Léim ar aghaidh chuig an bpríomhábhar

Dáil Éireann díospóireacht -
Tuesday, 16 Oct 2012

Vol. 778 No. 3

Leaders' Questions

The Taoiseach promised in page 6 of the programme for Government:

Investment in the supply of more and better care for older people in the community and in residential settings will be a priority for this Government. Additional funding will be provided each year for the care of older people. The funding will go to more residential places, more home care packages and the delivery of more home help and other professional community care services.

The reality on the ground is very different from the promises and commitments he made. A cut of 600,000 home help hours was announced earlier this year and that has been followed by a cut of €8 million in the budget for the service, which will take out another 450,000 hours. This amounts to approximately 1 million hours in what is clearly a cold and callous cut by this Government.

The Older and Bolder organisation, a respectable and reputable body engaged in supporting people in terms of their care needs, has a significant campaign under way to identify the views of people on the ground regarding the impact of these cuts. I will quote one or two of them who wrote to the Taoiseach. One states:

Dear Taoiseach,

I note from my inquiries on behalf of a relative that there appears to be no home help currently available to elderly in the community no matter how vulnerable. This needs to change.

Another says:

As a carer for my 81 year old mother, I can see the difference that being at home has done her even though she is in total heart failure. I believe she would be gone a long time if she was in a home or a hospital ... I hope that your Government will keep all their promises and home helps in place so that my mother can enjoy the quality of life that she now has.

By any yardstick or objective, it is accepted that home help and care in the community is essential in dealing with and helping older people to have a decent quality of life. Can the Taoiseach indicate why there is such a gulf between the language contained in the programme for Government and the decisions his Government has taken regarding home help? Does he intend to review the programme for Government in light of the yawning gap between the two?

The Deputy should deal with the reality. The target in the 2012 HSE service plan was to deliver 10.7 million home help hours to 50,000 people with a budget of €200 million. The reduction will see 10.3 million hours delivered to them. There will be a reduction of €8 million in the budget for the service between now and the end of the year because the money is not there. I have made it clear that decisions on the home help service and on home help hours will continue to be based on a review of each individual's needs and they are all different. No current recipient of the service who has an assessed medical need will be left without a service. The overall provision of home help services is reviewed regularly at national and local level in the context of the needs of each client and of the resources available.

As I said in answer to questions last week, two reviews have happened this year. The focus now will be on those who are most dependent and require personal care and hygiene services such as washing, incontinence management and so on, which are sensitive and personal.

We will maintain those by, if necessary, reducing lesser dependency duties like shopping or cleaning. The money is not there and we must adjust accordingly. The overall position is that anyone with an assessed need for a home help service will not be left without one. The HSE is under instruction from the Department and the Minister to implement this in as sensitive and caring a fashion as possible.

Does the Taoiseach accept the commitment in the programme for Government is dishonest, cannot be fulfilled and should be withdrawn? It is not the wording of the Opposition but the Government. The programme for Government says additional funding will be provided each year for the care of older people. The Taoiseach said that less than 18 months ago, after the election.

Promises, promises.

Much more was promised before the election. The Taoiseach said the money would go to the delivery of more home help services and hours. From what the Taoiseach said today, that will not happen and we know this because, as Deputy Simon Harris said at a meeting of the Committee of Public Accounts last week, the health budget is clearly built on sand. That was his comment, which I have been saying for quite some time.

The funding was there previously but it was not raised subsequently. People who depend on home help hours are suffering because of the inability to raise €220 million between health insurers and drug pricing. As a result, there will be savage cuts at the 11th hour for those depending on home help. These people are fragile, ill and living in difficult circumstances. We do not want them to go into institutions or long-term care settings if we can avoid it. Does the Taoiseach accept the commitment made in plain language is false or, at the very least, should be withdrawn because it cannot be fulfilled?

The situation is as I have outlined. The requirement is to live within the budget to which the Minister for Health signed up. It is a requirement he must meet this year.

It is in the programme for Government.

I understand the programme for Government.

Does the Taoiseach remember it?

The work of restructuring, in terms of the Croke Park agreement, its review and its implementation, and squeezing the maximum out of the programme, in order to lessen the impact on front line services, is under way. The decision on the agreement reached in respect of the cost of drugs will yield substantial savings of €400 million over the coming three years. The decisions and agreements on consultants rostering, some of which may go to the Labour Court, will bring about savings in the future. I would like to have seen these things happen by now but, for a variety of difficulties, they could not be finalised.

