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Care Services: Motion (Resumed) [Private Members] (Continued)

Wednesday, 19 December 2012

Dáil Éireann Debate
Vol. 787 No. 4

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(Speaker Continuing)

[Deputy Damien English: Information on Damien English Zoom on Damien English] "Design a service" are the actual words used. We need to design a plan for each person.

We must look at the overall spend on caring for people with disabilities, the elderly and people with various ailments. We can do more with the available money. The people who need the money spent on them, around them, with them and on their carers could get more from the State without an increase in the spend. There are many areas where we could reform and rearrange how we spend. We must look at all the budgets and not pit one Department against another. Even within Departments, community care vies with other care budgets, for example.

I have worked in the accounts end of the old health boards and I have seen all the categories, cost centres and places where money is spent. There is not much joined-up thinking across those sectors. That is the reform the Government must tackle. Everyone must become involved in that reform.

In a debate on another issue last week, I said we need to use our imagination but we also need to hear from everyone in the service how things can be done better. Money is going to waste and some systems are not right.

I will focus on a number of key areas. At the time of the budget some carers came to my office to protest. I met 15 or 16 carers, along with 15 or 16 activists from Sinn Féin who joined in for political reasons. It is a pity they were there, but that is what they do. Nevertheless, we had a chance to discuss the issue at length with the carers. Most of them had been to my office over the years. Whether I am in opposition or in government I recognise what they do for the country and for their loved ones. We could never pay them enough. Thousands would not be enough for the work they do. Most of them talked to me, not so much about money as about services for their loved ones.

The majority of people who have contacted me on this issue, and I have spoken to hundreds, are people with disabilities and their carers. I accept that care for the elderly is vital and their carers also need the respite grant. The majority who are affected, however, are people who care for children, sometimes adult children, and loved ones who have a disability. They need the respite care grant, the domiciliary care grant and all the other payments purely to add to the pot to buy extra for the person for whom they are caring. The respite grant is no longer used solely to provide a break for the carer. It now provides the means to buy extra services. Our discussion was about getting services for their loves ones, getting more help, more hours tuition for a child with autism, physiotherapy or swimming lessons. Respite has become a much broader area.

This convinces me even more that me must look at the overall package. There is a duty on all of us, even with tough budgets, to find ways to get people the services they need. Respite care needs to be dealt with through community services and by the HSE, which does provide respite care for some but not everyone. We must completely rethink how we do this, and do it very fast. I accept that this cut is very harsh on people and will put them under great difficulty, but we can move fast to close the gap. I gave a commitment to the people who came to my office that I will work on this issue and that we will rearrange how we do things to make up the difference in the money.

Respite has become expensive in the last number of years, and it should not be so. The overall package and services are what concern people.

We do not listen sufficiently to parents and carers. Not enough common sense is built into our systems and this has been building up over a long number of years. We must bring back common sense. It is common sense to make a decision about carer's allowance, not in one or two years, but in a reasonable timeframe. Do we make decisions on domiciliary care allowance in a reasonable timeframe? I believe 12 weeks is the target. That may not be realistic in the current climate but two years is not good enough. A year and six months is not good enough either. We must come up with a solution.

There are plenty of staff working in the public sector who could be switched over to the areas where there are backlogs, whether in medical cards, domiciliary care allowance, carer's allowance or whatever. It is not good enough that carers, who have enough problems and enough to do with their time, should have to worry and spend time chasing paperwork and filling in forms to get the help they need.

I said when I was in opposition and I say now that we must provide a single place where a carer can go to find services. A carer of a child with a disability should be able to go to one place and access all the services and help that is needed. That place should fight for carers. We have done this for small businesses. We have provided a single place that will deal with nearly 50 or 60 licences and requirements. The same needs to be done for people who need State help to raise and mind their loved ones.

We have a duty to do more. It is not just about money. It is about reforming our systems and getting them right. I hope this debate will feed into that. We will get there if we continue to focus on this issue.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt There are 13 minutes to be shared by Deputies Regina Doherty and Áine Collins. I suggest eight minutes for Deputy Doherty and five for Deputy Collins. Is that agreed? Agreed.

Deputy Regina Doherty: Information on Regina Doherty Zoom on Regina Doherty Ireland's 161,000 family carers play a vital role in our health and community care sectors. Carers contribute about €11 million every day, providing 900,000 hours of care daily and saving the State more than €4.7 billion every year. The recent 2011 census found we had a 16% increase in the number of carers since 2006. They put in an estimated 3.5 million hours every week, saving the State €2.1 billion per annum.

We all know it is about much more than just that. They are our invisible army. I try to be positive most of the time but I found it a little disingenuous of some members of the Opposition to present themselves as having a monopoly on caring. There is not a person in the House who is not affected in some way, through someone they know, love or care about, by the issues that have been raised recently by the budget cuts.

We must remember it was the previous Government that scrapped the National Carers' Strategy in 2009. In July of this year, the current Government kept its commitment and published the National Carers' Strategy, signalling the Government's commitment to recognising and respecting carers as key care partners and responding to their needs across a number of policy areas. This strategy complements reforms occurring or being considered in community care across aged care, disability, mental health, primary health care and our hospital systems. The Carers Association welcomed the strategy as an important first step and noted that this is the first time a Government has recognised that carers are key players and providers in our health system.

The Minister of State, Deputy Kathleen Lynch, said recently that she hopes carers will now be recognised, supported and empowered. The strategy says the value and contribution of carers should be recognised and their inclusion in decisions relating to the person they are caring for should be promoted.

Caring touches, or will touch, every family in Ireland. I would like sufficient supports to be in place to enable carers to have lives of their own alongside caring. Many carers feel strongly about their contribution to society, which they feel is still underestimated and unrecognised. Instead of being supported, they often find their needs are overlooked, they have to fight go get support or that the available supports are insufficient or of poor quality. Carers say caring can be rewarding, giving relatives the best care possible, giving back to relatives and close friends who provided care themselves, and giving them a strong sense of family, community and friendship.

The cost to them, however, is considerable. One in five carers gives up work to care. Carers are twice as likely to suffer from ill-health and many struggle to make ends meet. We have a duty to support our carers in managing their physical, mental and emotional health, as well as their well-being. Through the provision of adequate information, training and services, they should be empowered to participate as fully as possible in economic and social life.

This means that, as a society, we need to think differently about how care is provided and how we support families who decide to provide that care. Just as increased participation of women in the labour market led to more and better provision of child care, so care services should and must be seen as an enabler as our population ages.

The Government has pledged to strengthen awareness of the role of carers and recognise their needs through income supports. The strategy also commits to supporting the development of supports and services and to protecting the physical, mental and emotional well-being of carers. It aims to provide better training and access to the labour market for carers and give them access to respite breaks.

The role of care organisations and the voluntary sector is universally highly praised. We need to recognise the importance of building the capacity of the voluntary sector and the potential benefits of care representative organisations, combining their efforts to ensure that views of carers are communicated more effectively at a national level.

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