Tuesday, 26 April 2005
Dáil Eireann Debate
Ms B. Moynihan-Cronin: I thank the Leas-Cheann Comhairle for the opportunity to raise this very important matter of the shortfall in funding to meet the demand of the Cúram home care grant in County Kerry and the associated waiting list created as a result of the funding deficit.
The home care grant, or Cúram grant, was introduced last October on a pilot basis in the HSE, southern area, to help older people and their families or carers meet the cost of care for their relatives in the home. It is available to people on low income who are struggling to pay to provide care for a sick or disabled person at home. However, the funding allocated is completely insufficient to meet demand. Some 67 people in County Kerry have been awarded the home care grant this year but only 23 received payment. The remaining 44 people who have been awarded the home care grant are not being paid because the HSE, southern area, does not have the money to pay them.
What would be required to pay the grant to the 44 people on the waiting list is the tiny sum of €6,664 per week. That is a small sum of money, which if paid to the qualifying applicants, would have enormous benefits. Many of the Government’s spin-doctors and managers probably earn €6,664 just to get out of bed in the morning. The Taoiseach probably spends that much every day on his make-up. However, the Department of Health and Children is denying 44 people in County Kerry in need of additional care in the home the tiny sum of money to meet the cost.
What is more reprehensible is that people are getting a letter from the HSE, southern area, telling them that they have been approved for the grant and how much they have been awarded. However, in the next paragraph, they are told the HSE cannot afford to pay the grant. It is a terrible insult to people to tell them they qualify for the grant and to how much they are entitled but in the next breath tell them they cannot be paid.
Why was this grant introduced on a pilot basis? If a Department, county council or other body does not have money, it writes to the applicant to say that due to funding constraints, it cannot process the application. However, the HSE, southern area, is writing to people telling them they are “maximum dependency” and are entitled to something but that they cannot get it. The individual about whom I spoke cannot wait. He is over 75 years of age, his wife is confined to bed, an invalid, and he is the only one who can look after her. There are 44 people like him on the waiting list in my county alone. I know the Minister of State, Deputy Seán Power, is a decent individual. Is there any possibility he could provide the funding so that this man is not forced to put his wife into care, which he does not want to do?
Minister of State at the Department of Health and Children (Mr. S. Power): I thank Deputy Moynihan-Cronin for raising this matter and I am happy to reply. The Health Service Executive has piloted home care grant schemes in several areas. The purpose of these schemes is to support older people at home in the community as an alternative to long-term residential care. Older people who are being discharged from the acute hospital system and those living in the community have been targeted under these schemes.
Following discussions with my Department, the HSE, southern area, introduced with effect from October 2004 a pilot home care grant scheme through a system of direct payments to older people, their families and carers which allows them to purchase additional home care.
With these home care packages, the HSE, southern area, is supporting the expressed wish of older people to remain at home as long as possible as prioritised in the area’s “Ageing with Confidence” strategy. This home care grant is called cúram in the HSE, southern area. This new service is for those aged 65 years and over and is designed to supplement the community services already in place for these persons.
The former Southern Health Board’s letter of determination for 2004 provided funding of €125,000 to commence the development of home care packages. The 2005 letter of determination provided further funding of €320,000 bringing to €445,000 the funding for the scheme that my Department made available to the HSE, southern area. The HSE, southern area, has supplemented this sum by €65,000 bringing to €0.5 million the funding available for this scheme in 2005.
Currently, 64 people are in payment of average weekly payments of €151 under this scheme which commenced in October 2004 as a pilot project in Cork and Kerry. Some 36% of those currently in receipt of payment reside in County Kerry. The level of home care grant that can be funded from the existing allocation of €0.5 million for 2005 is limited to approximately 65 recipients at any one time. Accordingly, there is a waiting list for this service which stands at 87 approved clients, including 44 from County Kerry.
The home care grant is but one of a number of services available in the HSE, southern area, to support older people at home. These support services include general practitioner services, public health nursing, home helps and access to respite services.
My Department has been working with the representatives of the HSE areas, including the southern area, to develop a national home care grant scheme. A draft of the scheme is currently being finalised. Funding of €2 million has been allocated to the HSE in 2005 to introduce the scheme. In addition, funding of €113.75 million was allocated in 2004 to the home help service to support older people living in the community with this funding being increased to €118.75 million in 2005.
I will take on board what Deputy Moynihan-Cronin said, particularly the wording of the letter and the expectation one would have on reading it. When writing to people, it is important we are sensitive. This is a sensitive subject for the people with whom we are dealing. On the basis of what the Deputy said, I will make further inquiries and revert to her on the matter.
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