For the foreseeable future, between now and the end of the year, the Minister for Health must make adjustments to his budget. In each case, the review will be carried out sensitively and with a degree of understanding. I would much prefer to be saying here that we are in a position to continue the level of hours for home help services and to expand the service between now and the end of the year. However, that is not the reality.

That is what the programme for Government says. I agree it is not grounded in reality.

The review will be based on individual needs and will be based on medical requirements. Where the medical assessment says the person requires a certain level of home help, the person will have that.

There will not be 10 million assessments.

The review also takes into account where hours are allocated to individuals who are not as needy as those who require medical services on a regular basis. They speak for themselves. The Minister must make adjustments within reality and the changes made to structure of the health service will deliver savings that will lessen the impact on front line services. That is why the ongoing work in discussions and negotiations on the Croke Park agreement can evolve to a point where substantial savings can be squeezed out as a consequence of the implementation of the agreement in full in the shortest possible time.

I welcome the remarks of the Taoiseach in Cleveland about a united Ireland. Nothing in life or politics is inevitable. Uniting the people of this island and ending partition is one of the major challenges facing us at the beginning of the 21st century. Aontaímid, sin é mo bharúil, agus creidim sin go han-láidir. Tá ceart ag muintir an oileáin seo a bheith saor agus a bheith le chéile ach ni tharlóidh sin gan obair, gan phleanáil agus gan an Rialtas a bheith ag obair le daoine eile.

We need a plan. The Taoiseach's statement in Cleveland was welcome. A united Ireland will only happen when those of us who want it persuade those who want to maintain the union that their future and the future of their children is best served in the new dispensation. Partition is unjust, inefficient, is not working and is costly. We must demonstrate in practical ways why working together as partners and living together as equals is better.

Yesterday, the British Prime Minister and the Scottish First Minister, Alex Salmond, agreed a date for a referendum on Scottish independence. The union is now a live debating issue and the people of Scotland will have their say in 2014. The Good Friday Agreement provides for a similar poll, a Border poll, and I invite the Taoiseach to begin dialogue, with those who want a united Ireland and those who do not, about the future. I ask the Taoiseach to come back to the Dáil within the next short while with an outline of how he envisages securing the full implementation of the Good Friday Agreement on the Border poll.

The question I was asked in Cleveland was whether I believed there would be a united Ireland by 2016. I said I did not believe there would be a united Ireland by 2016 and gave reasons for that. On 12 October, part of the Good Friday Agreement was being implemented and demonstrated here by virtue of the work of the Ceann Comhairle and the Speaker of the Northern Ireland Assembly, where the North-South Parliamentary Forum met for its first session. I also pointed out that in terms of the development of the economy of the island of Ireland, great co-operation takes place within North-South Ministerial Councils, which I chair, in areas such as health, education, transport, commerce, business and trade. The next meeting is in November. These are important elements and I referred to the effect they have on developing the economies North and South. I referred to the work under way by the Chancellor of the Exchequer and the politicians in Northern Ireland in respect of the possibility of reducing the corporate tax rate to the level that applies here, 12.5%. I also referred to the fact that we have made arrangements for personnel from Northern Ireland to participate in the permanent representation in Brussels, so that they are fully informed and up to date on logistics for the Presidency, which will have an impact in respect of the multi-financial framework, possibly to be decided before the end of the year, and Common Agricultural Policy reform, which will fall within the Irish Presidency. From that point of view, it has implications for the agri-sector in Northern Ireland. That is the question I was asked and the answer I gave.

It is appropriate to continue our dialogue and work to demonstrate to people that the impact of the Good Friday Agreement can have a beneficial effect on the economies, North and South. Therefore, as a consequence, it has an effect on employment levels and job opportunities, which are the most important factor in our consideration. I am well aware of inclusion, in regard to the reference Deputy Adams made to Border polls, but the priority is to rectify our public finances, see that our colleagues in Europe implement the decisions made there, which will have a beneficial impact in this country, and to continue to work towards those so that we can emerge from our bailout programme and decide in a more individual way where our future lies.

Go raibh maith agat, a Cheann Comhairle, agus ag an Taoiseach.

