board in 1984 and when I joined the health board in 1994, he was always extremely helpful to us all, ensuring that the resources of the health board were made available in various areas. He did a tremendous job and he continued as chairman of the Eastern Regional Health Authority. I had the privilege of bringing the Minister of State to the new senior citizens centre in Kiltipper Road, Tallaght, a little while ago. Not only did he have a cup of tea but joined in the singing and dancing. Fianna Fáil Ministers are on the ground, doing their job.
I come from a community which has a very young population, but we are all ageing. I am from a generation where I am as aware of that as anybody else. In Tallaght we are doing a great deal of work for the elderly in Glenview day care centre and the Kiltipper centre. The health board has a facility in Brittas, which is almost in Tallaght.
I am not afraid to make the point that we need more resources to meet the needs of the elderly. I strongly support the private nursing home development taking place in Kiltipper Road. When it opens this summer it will be a boost to services for the elderly in the area.
I compliment the Independent Members for tabling this motion because it gives colleagues across the House an opportunity to debate issues of the day. Caring for the elderly in our communities is one such issue. It is a shame we do not have more time to debate it.
I have read the motion and the Government's response, which is very positive. I look forward to remaining in touch with the Minister and the various agencies to ensure that we continue to care for the elderly among us.
I might take a leaf out of the previous speaker's book and be parochial. We get a pain in the head sometimes from hearing about Tallaght. I am not saying that in a derogatory way, but the Deputy refers to it frequently.
The cottage hospitals in Schull, Clonakillty, Dunmanway and Castletownbere were neglected for many years. Phenomenal work has been done in those hospitals in the past four or five years which has been gladly welcomed. Extra facilities have been provided in Bantry hospital at a cost of several million euro. The needs of the elderly are now met by the appointment of a geriatrician among other things. In excess of €2 million was spent in Schull where we were campaigning and raising funds for more than 30 years for a day care centre. It was eventually opened last year. In Castletownbere we had similar a situation. The local hospital was upgraded with new beds, new facilities and additional staff to care for the elderly. It also happened at another small hospital in Dunmanway. When one compare what the Government has done for the elderly, not alone during this term of office but over the last six or seven years, with what went before, we can hold our heads high.
While canvassing during the last general election campaign, I met a 93-year-old man on Bere Island. He was an old republican and remembered Éamon de Valera coming to Castletownbere in 1932. The old man did not know me well but, unfortunately, he knew my constituency colleague, the Minister for Agriculture and Food, Deputy Walsh, much better. I had a job to persuade him to come on the right side of the fence. He remembered when there were no pensions and he remembered the shilling pension that was introduced later. He is in receipt of a pension now but due to his advanced years he is unable to travel to the mainland to spend it. He said, "Why should someone like me complain?" He was living on his own on that island. He had no axe to grind, although he probably went through hard times in the past, having lived for almost a century on an island that had been occupied by the British forces for several years. Yet, as far as he was concerned, he was well catered for by the Government.
In 1997, approximately €12.7 million was spent on care of the elderly. By 2003, that sum had risen almost tenfold. Inflation has been relatively steady during those years and never went into double figures, yet almost €112 million was spent last year, and the figure is rising annually. Having said that, I welcome the motion tabled by the Independent Deputies because care of the elderly is an issue — like looking after people with sensory or physical disabilities — about which one cannot do enough. We must care for the less well off in our ageing population. Even if we doubled funding for care of the elderly, we would probably still be lacking part of the provision of such services. I welcome this debate but we should take into account the improvements in care for the elderly that have occurred over the past decade.
I compliment the Minister for Health and Children on the work he has undertaken in the Department and his achievements to date. The speech by the Minister of State, Deputy Callely, was most impressive because, as well as dealing with the usual schemes, he also outlined the various pilot schemes that have been undertaken in other health board areas. I am impressed by the imaginative schemes that are currently in place and the sooner they can be implemented in other health board areas, the better. Care in the home is something that every elderly person desires, rather than being hospitalised. The Minister of State mentioned the personal care packages, which can ensure that old people are cared for in their own homes.
I compliment the work of the senior citizens' parliament. In my own constituency its members have made a positive contribution to this debate in identifying areas where action can be taken, which will result in improved schemes for the care of the elderly.
In addition to what the Minster is doing, we must also examine the schemes that are already in place and judge them in terms of value for money, efficiency and delivery. The DPG scheme and housing aid for the elderly need to be re-examined. They attract a significant amount of national funding from the Exchequer but there is too much of an overlap from health boards and local authorities. We could achieve greater efficiency while spending more money on such schemes.
I wish to draw the Minister of State's attention to the need to deliver a 30-bed unit at St. Canice's Hospital at a cost of €2.4 million. That unit would fill a gap in the care of the elderly in Kilkenny city. The issue has been debated as part of the political agenda for the past 20 years but we need to take action on it. We also need to examine the role of health boards. The South Eastern Health Board has 114 acres of urban development land and 235 acres of agricultural land over and above its requirements. It is time we drew attention to these landbanks all over the country. Alongside the investment the Government is making for the care of the elderly, and health services generally, we should encourage health boards with such landbanks to dispose of them. In that way they could invest in frontline services, including the care of the elderly. We must ensure that a bias is built into health policies to deliver services for old people.
The disposal of large landbanks should be prioritised by every health board. For example, I am sure that if the landbank I referred to in the South Eastern Health Board's region was disposed of, it would deliver not only the 30-bed unit at a cost of €2.4 million, but would also deal with many other health issues in the counties comprising the region.
We need to focus on the care of Alzheimer patients through local partnerships that can be formed with groups acting to raise funds and care for such patients. We should examine the possibility of working in partnership through health boards to work with local groups to deliver services for elderly Alzheimer patients in particular. We should also ensure that local units can provide institutional care based on the same kind of care that patients would receive at home. Such services need to be developed rapidly throughout the country. If money raised through the sale of landbanks owned by health boards could be invested directly in such projects, there would be less demand on other health board funding. We would then see the kind of health services that all of us in the House argue for, being delivered more quickly. In that way, services for the care of the elderly would be improved. I would encourage the Minister to examine that proposal.
It never ceases to amaze me how Opposition parties manage to work themselves up into a frenzy of indignation at the mere mention of the Tánaiste or the achievements of the Progressive Democrats.
Spare us.
They regularly break out in a sweat at a list of our policies and achievements in Government. They reach their highest state of indignation and agony when they decry what they claim the Tánaiste said, rather than what she actually said.
Tell us what she said.
Have they nothing better to do, nothing to offer the electorate and nothing further to say? As my colleague, Deputy Sexton, said earlier in this debate, no one in this House has a monopoly on social concern, justice or care in the community. We accept, for our part, that that applies equally to the members of the Technical Group. We recognise fully the record of life expectancy and the effect on mortality in Ireland its members from the republican movement have had. We recognise fully what the republican movement has done for active retirement in the cases of Detective Garda Jerry McCabe, Jean McConville and many hundreds of others. We recognise the contribution they have made to the health status of the population with baseball bats, blindfolds and balaclavas.
We recognise that the parties in the Technical Group promise everything, yet deliver nothing. It is always easy to call for more money, extra expenditure and additional services — more of everything they know they will never be asked to implement and deliver. Predictably, therefore, the motion seeks more of everything. No one is against more services, more support or more care. It is highly relevant that these are the very services and supports that the Government has introduced and that the parties opposite have never done anything about.
