I take this opportunity, on my behalf and that of my party, to congratulate President Obama on his success in the US presidential elections. He and the United States have been good friends to Ireland and we wish him and the United States every success in what will be a very challenging environment over the coming years. I also pay tribute to Governor Romney for what was a very competitive campaign, which riveted many people over the past weeks.

On the domestic front, I mention an issue that I raised some weeks ago with the Taoiseach, the savage cuts in home help hours. The rhetoric being used in this House bears no relation to the reality with respect to the impact of these cuts. I met thousands of people last Saturday when people from all over Munster were marching in Cork, and I got first-hand accounts from people whose elderly relatives have had home help hours cut. I recall the Taoiseach saying some weeks ago that the overall position is that anyone with an assessed need for a home help service will not be left without one. That is not the reality.

I met a young woman on Saturday who detailed the case of her elderly disabled mother. She said that although it was difficult for them to manage before the cuts, it is now impossible because of these cruel measures. She indicated that there was no alternative to considering placing her mother into long-term care, which she is sure will cost the State dearly compared to care at home. Her GP wrote to the HSE and the Taoiseach noted there would be medical assessment in that regard. The GP indicated that although cost-saving measures must be addressed by the HSE, it is inhumane to deny a disabled, elderly person the fundamental right to live in her own home with dignity. He went on to say that he finds the cutting of home help hours for vulnerable patients very upsetting and unjustifiable, and it makes no economic sense.

There is a range of other cases, and I am sure every Deputy in the House has had people outline details of elderly people who have had hours cut fully and the service fully stopped. There are two elderly sisters who are nearly blind who have had their hours fully stopped. This position is untenable and unfair. The manner in which these cuts have come about, as the campaign for Older and Bolder and others have argued, means that there has been no notice in many cases. The impact has been "colossal and potentially dangerous" in the words of Age Action Ireland.

Does the Taoiseach accept that these cuts fly in the face of repeated commitments in the programme for Government? Will the Taoiseach consider reversing those cuts imposed on families?

Every time the Deputy raises an issue about matters to do with the elderly and disabled, there is an immediate emotional contact. It is true that this is a very difficult area in which to make any kind of adjustment without individual difficulties arising. I understand that. I meet such circumstances myself and I have had occasion to have queries about individual cases raised where particular circumstances apply either with a person's position or the change in a service being provided.

The service plan for 2012 was to deliver 10.7 million home help hours to 50,000 people. The reviews carried out are done in such a way so that anybody who is a current recipient of a service and who has an assessed need for a service will not be left without a service. I have seen cases where people may have a medical service that washes and changes them, which is a personal and sensitive matter, and a spouse or family member may not be trained to do that kind of work for an elderly person. There are different sorts of assistance given through various measures from the HSE, such as respite care, home care packages, home help or the meals on wheels service.

In the Cork area, for example, HSE south has provided in excess of 1.2 million home help hours to more than 6,100 clients.

Break it down.

The current activity in the Deputy's county delivers over 82,000 hours per month over the plan already agreed for 2012. The Cork city team and management of professional staff are working so that it can be realised in a measured and appropriate manner. It is not a case of simply having a blanket reversal but rather making an adjustment which is not without difficulty for some people. For those with an assessed medical need, the HSE has been instructed by the Minister that such people be treated sensitively.

We can all come up with individual cases straying outside that boundary. The Deputy asked me to reverse these but that is impossible. The managing professional teams dealing with the issue - I met some service providers when I was in Cork recently - must work in a measured and sensitive fashion, so those who need the service will continue to get it.

It would cost more for these people to be in hospital.

The Taoiseach promised increased funding for home care packages and more home help hours. That promise has been clearly broken. Apart from that, the Taoiseach mentioned medically assessed need. I have told people what the Taoiseach said to me in the House six weeks ago, that services for people with such an assessed need would not be cut, there would be sensitivity and so on.

They just laughed at me and asked whether I and the Taoiseach were for real. This is not what is occurring on the ground. People are being left without a service that they clearly need.

All of the time.

I know of a case of two sisters, one aged 84 years and the other aged 93 years. One is wheelchair-bound and both are nearly blind. They used to have five hours, which clearly means that there was an assessed need. Their time was reduced to two hours and has now been stopped fully. People with clear medical needs and who were receiving home help hours have had their services stopped fully.

I want the Taoiseach to move away from the rhetoric of the House. For many families looking in, there is no relationship between the rhetoric used and the reality on the ground.

None whatsoever.

We owe it to people to go beyond the set piece replies from the HSE, the Department or the Minister concerned.

Spin doctors.

We need to interrogate what is occurring on the ground. The original case of a disabled elderly woman in west County Cork that I identified to the Taoiseach was horrendous. Her daughter has been actively supporting her mother, but the former is at the end of her tether in terms of being able to keep her mother at home. The general practitioner, GP, has written to the HSE to confirm this and to say that something must give.

Deputy Martin's Government abolished the health boards.

If we force elderly people from their homes into institutions, nursing homes and community nursing units, we will cost the State far more than is currently the case under the home help service. The Government has proposed additional cuts worth €8 million. That decision is reversible. It is within the Government's capacity.

I invite Deputy Martin to send me the details of the particular case he mentioned in west Cork.

Can we all do that?

Will the Deputy hold on one minute, please?

Yes. We know about the Deputy's cases as well. I do not know the details-----

I do not know the details of the provider who is providing the service in that case.

Just cutting the services.

I do not know the extenuating family circumstances. I invite Deputy Martin to send the details to me and we will see. I am not standing up-----

We all know of cases.

Fine Gael and the Labour Party are cutting the services.

We know all of that. Deputy Martin mentioned a specific case that he says is horrendous. As far as I am concerned, the elderly woman in west Cork who is disabled and who needs medical attention should get it on the assessment carried out by the professional teams of the HSE.

Reverse the cuts.

Two reviews have been carried out already this year. In each case, all of these circumstances can vary from house to house, from person to person or from family circumstances to family circumstances. Is that person receiving home care assistance outside of the home help service? What other elements of health provision for that person are being received? I do not know. I invite the Deputy to send me those details.

She wants her cut home help hours back.

As far as I am concerned, having spoken with the Minister for Health and the HSE about this, in the assessment of needs that are carried out by professional people in providing this service, where there is a medical assessment required and where there is a medical need, that person is not going to be left without a service.

That is not happening. They are being left without a service.

What is "medical assessment" in English?

All Deputy Martin wants is to say "Reverse all these things". In this case, that woman is living in west Cork this morning. If she needs medical assistance through some form or other of this scheme-----

That is fine, but we are discussing home help hours. Let us not try to confuse the matter.

-----then that is the assessment to be given to her.

Deputies, please.

In the assessment of home help hours-----

They are being cut.

-----it may well be that the provider is calling to the house in the morning to get that person up and to get that person bathed, dressed and ready for the day. Is that the service that is being provided?

The Taoiseach is out of touch.

I did not go through all of the details.

If the Deputy knows all of the details-----

Yes. I have them here. We all do, including Deputy Buttimer.

-----I invite him to send them to me. We will check that case with the HSE and he can return to it next week.

We want the case's details.

All the Taoiseach will do is refer the cases to the HSE.

Deputies, please. This is Leaders' Questions.

The Taoiseach is not answering.

Shouting and roaring means that no one can hear what anyone is saying. Will Deputies please stay quiet, allow a person to ask a question and allow it to be answered?