I read the Taoiseach's remarks which he has repeated here today. It is obvious why I would welcome them. They were a good outline of what has been achieved and of what is continuing.

I also commend the Ceann Comhairle and the Speaker of the Northern Ireland Assembly on the North-South Inter-Parliamentary Association meeting. This is a good and quiet example of working for mutual benefit. The North-South Ministerial Council and all the sectoral elements are working together to erase at least some of the worst aspects of the negative effects of partition.

I am consciously not asking the Taoiseach simply to give a response here today. I am asking him to consider that we have to go further than this. The issue is topical because of what is happening in Scotland but it is also one of the huge challenges facing us. No Irish Government has brought forward a plan. I spent yesterday at Stormont. The atmosphere in the North is totally different from what it used to be when I was growing up there. There is considerable potential.

Would the Taoiseach go away and consider the Government's attitude to a Border poll, a Green Paper or to opening up a dialogue? We have ideas on many of these issues. They are part of an international agreement, the Good Friday Agreement, aspects of which have yet to be implemented.

I invite the Taoiseach to prepare a strategy in co-operation with the rest of us and to commit the Government to taking the lead on this issue.

I thank Deputy Adams for his comments. When I was speaking to the First Minister of Scotland, Mr. Alex Salmond MSP, at the British-Irish Parliamentary Assembly some time ago, he outlined the opportunity that might exist for people in Scotland to cast their votes on independence. That opportunity is to be given. The agreement to do so was signed yesterday. One question will be asked of the electorate. There are various views as to what the Scottish people wish to do. I do not want to go that far now.

I was struck by the presentation made here some time ago by the survivors of Kingsmill. I want to meet the group Ms Arlene Foster MLA wishes to bring here from Fermanagh, and with the Ballymurphy people Deputy McDonald spoke of last week. Other groups have requested meetings. There is a great well of emotion which needs to be released from ordinary people whose loved ones lost their lives on either side of this conflict. It is not the time to have a poll in a Border situation when such a well of emotion needs to be released so that a new understanding about the future is brought about.

This is not the time for a Green Paper. I take the Deputy's point and I am well aware of what the Good Friday Agreement says. There is, however, a time and place for everything. We need to get our economy in order here. We need to see the excitement and encouragement that people will experience when the economy is growing and thriving and jobs are being created with direct beneficial impact on the Border. I hope the same can apply to the Border areas in the Six Counties and beyond.

The Constitutional Convention may have an opportunity to reflect on this. I sent invitations to all political parties. One of those parties has declined to send a representative to the convention when it is set up. That forum will have an opportunity to reflect on the issues raised by the Deputy, such as Green Papers, Border polls and so on.

A priority of the Government is to deal with our economy and the issues that arise from that. With regard to Northern Ireland issues, I would like to provide an opportunity for those who have never had the chance to speak their minds about what happened within their family units on either side of the conflict, with devastating and tragic results. We owe them that, at least.

The group of home helps, mostly low paid women workers, whom I brought to the Gallery for Leader's Questions two weeks ago will hold a demonstration tomorrow against the Government's moves to cut home help hours and privatise home help services. They decided to hold this protest because they were so furious at the Taoiseach's response to the concerns I raised on their behalf and the way he misrepresented their plight and that of elderly and disabled people for whom they provide services.

The Taoiseach dismissed the idea that home helps are now working on an on-the-clock system, when they are. He also said people who need home help hours are getting them, when huge numbers of home help hours are being cut. A woman contacted my office today to tell me she has been on a waiting list for home help for weeks and now has to pay a private home help company €26 per hour to get the services the Government is not providing for her. That example is at the nub of the issue. Home helps who are working for not-for-profit organisations and earning approximately €12 per hour are being replaced by private companies that are charging €26 per hour.

It gets worse. The person advising the Minister for Health, Deputy James Reilly, was until last year working for Sedexo, the parent company of one of the private home help providers that is benefitting from Government cuts in home help hours and the privatisation of the home help service.

Will the Taoiseach reverse these despicable cuts in home help hours which are being directed at the elderly and disabled in our society? Will he halt the agenda of privatising home help services to the benefit of private companies that see the needs of the elderly and disabled as nothing more than an opportunity to make profit? Will he come out of the bubble of the Dáil tomorrow and meet the home helps when they arrive at the gates of Dáil Éireann and assure them that he is not going to sacrifice their jobs and their service in order to pay back the bankers and speculators who wrecked our economy?