The Progressive Democrats ideology is cutting back on services.
It is highly relevant that each and every support for carers that has been delivered, was introduced when the Progressive Democrats was in Government.
The party has no democratic mandate.
It is also relevant that the Progressive Democrats-Fianna Fáil Government has got on with the job, delivered more pension increases, more money for carers and more home help. It is about making a difference, not making a fuss.
Ask the 70,000 people without services.
Behind this motion there is no real effort to enhance services or to put financing of long-term care on a fair or sustainable basis. These are challenges only parties in Government will address. I am talking about parties currently in Government which are prepared to accept the responsibility of Government.
We are willing to address issues for an ageing Ireland, issues which mean taking a long-term view of sustainable services for an older population. It was for this reason the Progressive Democrats organised its recent conference. The issues are complex and require thought, consultation and reflection. The clear reason the Technical Group has nothing constructive to say on the matter is that this consideration has not taken place.
We have an opportunity now to address age issues and to avoid the problems that have beset older populations in other countries because they acted too late. We must think and act strategically. As my colleague, Deputy Sexton, said yesterday, we must counter the aura of negativity that surrounds debate about older people, an aura to which this motion only contributes.
We are all ageing and some of us are aged already. We will not become dependent, decrepit and demented just because we turned 65, 75 or 85. Our policy for ageing Ireland should be developed to meet this reality as well as the real needs for care and financial support of many older people. We in the Progressive Democrats are doing this. We are getting on with the real job of policy development, called governing — not that this is of much interest to the Technical Group.
I am glad to have the opportunity to defend the Government's record on the provision of care to the elderly. The Government has been fully committed to enhancing the care of the elderly and the Taoiseach is to be complimented on appointing a Minister of State with responsibility for the care of the elderly, Deputy Callely, who has done an excellent job during his short time in office.
It has long been the policy of the Department of Health and Children to encourage older people to remain in their communities and retain their independence for as long as possible. It is necessary to have certain provisions in place for them to do this. The old age pension has been increased substantially since 1997 to the current figure of approximately €150. This will be enhanced to a figure of €200 by the end of the lifetime of the Government.
Everybody over the age of 70 in the country is in receipt of a medical card. This is important for those people who need to visit their general practitioner or get medicines on a weekly or monthly basis. People in receipt of old age pensions also have additional entitlements such as free units of electricity, free telephone rental, an additional fuel allowance and a free television licence.
We also have three different schemes in place to ensure that people have proper facilities in their homes: housing aid for the elderly, which is administered by the health boards, disabled persons' grants and essential repair grants. I encourage the Minister of State, Deputy Callely, to streamline this area because some people avail of all three grants while others get none. This area needs to be examined. The Minister of State has a review group in place which will try to ensure that we enhance the area by having one scheme which will cover all older people who require work to be done on their homes.
Besides these schemes for people who live in their own homes, we have day care facilities in almost every town. People may avail of transport and leave their homes to come to the day care centres where they can avail of either social or medical therapy, something they appreciate greatly. We also have respite facilities available for them.
Our carers must be rewarded for the fantastic job they do. The carer's allowance is being paid and over the past number of years there have been changes in the means test so that more people can avail of the allowance. The carer's benefit means that people may leave their jobs for a short term to care for elderly relatives. These schemes are in place to help people who want to live in their homes. The Government must be complimented on putting these schemes in place. I do not say we have a perfect system; we do not. There are gaps to be filled and anomalies to be rectified. I encourage the Government and the Minister of State to continue the good work to ensure that people do not fall between stools and lose out on the different payments and services available.
Unfortunately, some older people cannot be cared for in their homes because they need specific treatment. We have some excellent facilities in our public geriatric hospitals. In St. Ita's Hospital in Newcastle West in my constituency, people receive top-class care, sometimes indifficult circumstances. I compliment the staff and management of such hospitals on the manner in which they carry out their duties. We also have private nursing homes and tax breaks available for people who have invested in these. Nursing home subvention has been increased over the years. I would like to see the subvention increased and improved because some families have no choice but to place their elderlyrelatives in care. They often find at the end of week that there is a shortfall which they must meet.
There has been a ten-fold increase in spending in care for the elderly from 1997 up to 2004. This must be admired although there is more work to be done. I compliment the Government on what it has done and encourage it to do more.
The policy of Fianna Fáil in Government is: to maintain older people in dignity and independence at home, in accordance with their wishes as expressed in many research studies; to restore independence at home to older people who become ill or dependent; to encourage and support the care of older people in their community by family, neighbours and voluntary bodies; and to provide a high quality of hospital and residential care for older people who can no longer be maintained in dignity and independence at home.
There are more than 900,000 people aged 50 or over in Ireland. In the past, the growth in the number of older people has been referred to in negative terms. While old age has been associated with dependency, the vast majority of older people are healthy and independent. Our aim in Fianna Fáil is to provide improved services which benefit an older population whose contribution to society is fully acknowledged by the Government.
All our budgets have been characterised by measures to improve the position of older people in society through their pensions. Those with selective political memories should not be allowed to forget that, over the three budgets of the rainbow Government, the Labour Party Minister for Finance gave pensioners an average increase of €2.95. In contrast, the average increase to pensioners under the budgets of the Minister for Finance, Deputy McCreevy, now stands at €9.75. In percentage terms, the old age contributory pension increased by less than 10% under the rainbow Government. Under Fianna Fáil it has increased by well over two thirds. The figures speak for themselves.
The effect of the increases under Fianna Fáil is that the rate of old age contributory pension will now stand at €167.30 per week, an increase on the €99 per week which was payable on the day the rainbow Government left office. The increase in pensions this year is real and ahead of inflation. Our critics on the Opposition benches should explain why, when they were last in office, old age pension increases stood below the rate of inflation.
The cornerstone of policy on the care of older people is care in the community. The overall aim is to support older people to allow them to live with dignity in their own communities for as long as possible. I pay tribute to all those who look after the elderly. The people who work in public and private nursing homes are an example to us all.
I wish to share time with Deputy McManus.
Is that agreed? Agreed.
I welcome the opportunity to speak on the motion and to commend the Technical Group on choosing to debate the important issue of care of the elderly. In his speech last night, the Minister of State with responsibility for the elderly, Deputy Callely, asked the House to believe the Government was aware of and is addressing the needs of older people. He said little to convince us and the wider community that this is the case. His statement contained no proposals to deal with the issue. It was full ofreferences to reports, reviews, working groups, interdepartmental groups, pilot schemes, national implementation groups and public private partnerships, the last of which will be a disaster. While there has been no shortage of talking shops to date, there has been precious little action.
The situation facing many older people has reached crisis proportions. Following telephone calls and visits from constituents, I visited accident and emergency departments at a number of Dublin hospitals. It was appalling to have to speak to older people, some of whom were crying and asking me to get them out of the hospital and bring them home. People were lying on trolleys for up to 40 hours while public beds were left unoccupied. It is a scandal. While I commend the professionalism and the caring attitude of the staff working in such atrocious conditions, the Minister must address the lack of dignity afforded to older people. They have scraped and made sacrifices over the years on behalf of their families and the State but must now endure terrible conditions when they are in need of medical care in old age.
