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.

Chillax.

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?

What is in 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.