Last Thursday morning, Deputy Boyd Barrett brought a number of people with disabilities to the House and put them up in the Gallery. They were looking for services. Deputy Boyd Barrett e-mailed them and told them not to meet local health service officials, because the Deputy had an opportunity to embarrass the Tánaiste, who serves the same people in his own constituency.


Shame. Disgraceful. Scandalous.

That was disgraceful treatment.

The Taoiseach is misleading the Dáil.

Deputy Boyd Barrett is misleading his constituents.

That was disgraceful treatment by a public representative of people with a disability. If the Deputy can deny what I say he should do so.

I hope the media are taking note of this because I can show evidence that what the Taoiseach said is not true.

Exposure in the media is all the Deputy wants.

The adviser to the Minister for Health has been an adviser since February of this year. Her job is to give the Minister advice in the best interests of the health service, in which she is an expert. In 2005, this person took on a role as a consultant to Zehnacker, a German company providing a range of services to health services and other areas in a number of European countries. That company provided services such as catering, cleaning, facility management and so on. In June 2010, Zehnacker merged with the multinational company Sedexo. It is Sedexo that is the parent company of Comfort Keepers. The adviser to the Minister was never involved with the new aspect of that business venture.

I am also advised that the HSE has confirmed that the recently concluded tender for certain home care services has been carried out strictly in accordance with all appropriate EU legislation.

It should be noted that the outcome of this tender process will not impact on existing service providers and will only apply to any new home care packages to be assigned during the lifetime of the agreement. The fundamental motivation for the tender was the introduction of improved standards for enhanced home care services for clients nationwide. The tender is due for review in 2013.

I hope the Taoiseach will correct the record of the Dáil when I show him and the media the evidence that what he said was misleading the Dáil. I had never seen and certainly had no hand in writing the e-mail to which the Taoiseach referred.

The Tánaiste had a copy of it.

He did not. That e-mail-----

Would you please ask a supplementary question?

I discovered afterwards from the parents in the Gallery that the e-mail was sent by the parents themselves to the director of services at Dunmore House. It had nothing to do with me.

You set it up and it backfired on you.

The Taoiseach has misled the public and the Dáil.

Will you ask a supplementary question?

In it they expressed their anger that they had contacted the Tánaiste, Deputy Eamon Gilmore, the week before and he had not responded. He later refused a meeting which the parents wanted.

The Deputy's time is up.

The question I asked the Taoiseach was about the cuts in hours for home helps and the moves to privatise the home help service. Does he not think it is a very serious conflict of interest to have somebody who was working for a private company, which is involved in the provision of for-profit health care services, now advising the Minister to privatise the home help services to the benefit of private for-profit companies?

I must interrupt the Deputy. You cannot come in here and make suggestions or allegations concerning individuals.

I did not mention the individual, a Cheann Comhairle.

There is a time and a place to deal with that issue, not on the floor of this House.

The Deputy said enough to identify the person.

It is tradition that we do not do that.

I did not mention the individual.

You referred to a person who is easily identifiable. Would you please adhere to the normal Standing Orders of this House?

Will the Taoiseach tell the home help workers and the elderly and disabled people to whom they provide services that he will reverse these cuts and halt the moves to privatise home help services, where not-for-profit organisations are being replaced by profit hungry private companies that are charging much more from our vulnerable and elderly citizens and degrading the quality of that service by demanding that home helps work on the clock?

It is disgraceful conduct by the Deputy to involve himself with bringing persons with a disability to the House in order to make a politically opportunistic charge against the Tánaiste.

Answer the question.

I hope the Taoiseach will apologise for misleading the House when I provide the evidence that he is.

Second, I advise Deputy Boyd Barrett to table a Topical Issue matter-----

That is the sort of dishonest spin that characterises the Government.

-----and the Ceann Comhairle might allow it to be discussed.

In respect of the tender, it was awarded strictly in accordance with the EU requirements.

Address the cuts.

It was designed to provide enhanced services for people who need them.

In respect of the third issue the Deputy raised, the Ceann Comhairle has already dealt with him comprehensively in that regard. However, it is not beyond the Deputy to try again.

You are worse than Bertie Ahern now.