I have paid visits to elderly people in my constituency and received numerous telephone calls on their behalf. I provide the House with the example of a husband and wife aged 78 and 82, respectively. The husband suffers from Alzheimer's disease and in recent weeks has been confined to a wheelchair. He must be helped into and out of bed. His frail wife, who has been diagnosed with the early stages of Parkinson's disease, has endeavoured for the past ten years to care for him and continues to do so. While he is in receipt of a limited though welcome amount of respite care, she cannot cope on her own. Her husband has an immediate requirement of long-term nursing home care, but I question his prospects and the prospects of thousands of other older people of receiving this care.
Older people in need of long-term public nursing home care in areas of Dublin now face a waiting period of up to 12.5 years. While the Tánaiste lectures families as to their responsibilities to care for the elderly, the Government fails to meet its obligations. It is turning its back on the crisis it has allowed to develop. Approximately 150 elderly people are on each of the waiting lists in community care areas Nos. 6,7 and 8, which are north of the Liffey. This is about 450 people in total. I have been reliably informed that the withdrawal of contract beds, which are beds in private nursing homes which were hired by the health boards last September, means there has been an average of only one placement from each waiting list per month.
A vacancy occurs only when a patient in care passes away. This means a hospital in-patient capable of being discharged to a nursing home or an individual in the community seeking permanent care must wait for up to 150 months for placement. Clearly, this is ridiculous. If it is allowed to continue, many of those on the waiting list will have passed away long before they are offered a bed. Consequently, many elderly people are forced to remain at home and rely on family support where available at a time when community care and home help services are being cut back. It is also the case that hundreds of acute hospital beds are being occupied by elderly people who do not require that level of care.
Older people may have to wait for up to 12.5 years for long-term nursing home care, should they live that long. It is appropriate and imperative that home help services be extended and developed. Last night, the Minister of State said the Government was committed to developing these services for the elderly. We must ask if we can believe him given that the facts do not bear out his statement. From information received from the different health boards, I can confirm that there was a reduction of 250,000 home help hours in 2003 from 2002. I do not have all the information yet and this figure does not include returns from the Eastern Regional Health Authority. The statistic emphasises clearly that basic care for people in their homes is being cut back drastically by the Government whose members pay lip-service to the elderly in this Chamber.
Community care services are essential to maintain at least 90% of people aged 75 or over in their own homes. It is clear to the Labour Party, which carried out investigations throughout the country, that they are not being provided. The key community care services for older people and their carers are domiciliary nursing, general practitioner services, home help, respite and day care services, and meals and transport services. However, other factors and services must be provided. These include paramedic services such as occupational services, physiotherapy, chiropody, speech therapy and social work services. Chiropody and physiotherapy care is required by 50% of olderpeople.
While the pressure on hospital consultants to treat medical ailments will decrease, there is a serious chiropody problem. People have an ongoing problem trying to access chiropodists. The issue must be resolved as proper chiropody reduces an older person's chance of suffering a fall and ending up in an acute bed or a nursing home. There is evidence that people with medical cards cannot find a chiropodist to provide them with a free service. Chiropodists who provide a service now ask for a top-up fee. This is a serious issue. It is also very difficult to get a registered chiropodist to provide a home service because of current fee levels and structures.Perhaps the Minister might clarify those allegations, which are scandalous and, if true, unacceptable.
This wide-ranging issue needs debate on an ongoing basis. However, judging from the Minister's commitment and the needs of the elderly who served this country, the Government has failed them. Unfortunately, I cannot envisage from any commitment given today that this will change in the near future.
I have listened to many comments from the Fianna Fáil side of the House regarding the dignity of older people. I suggest that the party's members might like to visit an accident and emergency department and see how much dignity is provided for elderly people awaiting treatment or a bed. In Cavan Hospital, a patient in her 70s and on a drip was left sitting in a chair overnight waiting to get a bed. However, I welcome the opportunity to speak on this issue, which is extremely important, and the Technical Group, including Deputy Harkin, should be complimented on introducing it.
It is fair to point out that the vast majority of older people live independent lives and make a contribution to society. Although that is obvious, we should state it. It is a time of opportunity, wisdom — one hopes — and change. A full life can certainly be lived by older people. More people are getting old. The greying of Europe is a well-known phenomenon. By 2020 approximately one in five Europeans will be aged 65 or over. In Ireland, the rate of greying is not as rapid. At that stage, in 2020, our average age will be five per cent lower than that in continental Europe. In that regard, we do not have the same scale of issues to address as others, particularly in Europe. The challenge is much less acute, and we should be able to meet it, especially at a time of such prosperity.
Unfortunately, however, there is no real evidence that this Government is setting out to address the issues and meet that challenge in ways that are humane, competent, systematic and methodical. Those are the people who created the prosperity for us and who deserve our collective attention as a community to ensure that they live out their lives with some kind of comfort and security.
One organisation that represents older people made some valuable points in a very recent publication on long-term care. Age Action Ireland described the situation regarding long-term care beds for the elderly as "a mess". Three Dublin consultant geriatricians used the word "crisis". Whatever the most appropriate description, few professionals or clients of the service can doubt that there is a significant political, financial and logistical problem to be solved. They go on to talk about the shortage of beds, the fact that their numbers are being reduced, and that, although elderly so-called "bed blockers" are in hospitals, many elderly people in the community suffer from respiratory and cardiac conditions or anaemia who should be in hospital and cannot access the beds. The situation is serious. It is therefore very regrettable that, instead of getting good, meaty policy regarding the care of the elderly, there is a situation regarding long-term care described by Age Action Ireland as "a mess".
From the Tánaiste, in particular, we get ideology, and that is very regrettable. It is important to remember what she is reported as saying in The Irish Times: “Is it fair that people require the State to pick up the bill, and then they get the benefits when people die?” She is also quoted as saying that society has become increasingly greedy. That is ironic. She says that too many families leave the responsibility for minding family members to the State or someone else. Just in case anyone missed the point, she talked about using a carrot and stick approach to the issue of care of the elderly. What is that about? That is ideological rather than dealing with reality. It must certainly be challenged, and that she has become so furious about the criticism she has received does not alter anything about what she said.
If saving the taxpayer an expense is the issue, she is saying that no elderly person who might wish to be independent can expect to have the right with community supports such as home helps, or even dished footpaths or the services of the district nurse. Are those not things that elderly people might expect to have as a right? The reference to nursing home care suggests that people were not looking after their elderly relatives and had somehow decided that they would not care for their mothers anymore. That is not how things are. People put great effort and expense into looking after their elderly relatives within their families.
If the Tánaiste had any honesty, she would have pointed out that, when it comes to the idea of family assessment or any way of engaging with younger generations to contribute towards the elderly, she should look to the record of her Government. The Ombudsman discovered that the State, without any statutory authority, had robbed family members of up to £6 million through forcing families to pay contributions to nursing home subventions.
The most extraordinary aspect is that her words now were mirrored then in 2001 by those of the Minister for Finance, Deputy McCreevy. There are Progressive Democrats in Government who are members of Fianna Fáil, and the Minister for Finance, Deputy McCreevy, is one of them. He certainly found a soul mate in the Tánaiste when she made her recent comments. He was being asked to reimburse the people who had been robbed of their money, and he wanted to ensure that the Government held firm and did not pay back what it owed. Even though the law was quite clear according to the Ombudsman that a health board, under the Act, is to pay such a level of maintenance as it considers appropriate, having regard to dependency and the means and circumstances of the person, the Minister for Finance, Deputy McCreevy, tried to prevent the State living up to its obligations. That is a shabby record, and the two parties in Government must live with it, especially when they resurrect the issue themselves. Is that what the Tánaiste, Deputy Harney, is talking about now — that the same family assessment which turned out to be a shambles will be applied by health boards with no authority in law?
