Wednesday, 14 May 2003
Dáil Eireann Debate
Mr. Costello: We have heard a lot in recent weeks about the amount of cutbacks since the election. I do not think there are any as harsh and miserly as those being implemented by the health board regarding cutting community-based services to the elderly. The savings being made are paltry. Much of the work is carried out by volunteers. If meals on wheels and other community-based support services to the elderly were staffed by the health board or the Department of Health and Children, it would cost a much greater amount compared with the volunteer service which operates at a fraction of the cost. These services are provided voluntarily by people and it serves as a bonding force in the community.
In April, the East Wall day care centre received a letter from the health board informing it there would be a reduction of €100 per month  in the funding for meals on wheels from May 2003. The centre was informed that this money would be taken from its existing surplus. Prior to that, a bevy of administrators had examined the operation of the East Wall service and found that it had a deficit of €3,800. How can that possibly be taken from an existing surplus? The centre had told the health board of the difficulties it was experiencing in providing a five-day service because of the shortage of volunteers. At that time it asked for one key worker to be provided and the health board agreed to that request as long as the day care centre met the requirements of the health inspector – that it operate a five-day service and liaise with CERT for training. The centre met those requirements but the health board cut its miserly €1.27 per meal – one old pound – by €100 per month. To compound the situation, Dublin City Council imposed a commercial bin charge.
The same letter informed the centre that the current grant allocation for Iona parish will remain unchanged. Iona parish is one of the wealthiest parishes in Dublin Central and East Wall parish is a very deprived parish. How can a health board exercise its discretion regarding providing subsidies and grants to day care centres in this discriminatory fashion?
Cutbacks in funding by the Department of Health and Children are blamed for the cutbacks in the region of €20,000 to the meals on wheels service to the elderly in the north inner city area. I find it unbelievable that such a thing can happen in this day and age. The health board's administrators knew that the centre was in deficit and was operating thanks to voluntary effort, but it imposed a cutback of €100 per month to further reduce the funding available and then reneged on its promise to provide one full-time key worker to help out because of the shortage of volunteers.
Elderly people who are unable to cook for themselves and who are disabled will fill up the hospitals. This is an essential service and the Minister should ensure there is reasonable funding available.
Mr. B. Lenihan: I make this reply on behalf of the Minister of State at the Department of Health and Children, Deputy Callely, who has special responsibility for this area within the Department of Health and Children. The provision of health-related services for older people in north Dublin is a matter, in the first instance, for the Northern Area Health Board operating under the aegis of the Eastern Regional Health Authority. Government policy regarding the care of older people is to maintain them in dignity in their own homes for as long as possible in accordance with their wishes. Since 1997 my Department has allocated significant levels of funding to services for older people, resulting in substantial advances in the quality and quantity of the health-related services being provided.
In the case of services for older persons, approximately €230 million of additional funding has been provided to the health boards since 2000. A range of services, including the home  help service, community support structures, the support of carers, support for the Alzheimer's Society of Ireland and various voluntary groups have been developed and there have been improvements in staff ratios and in funding for the nursing home subvention scheme.
I am glad to say that additional funding for non-capital investment was made available in 2003 and a large proportion of this funding was allocated to the health services. This funding is being applied largely to maintaining existing levels of service across all service programmes, including services for older persons. In 2002, 16,510 persons received a meals on wheels service in the Northern Area Health Board region. It is acknowledged this is a valuable community support service that enables older people to live in dignity in their own homes for as long as possible. During 2002, the Northern Area Health Board examined various protocols to ensure a more efficient use of resources as well as the upgrading of premises and equipment and of training of staff in food safety hygiene standards. Unfortunately, the withdrawal of community employment workers who were employed in this service has led to reduced services in some areas.
The authority has advised my Department that the meals on wheels service for 2003 is under review with the intention of putting a substantial proposal for the expansion of this service to my Department later this year. This proposal will be considered in the context of funding available to my Department in 2004. The authority has further advised that it will ensure that the meals on wheels service being provided to older persons in 2003 will be prioritised on the basis of those most in need.
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