I have very little time left, but I would like to mention a young man who came into my clinic in south Wicklow. His mother lives on her own in a little house in a rural part of the county. Her suffering from Alzheimer's disease has worsened in recent months. He and his brothers and sisters are trying to look after the woman. It is now impossible for them to do so. She needs 24 hour care. They are on very modest incomes and have children to raise. To hear a lecture being given by the Tánaiste from the comfort of this House or a seminar to those people trying to manage in a rural area with very little support apart from very good voluntary agencies and the district nurse is hard to stomach.
At present, the woman is in respite care for two weeks. At the same time, there is a private nursing home down the road with empty beds, and the Minister for Health and Children has provided those who built those nursing homes with fantastic tax breaks. His generosity was so overwhelming that he went further and extended the breaks to one of his constituents, who is now building a private hospital. Today, under the Finance Act, he is extending that generosity on private nursing homes even further. I do not know what that thinking is about. The nursing homes representatives are pleading with the Minister to end the tax breaks because of the danger of a glut. There are empty beds andthere are frail, vulnerable elderly people who need to be able to access them but that is not happening.
It is the core responsibility of this Government to deal with that need. It should not lecture us or try to stop legitimate payments, as has been done in the past. It should keep ideology out of the debate and start to look at the real needs of people who are struggling and who will continue to do so without a proper home help service, the chiropody they need when they get older and help with looking after eyesight and hearing. These are services people need but cannot get without resources. The Minister for Finance and the Tánaiste can lecture us about our responsibilities but I point to their responsibilities in this issue.
At the outset I thank the proposers of this motion for highlighting many of the important issues surrounding the well-being of elderly people in this State. I am well aware from my constituency that there are far too many people living in poor circumstances which are the consequence of neglect. Indeed, I know of cases in which elderly people are living in truly appalling circumstances. In many cases, these people are living in isolated parts of the country, although living in a town or city is no barrier to this social isolation.
Elderly people living in rural areas are often in a vulnerable position. It is made worse by the fact that a higher percentage of the rural population is elderly. In the last census almost half of those over 65 years of age were living in rural communities. Elderly men in rural areas were almost twice as likely to be bachelors as those living in cities and towns. Again, that is something which adds to the problem of isolation. It is a documented fact that older, unmarried men living in isolated circumstances are more likely to suffer from a range of problems affecting their mental and physical health. They are more likely to drink heavily with all the problems that creates. It is no coincidence that the president of the IFA was asked to make an advertisement for the Samaritans in the recent past. Unfortunately, the reality is that more and more people, particularly men from isolated rural areas and small farming backgrounds, are inclined to take their own lives. None of us can ever know what causes a person to take their own life but it does not take a genius to discover a link between suicide and social deprivation, whether material or simply a lack of a humane society.
It is, therefore, a duty of society as a whole to ensure that the elderly are not allowed to slip into such a state. Of course each of us, especially if we have elderly relatives, share in that duty. Communities have an obligation to ensure old people living among them are made part of them. However, the State also has a duty to provide the wherewithal to ensure that elderly people have sufficient money on which to live and that they have secure and safe accommodation and access to whatever public services they need.
There are some on the extreme right who will argue that this is not something the State should be doing and that people should provide for their old age while they are working. Most people try to do so, through insurance and so on, to the extent that they can. However, I would argue that any person who has contributed to society through work and paying taxes or in any other way has a right to expect that society will protect them in their old age. That has been one of the marks of a humane society since the ancient so-called primitive times. Indeed, I doubt if the stone age ancestors threw people out of their caves when they were no longer able to go out to get food. However, that would appear to be the mentality of some of our liberal economists who see nothing wrong with elderly people being deprived of their homes if they can no longer afford them.
Thankfully, this society has not yet been captured by that kind of thinking but there is evidence that the elderly and the vulnerable are paying the price for a public policy that is increasingly market-led. Not only are elderly people finding it difficult to remain their homes because of rising costs, but they are also suffering because of the cutbacks in public services.
I draw attention to an old lady of 92 years age who lived in a single bedroom house in Tralee. She had the services of a home help for one hour five days per week. Many public representatives from the area tried to have it increased to seven hours per week so that she would have that service everyday. Unfortunately, she fell and broke her hip on a Saturday and was not discovered until the Monday. She subsequently died. What is ironic is that she was part of the 1916-23 period of struggle which created a society in which all of us have enjoyed some relative freedom. This Government and the system failed that old lady as it fails tens of thousands of others throughout this country. It is a shame that people who are charged with responsibility to regulate society so that we can have equality and justice and look after our elderly and the people suffering from social deprivation fail in the responsibilities with which they are charged. They are failing to take care of the most vulnerable sections of our communities, both the young and the elderly.
The programme for Government contains a small section dealing with older people. The first sentence is worth quoting. It states: "One of our core objectives will be to help all older people live in dignity which their immense contribution to the development of our country deserves." Reading through the ever damning statements on the motion put down by the Independent Members, which Sinn Féin is proud to support, I wonder whether the Government Deputies lined up last night and tonight to defend its record on assisting the elderly really think the Government is adequately rewarding them for their immense contribution.
A survey carried out by the Economic and Social Research Institute and reported before Christmas found that one in four people living alone have no central heating. Is it any wonder that the State is joint second with Spain on the European league table for winter deaths? There are 2,000 premature deaths per year in the State while in the Six Counties, another 1,300 people die from the cold — a holocaust of the old and the infirm. However, this is what the Government believes is living with dignity, as promised in its programme for Government. Elderly men and women wearing layers of clothes huddle close to small fires, shiver in the dark beneath blankets and duvets and sit alone in their homes because they cannot afford to go out. Some 58% of them cannot afford to run a car. They eat frugally as they try to make their miserly Statepensions go that little bit further. Almost one in ten are unable to afford a meal that includes meat.
The Tánaiste recently said society cannot be indifferent to older people living in neglect. She is right but it is not society that is indifferent, it is the Tánaiste and the Government. What else can we do to explain the cuts in the home help service and in the community employment scheme, including meals on wheels and support for the elderly, or the failure to abolish the means test for the carer's allowance or the cuts in nursing home subventions? Why do we blame the elderly? Last night Deputy Sexton claimed that the Tánaiste was speaking out on behalf of older people abandoned by their relatives. The truth is that there are elderly people in hospitals throughout the State who would like to go home and whose relatives would like to have them home to look after them but this Government especially, led by the Progressive Democrats, has abandoned the elderly and it is nothing but hypocrisy to try to pass the buck to the families of the elderly.
According to the Irish nursing homes organisation, a staggering 400 nursing home beds were free last September at the same time as Beaumont Hospital had 26 patients on trolleys and chairs in its accident and emergency department. The hospital had 65 patients fit for discharge to nursing homes and rehabilitation facilities but they had nowhere to go. A survey of accident and emergency departments across the State announced by the Irish Nurses' Organisation last week stated that 207 people were on trolleys and chairs while elderly patients whose families wanted to take them in but could not afford to do so are in acute hospital beds. In the meantime, a report in the Irish Examiner a couple of weeks ago stated that 150,000 hospital beds were denied in 2003 due to cutbacks and the lack of alternative care facilities. It also stated that patients declared fit for discharge had to be kept in acute hospital beds because funding cutbacks meant they could not be sent to nursing homes and their families could not afford to take them in.
If the Government were to assist these families, make it easier for them to make improvements to their homes, provide a more generous carer's allowance and end the means test, the elderly would return home. If no other argument will convince the Progressive Democrats Party that such measures would be worthwhile, perhaps it will be persuaded by the fact that such a policy would ultimately save money by freeing up hospital beds and staff for accident and emergency patients.
I commend the Independents on tabling the motion and giving the Opposition an opportunity to hold the Government to account on this issue. Far from living their lives in dignity, the elderly find themselves facing constant increases in the cost of living, including increases in the cost of fuel with which the fuel allowance does not keep pace, and living in fear, alone and frightened in their homes. What sort of life are we allowing them to live?
I welcome the opportunity to speak on this important matter and thank the Independents for tabling the motion which has the full support of the Green Party. This debate is no doubt the result of the Tánaiste's recent unfortunate remarks about the elderly. At the time, she stated that she realised her comments were controversial and she was correct. Later, she tried to wriggle out of her faux pas but the damage had been done.
The Tánaiste has the unfortunate habit of putting both her feet in it. The House will recall remarks she made about unmarried mothers and 25,000 Civil Service jobs which cost her party dearly. Her problem is not that what she says is wrong in terms of Progressive Democrats Party policy but that sometimes she does not possess the political skill to disguise its real agenda. The cardinal sin of the new Progressive Democrats Party theology is to be a burden on the State. The elderly have now fallen into this category and joined the aforementioned unmarried mothers as well as immigrants, the unemployed, the sick, people with a disability and those who simply cannot cut it. In its harsh Darwinian world the weakest will always go to the wall and the fittest and richest will not only survive but thrive.
To cap it all the Tánaiste now has the effrontery to accuse society of becoming greedy. This accusation emanates from the greed party, of which Gordon Gekko, who claimed greed was good, would be proud. No doubt he would also have given it a few bob — as a legitimate contribution — to ensure it further facilitated his greed. This is the party that boasts we now have the lowest tax take in Europe. We witness the terrible consequences of this greed daily in our hospitals where people lie on trolleys if they are lucky and on chairs if they are not, and are dying because of our inferior health service. Yesterday evening, a gentleman on a radio programme stated the treatment he received in a hospital in Brazil for an asthma condition was superior to what he could have received here. Given our wealth, this is an indictment of the Government.
We also see the consequences of this greed in our public services, including our appalling transport system with its sub-standard trains in which passengers, many of them elderly, must stand in the aisles. I felt ashamed to live here when I saw this.
The Tánaiste and the Progressive Democrats Party are now worried about our new demographic problem, namely, the ageing population. As Deputies stated, the people in question have made a contribution to our society. They paid their way while the tax cheats got away with millions and they watched this country prosper in recent years as a result of their efforts. The Tánaiste's accusation that they are greedy is an insult. Her real fear is that caring for the elderly will cost the State and require the tax take to be increased. This would not be in line with the low tax, low spend ideology of the Government.
The Tánaiste's solution is to make the elderly pay but her analysis is flawed because, as previous speakers stated, the Government is out of touch. The Progressive Democrats Party, in particular, lives on "planet privilege" and does not know what life is like for many people. We may be living longer but, as the Minister of State at the Department of Health and Children, Deputy Callely, should know, our life expectancy rates are not what they should be because of our inferior health service.
The Minister of State should stick to dancing.
He should certainly do something about this problem but, as he knows, nothing will be done because we do not contribute enough to our health service.
The question as to what we mean by "elderly" is a fundamental one. Given that 50 years is now supposedly the new 40 and 75 years the new 65, the Tánaiste and her party appear to be unaware of the new reality. People in their 60s, who are sometimes considered elderly, frequently find themselves in a difficult position of living with their children and their elderly parents for whom they must care. They are, therefore, sandwiched between two generations and sometimes suffer great stress as a consequence. The reason their children still live at home is that they cannot get on the property ladder, which is also due to Government policies. Parents could downsize and sell their property to give money to their children to help them onto the property ladder. This raises the question of what they will do in their oldage now that they have sold their asset, as itwere.
We need to examine the consequences of these trends and apply some lateral and holistic thinking. Let us examine the statistics on health. During a debate on immigrants last week, I noted that we had received a demographic bounce because so many of our elderly people live in Britain, having emigrated there. According to the health economist, Dr. Seán Barrett, this resulted in a demographic bounce of about 1.9%. Notwithstanding this, however, in 2001 some 11% of our population was aged over 65 years, while 27% of the hospital population was aged over 65 years and a massive 46% of bed days in hospital could be attributed to that age group. According to projections, the percentage of the total population aged 65 years or over will increase significantly to 15% by 2001 and nearly 20% by 2030. Inevitably, this will require increased health spending which will mean increasing the tax take in some shape or form. That is the reality the Progressive Democrats Party does not want to face.
Rather than coming down hard on the elderly, the Tánaiste and her party should have examined a number of initiatives. The best way to deal with the issue is to consider some of the proposals made by the National Council on Ageing and Older People, including its call on the Department of Health and Children to donate millions of euro annually to support and promote the development of national healthy ageing initiatives. This will be vital.
We should also target older women who, compared with their counterparts in other European countries, have a lower life expectancy and greater incidence of ill health. They must be prioritised in policy and strategy planning by statutory and voluntary bodies working on women's health issues. My party is particularly supportive of Well Woman centres which address holistic approaches to support ageing women in health, lifestyle and environmental health issues. We should have a charter of rights for older persons and we also require a more systematic mechanism for consultation with older people at all stages of planning provision.
The Deputy's time is concluded.
I do not think I was given my full allocation of ten minutes. I began a little late.
I have no control over that, Deputy.
I support the motion and I congratulate the Independent Deputies on putting it forward. I hope that all right-thinking people will support it.
This is a bogus motion from a bankrupt Opposition.
That is not the Minister of State's usual form.
One sentence and the Opposition starts barracking. I have been in this Chamber——
The Civil Service wrote the script.
Allow the Minister of State without interruption.
——for the last 45 minutes——
The Minister of State always has a positive approach.
—— and I did not interrupt any of the Opposition speakers.
(Interruptions).
Allow the Minister of State. He has only five minutes in which to reply.
The Opposition attack on the Tánaiste is bogus, as is its innuendo about her views. Its hand-wringing about her values is totally bogus.
Who wrote that speech for the Minister of State?
The Technical Group has no policies to offer, no solutions and no initiatives, just empty, tired, bogus rhetoric.
The Minister of State is responsible.
For the sake of the Labour Party leader and his colleagues I remind them of the statements made by the last Labour Minister for Health, Deputy Howlin, who speaking in this House in 1993 on the nursing home subvention scheme said, "In determining the scope and scale of the actual subvention, it is reasonable to take into account the income of sons and daughters." In a reply to my colleague, Deputy O'Donnell, he stated, "I believe that sons and daughters who are in a position to contribute to the cost of a parent's nursing home fees should do so." At least the Tánaiste and I agree with Deputy Howlin who also said, "It is the natural Irish thing to support elderly relatives." Deputy Rabbitte might wish to read his statements as a Cabinet Minister.
I have listened to a lecture from several Members of the Opposition, in particular from Deputy McManus. It is a pity she did not confer with Deputy Howlin about his statements in 1993. The Labour Party and others on the opposite side of the House pretend to have a monopoly on compassion. I suggest there should be a health warning to the electorate that listening to the Opposition will shorten their lives.
This Government values our older people and emphasises an approach that helps all older people live in dignity and independence at home. We encourage and support the care of older people who become ill or dependent by family, neighbours and voluntary bodies. Most older people will never require long-term institutional care but for those who can no longer live in dignity and independence at home, the Government works to provide a high quality of hospital and residential care.
In the last six years the Government has made a constant commitment by allocating additional resources for services for older people. In 1997 an additional £10 million was provided, increasing by an additional £36 million in 2000; an additional £57 million in 2001; an additional €87 in 2002 and over €111 million in 2003.
(Interruptions).
The health strategy takes fully into account that the Irish population isageing at a rapid rate. It is estimated that by the 2011, the number of people aged 65 years and over will have grown by 25%. The over-65 population increases by 6,000 each year and the number of people aged 80 years and over rises by approximately 1,500. These are statistics to be celebrated as they represent great progress in our society.
In order to continue to meet our strong commitments, it will be necessary to significantly expand our current range of services. This is recognised in the health strategy which contains specific commitments over the next seven years: the continued development of community-based services such as community nursing, home help services and community supports, including the provision of 7,000 additional day care centre places; the provision of 1,370 additional geriatric assessment and rehabilitation places attached to acute medical units; and the provision of an additional 800 extended-care beds per year, including beds for those suffering with dementia.
This Government of Fianna Fáil and the Progressive Democrats has given very visible evidence of its commitment in this area.
Hear, hear.
It is also committed to further enhancing the level of support available to older people. The Government will achieve this in a sustainable and enduring manner by maintaining the economic growth that gives us the resources necessary for high quality and extensive care. Economic growth and the right priorities in Government have enabled us to expand services as no other Government has done.
(Interruptions).
I ask the Minister of State to conclude as there is a time limit on the debate.
I commend what the Minister of State, Deputy Callely, has done for the elderly. With continued economic growth we will achieve the further expansion——
I ask the Minister of State to give way to Deputy Finian McGrath.
——of quality services and support for older people.
I wish to share my time with Deputies Cowley, Harkin and Twomey. I welcome the opportunity to speak on this motion tabled by the Independent Deputies. This motion is dedicated to the 440,000 people, 11% of the population of the State, who are over 65 years of age and the 266,000 over 70 years of age.
The aim of the motion is to make Ireland a better place in which to grow old. It is also to thank older people for their years of service to this State as citizens and taxpayers. It is an absolute disgrace that after years of economic boom and wealth, our elderly are not being treated with respect by the State and this Government. There are 80,000 elderly people aged over 70 years living alone with few community-based services. I say to the Minister of State that this is not good enough. They feel isolated and intimidated and must bolt their doors and windows every night at 7 p.m. There has to be something wrong with a State, with a Government and with a society that allows citizens to be treated like this.
In response to Deputy Fiona O'Malley's remarks about the Technical Group, I suggest she drop the words "progressive democrat" because there is nothing progressive about her policies. There have been cuts in home help services, elderly patients on trolleys in accident and emergency units. The less well-off are dying because of unequal access to health care. There are 1,382 persons with intellectual disabilities on residential waiting lists; 621 seeking day care places; 823 waiting for respite care. Elderly parents are forced to accept services for their intellectually disabled children and adults which are often 100 kilometres distant from their homes.
I wish to suggest some new and radical ideas for the support of the elderly. Older people are people, not just patients or potential patients. We must look after all aspects of their lives, not just health, important as that is. Secure and adequate income with index-linked pensions must be provided and work options with a flexible retirement age and protection for older workers.
Hear, hear.
Equitable, timely, affordable and accessible health services should be provided. Affordable and appropriate housing combined with care is necessary, as is affordable and accessible country-wide transport. Safety and security in every part of the country and affordable and accessible lifelong learning and social contact should be provided. These are just some sensible proposals which will assist the elderly in a practical way. I urge all Deputies to unite in support of our motion which is good for our elderly, good for society and above all it is the right thing to do. I thank the Deputies who have spoken in support of the motion.
Our elderly population is lower because we have exported people as emigrants and we should bear them in mind also. For too many years we have allowed the export of our older people to institutions. We lost our young people to emigration and we are losing our older people. Those most vulnerable and alone who most needed our help were exported never to return. Just like the old Indians, they lost heart and died. I have nothing against faraway institutions but they are not home and they are not community.
Old age has been mismanaged. It is a physiological state, not a pathology requiring nursing homes and medical care. People need medical care from doctors and nurses when they are ill but not otherwise. People went to institutions because there was no community alternative. It is said that our institutions are full of people who would not be there if facilities were available in their own communities, but such facilities do not exist.
If one examines a comparison of the age of older people in institutions in Ireland with the age of such people throughout the EU, one will see that the age is lower here. People are moving into residential care prematurely. We know that nursing homes are being used as a catch-all. If facilities such as sheltered housing were available for people in their own communities, they would be the most appropriate place for them. Some 16% of residents in all types of long-stay units are there for social reasons. Such people should not be there. One in six older persons in nursing homes is categorised as low-support and certainly should not be there. They should be in their own communities.
There is a community alternative. The solution is to encourage developments such as St. Brendan's Village. This concept already exists and is seen as a model of best practice. It is a means of supporting people in their communities. It extends from support at home with a day centre to low-support sheltered housing with a caretaker, medium support and communal high support. In that way, one can receive a guarantee of staying in one's community regardless of one's age or level of disability. It is a continuum of support which ensures that people will not have fears for the future. Persons who are getting old or more frail can move sideways. That is all they have to do. Such people can live to the maximum ability with their disability. People want to be in their own communities.
St. Brendan's Village is the biggest employer in its locality. The concept has many advantages. It employs 65 people and supports rural enterprise. We are reversing the vicious circle of loss of services and increased depopulation. Why do more units like St. Brendan's Village not exist? Government policy favours the profit-driven nursing home sector rather than community care developments. Nursing home subventions increased by 400% in the mid-1990s compared to an increase of 8% for home care services. I do not claim that nursing homes are not necessary — of course they are doing a good job in the absence of a community alternative.
The development of the full potential of sheltered housing is being prevented by problems with rural planning, difficulties in securing adequate funding for high-support housing and the lack of a defined revenue funding scheme. The Government recently launched two reports, the Mercer report and the O'Shea report, which favour a redressing of the balance towards community care rather than residential care. The findings are based on the fact that the costs associated with residential care are higher than those associated with community care. While no particular model is mentioned, sheltered housing most successfully bridges the gap between living at home and in residential care. The St. Brendan's Village model facilitates these concerns and provides for residential care in the community.
Traditional sources of land are drying up. The budget increase for voluntary housing this year was just 5%. This is insufficient to realise the increase targeted in the national development plan. The Government needs to provide adequate funding to realise the potential of the community model. It should ensure, by statute, that the provision of older persons' accommodation in the community is preferred to non-community facilities. The same bias should be given to community care so that adequate funding is made available for this purpose. The priority should be to provide social housing to a greater extent than affordable housing. Life interest schemes should be offered to those who are ineligible.
This Private Members' motion, which is sponsored by the Independent Deputies, outlines the reality of the problems faced by many elderly people, their carers and families. The motion describes the day-to-day reality which, as public representatives, we see in our offices and clinics. Having listened to the stories of such people, we know that the Government's amendment contradicts the reality of the lives of many of them. The amendment refers to the Government's "policy of supporting older people who wish to continue living at home in the community". What is the reality for those who apply for special housing aid for the elderly? Approximately 340 elderly people in the North Western Health Board area are awaiting the necessary funding to enable them to stay in their own homes. Some of the people in question have been on a waiting list for more than three years. Their reality relates to draughty windows, damp walls, poor heating and broken ranges. Circumstances are similar in every health board area.
The Government's amendment recognises the need for "ongoing restructuring" to ensure that community employment schemes continue to meet "the specific needs" of "vulnerable groups", but the reality is different. Community employment workers in Sligo town worked on the special housing aid for the elderly scheme until recently, but they no longer do so. The backlog is increasing while community employment schemes disappear. There was a cut of 20% in the number of community employment workers in counties Sligo and Leitrim in 2003. The Minister told us last night that there will be no cuts in 2004, but they already took place last year. It is a nonsense for the Government to suggest in its amendment that the restructuring of community employment schemes continues to meet the specific needs of vulnerable groups. The Government's restructuring is doing the very opposite.
There are 170,000 full-time carers in this country, many of whom care for the elderly, but just 20,000 people receive carer's benefit or carer's allowance. Those who listened to Deputy Cregan earlier would have got the impression that all carers receive this benefit. Less than 15% of carers receive the benefit or the allowance. There are approximately 2,340 carers in Sligo, of whom just 404 receive carer's benefit or carer's allowance. That is the reality of the benefits system for many carers.
Earlier this evening, Deputy Fiona O'Malley lectured the Technical Group by telling us of the need for "thought, consultation and reflection". What good is reflection to a man aged 69 who receives the old age pension and cares full time for his wife who has Alzheimer's disease? All he has to live on is his old age pension. He cannot receive carer's benefit because he receives the old age pension. He needs carer's allowance and not "thought, consultation and reflection".
Hear, hear.
I have further bad news for Deputy Fiona O'Malley, who said, "The Technical Group has nothing constructive to say on the matter." She is wrong. We have many constructive proposals. I would like to add one more proposal to the list. Strong tax revenues exceeded spending by almost €500 million in January 2004. If the Government spent one month's excess revenue on carers, it would ensure that all 170,000 carers would receive a benefit or allowance. Such a measure would lead to the elimination of the waiting list for housing aid for the elderly in one year. It would put in place an effective home care scheme. By spending that money, some substance would be given to the Government's amendment this evening.
I ask the Government Deputies to join the Technical Group in doing something constructive. I demand that the Minister for Finance spend one month's excess revenue —€500 million — on care of the elderly. If this step is taken, we will all have done a good evening's work for those who deserve it most.
I would like Deputy Fiona O'Malley to withdraw certain remarks on the next occasion on which she speaks in the House. She should withdraw the suggestion that Independent Deputies were in any way responsible for the death of Detective Garda Jerry McCabe or have participated in punishment beatings. She seemed to imply in her statement that we have been involved in such matters.
The Minister of State, Deputy Tim O'Malley, should educate his party colleagues.
Regardless of what Members on the Government benches say, there is a distinct lack of Government policy on all the matters that have been highlighted by the Independent Group in the House tonight. This lack of policy can be seen in the reductions in home help payments in various health board areas. It is a very disjointed approach. The under-resourcing of day care centres throughout the country is having a significant effect on local communities.
That is not true.
The role community employment schemes can play in the health sector was mentioned earlier. We need a long-term plan if we intend to care for the elderly in our community into the future. Regardless of what has been said by Government Members, it is obvious to those of us who work at the coalface that carers are getting a raw deal. Nursing home subvention levels vary greatly between health board areas. The maximum level in all health board areas doesnot cover the minimum cost involved in any nursing home in that health board area. All Members of the House should take these facts on board. The average age of Members is 50, which means that the average Member will, just like one in four of the population, be over the age of 65 by 2030.
Will we still be here?
What can we look forward to in 2030? This is as important an aspect of tonight's debate as the question of what we can expect today.
The Minister of State, Deputy Callely, will be Taoiseach by then.
Maybe.
It is predicted that pension costs will exceed the current health budget, as a percentage of GNP, by 2030. The contribution of the Minister of State, Deputy Callely, to the debate last night, which I have read, does not inspire confidence. He wants to introduce personal care packages and home subventions as an alternative to long-stay care.
The Deputy has missed the boat — I have already done it.
I appreciate that personal care packages do not contain hand cream and tissues, but they contain such fine luxuries as a home help service and twilight nursing. I am not sure what is meant by "twilight nursing", but perhaps the Minister of State will explain at a later date.
I will be happy to do so.
The Minister of State is not often here as he is usually too busy.
This is the problem with our present and future planning of services for the elderly. There is too much window dressing and not enough reality. The Government prides itself on telling elderly patients they must wait five years for an orthopaedic appointment and a further year to have a hip replaced on the GMS system. What sort of poor planning are we seeing in the health services? We see health centres in Ballymun lying idle at a cost of millions to the taxpayer. A day hospital in Wexford has been built but is still not occupied. Government policy seems disjointed. There is a massive shortage of acute beds and poorly developed step-down facilities, yet 10% of those acute beds are occupied by patients who do not need them. What will happen in the future? Today's patients take up 25% of the acute beds and 46% of the day beds in each of these acute hospitals. Our population will double in the next 20 years.
Everybody remembers that we began to decimate the health services in 1980, when we started closing hospitals and cutting down the number of beds. If we take the same length of time to improve it, the elderly population will have doubled. However, nothing is happening.
We are not just talking about beds. We have advanced far from that point. The Opposition Members are in a time capsule.
The Government should move on from implementing pilot schemes and start doing something for the elderly in our population.
The good news is that it is happening.
Amendment put.
The Dáil divided: Tá, 75; Níl, 63.
Tá
- Ahern, Dermot.
- Ahern, Michael.
- Ahern, Noel.
- Andrews, Barry.
- Ardagh, Seán.
- Blaney, Niall.
- Brady, Johnny.
- Brady, Martin.
- Brennan, Seamus.
- Browne, John.
- Callanan, Joe.
- Callely, Ivor.
- Carey, Pat.
- Carty, John.
- Cassidy, Donie.
- Collins, Michael.
- Cooper-Flynn, Beverley.
- Coughlan, Mary.
- Cregan, John.
- Curran, John.
- de Valera, Síle.
- Dempsey, Tony.
- Dennehy, John.
- Devins, Jimmy.
- Ellis, John.
- Finneran, Michael.
- Fitzpatrick, Dermot.
- Fleming, Seán.
- Gallagher, Pat The Cope.
- Glennon, Jim.
- Grealish, Noel.
- Hanafin, Mary.
- Harney, Mary.
- Haughey, Seán.
- Hoctor, Máire.
- Jacob, Joe.
- Keaveney, Cecilia.
- Kelly, Peter.
- Kirk, Seamus.
- Kitt, Tom.
- Lenihan, Brian.
- Lenihan, Conor.
- McDaid, James.
- McDowell, Michael.
- McEllistrim, Thomas.
- McGuinness, John.
- Martin, Micheál.
- Moloney, John.
- Moynihan, Donal.
- Moynihan, Michael.
- Mulcahy, Michael.
- Nolan, M. J.
- Ó Cuív, Éamon.
- Ó Fearghaíl, Seán.
- O'Connor, Charlie.
- O'Dea, Willie.
- O'Donnell, Liz.
- O'Donovan, Denis.
- O'Flynn, Noel.
- O'Keeffe, Batt.
- O'Malley, Fiona.
- O'Malley, Tim.
- Parlon, Tom.
- Power, Peter.
- Power, Seán.
- Roche, Dick.
- Ryan, Eoin.
- Smith, Brendan.
- Smith, Michael.
- Wallace, Dan.
- Wallace, Mary.
- Walsh, Joe.
- Wilkinson, Ollie.
- Woods, Michael.
- Wright, G. V.
Níl
- Allen, Bernard.
- Boyle, Dan.
- Breen, James.
- Breen, Pat.
- Broughan, Thomas P.
- Bruton, Richard.
- Burton, Joan.
- Connolly, Paudge.
- Costello, Joe.
- Coveney, Simon.
- Cowley, Jerry.
- Crawford, Seymour.
- Crowe, Seán.
- Cuffe, Ciarán.
- Deasy, John.
- Deenihan, Jimmy.
- Durkan, Bernard J.
- English, Damien.
- Enright, Olwyn.
- Ferris, Martin.
- Gilmore, Eamon.
- Gogarty, Paul.
- Gormley, John.
- Gregory, Tony.
- Harkin, Marian.
- Hayes, Tom.
- Healy, Seamus.
- Higgins, Joe.
- Higgins, Michael D.
- Howlin, Brendan.
- Lynch, Kathleen.
- McCormack, Padraic.
- McGinley, Dinny.
- McGrath, Finian.
- McGrath, Paul.
- McHugh, Paddy.
- McManus, Liz.
- Mitchell, Olivia.
- Morgan, Arthur.
- Moynihan-Cronin, Breeda.
- Murphy, Gerard.
- Naughten, Denis.
- Neville, Dan.
- Ó Caoláin, Caoimhghín.
- Ó Snodaigh, Aengus.
- O'Dowd, Fergus.
- O'Keeffe, Jim.
- O'Sullivan, Jan.
- Pattison, Seamus.
- Penrose, Willie.
- Perry, John.
- Ring, Michael.
- Ryan, Eamon.
- Ryan, Seán.
- Sargent, Trevor.
- Sherlock, Joe.
- Shortall, Róisín.
- Stagg, Emmet.
- Stanton, David.
- Timmins, Billy.
- Twomey, Liam.
- Upton, Mary.
- Wall, Jack.
Tellers: Tá, Deputies Hanafin and M. Ahern; Níl, Deputies Harkin and Gregory.
Amendment declared carried.
Question put: "That the motion, as amended, be agreed to."
The Dáil divided: Tá, 77; Níl, 62.
Tá
- Ahern, Dermot.
- Ahern, Michael.
- Ahern, Noel.
- Andrews, Barry.
- Ardagh, Seán.
- Blaney, Niall.
- Brady, Johnny.
- Brady, Martin.
- Brennan, Seamus.
- Browne, John.
- Callanan, Joe.
- Callely, Ivor.
- Carey, Pat.
- Carty, John.
- Cassidy, Donie.
- Collins, Michael.
- Cooper-Flynn, Beverley.
- Coughlan, Mary.
- Cregan, John.
- Curran, John.
- de Valera, Síle.
- Dempsey, Tony.
- Dennehy, John.
- Devins, Jimmy.
- Ellis, John.
- Finneran, Michael.
- Fitzpatrick, Dermot.
- Fleming, Seán.
- Gallagher, Pat The Cope.
- Glennon, Jim.
- Grealish, Noel.
- Hanafin, Mary.
- Harney, Mary.
- Haughey, Seán.
- Hoctor, Máire.
- Jacob, Joe.
- Keaveney, Cecilia.
- Kelleher, Billy.
- Kelly, Peter.
- Kirk, Seamus.
- Kitt, Tom.
- Lenihan, Brian.
- Lenihan, Conor.
- McDaid, James.
- McDowell, Michael.
- McEllistrim, Thomas.
- McGuinness, John.
- Martin, Micheál.
- Moloney, John.
- Moynihan, Donal.
- Moynihan, Michael.
- Mulcahy, Michael.
- Nolan, M. J.
- Ó Cuív, Éamon.
- Ó Fearghaíl, Seán.
- O'Connor, Charlie.
- O'Dea, Willie.
- O'Donnell, Liz.
- O'Donovan, Denis.
- O'Flynn, Noel.
- O'Keeffe, Batt.
- O'Malley, Fiona.
- O'Malley, Tim.
- Parlon, Tom.
- Power, Peter.
- Power, Seán.
- Roche, Dick.
- Ryan, Eoin.
- Smith, Brendan.
- Smith, Michael.
- Treacy, Noel.
- Wallace, Dan.
- Wallace, Mary.
- Walsh, Joe.
- Wilkinson, Ollie.
- Woods, Michael.
- Wright, G. V.
Níl
- Allen, Bernard.
- Boyle, Dan.
- Breen, James.
- Breen, Pat.
- Broughan, Thomas P.
- Bruton, Richard.
- Burton, Joan.
- Connolly, Paudge.
- Costello, Joe.
- Coveney, Simon.
- Cowley, Jerry.
- Crawford, Seymour.
- Crowe, Seán.
- Cuffe, Ciarán.
- Deasy, John.
- Deenihan, Jimmy.
- Durkan, Bernard J.
- English, Damien.
- Enright, Olwyn.
- Ferris, Martin.
- Gilmore, Eamon.
- Gogarty, Paul.
- Gormley, John.
- Gregory, Tony.
- Harkin, Marian.
- Hayes, Tom.
- Healy, Seamus.
- Higgins, Joe.
- Higgins, Michael D.
- Howlin, Brendan.
- Lynch, Kathleen.
- McCormack, Padraic.
- McGinley, Dinny.
- McGrath, Finian.
- McGrath, Paul.
- McHugh, Paddy.
- McManus, Liz.
- Mitchell, Olivia.
- Morgan, Arthur.
- Moynihan-Cronin, Breeda.
- Murphy, Gerard.
- Naughten, Denis.
- Neville, Dan.
- Ó Caoláin, Caoimhghín.
- Ó Snodaigh, Aengus.
- O'Dowd, Fergus.
- O'Keeffe, Jim.
- O'Sullivan, Jan.
- Pattison, Seamus.
- Penrose, Willie.
- Perry, John.
- Ring, Michael.
- Ryan, Eamon.
- Ryan, Seán.
- Sargent, Trevor.
- Sherlock, Joe.
- Shortall, Róisín.
- Stagg, Emmet.
- Stanton, David.
- Twomey, Liam.
- Upton, Mary.
- Wall, Jack.
Tellers: Tá, Deputies Hanafin and M. Ahern; Níl, Deputies Harkin and Gregory
Question declared carried.