The recent report by the organisation ALONE, the aim of which is to help older people in need, poses the question as to why we are forcing older people out of their homes.

Hear, hear.

The statistics provided show that more than one third of older people in long-term nursing homes have low to medium dependency needs. This means they could live at home if provided with adequate home care.

The proportion of the elderly population in Ireland living in long-term nursing homes is higher than the European average. Many are in these homes because of the inadequacy of home care services here and the supports which the State offers. We are all in favour of older people living at home and within their communities, as they age, for as long as possible. However, negative developments such as the cuts to home care packages and reductions in housing adaptation grants for the disabled and the elderly are preventing this. Since 2009, more than 1.75 million hours have been cut from the vital home help service. This has had a devastating effect on home care services and resulted in many people moving prematurely into long-term residential care.

While the programme for Government, the HSE service plan and the national positive aging strategy all offer nominal support for the general idea of older people aging at home, the financial means of achieving this have not been, for the most part, provided. There is a great deal of lip-service, to say the least, and grand aspirations that have fallen short of the targets.

A question, please.

Will the Taoiseach and the Government revisit and address these shortfalls in the forthcoming budget and set out a strategy in this regard for the next five years?

I thank Deputy Fleming. The Deputy will be aware that discussions around the budget are a matter for the Ministers for Finance and Public Expenditure and Reform. All of that will take place, including public engagement with different sectors, over the next while. However, I take the Deputy's point.

The Deputy has raised a very serious matter, which affects families all over the country. Dementia does not distinguish between borders, or geographical boundaries. I am informed that in 2011, there were 47,000 people in Ireland suffering from dementia and that by 2021, this will have increased to 68,000, which is 40% to 42% increase, which speaks for itself in terms of the challenge we face in this regard. It is important to acknowledge that Government has recognised this. The Minister of State, Deputy Kathleen Lynch, and Minister for Health, Deputy Varadkar, and his predecessor, Deputy Reilly, have put in place a process by which the national dementia strategy has now been developed, agreed and published. The main focus of this strategy is timely access and diagnosis, support, nationally and locally, and training and support for families and health care workers. It is a priority of Government that people be able to remain in their own homes for as long as that is medically and physically possible. The HSE has introduced a whole range of initiatives to ensure that older people have timely and appropriate care and treatment at the lowest level of complexity and as close to home as possible, which is what people desire.

The HSE service plan 2015 references the intention of the HSE to progress the realignment of services to provide home care services and community care services in order to maximise the opportunity for older people to remain in their own homes for as long as possible. Currently, 10.3 million hours of home help service are provided, supporting 50,000 people. There are 13,800 people now in receipt of home care packages. This includes 600 people who are supported under the delayed discharges initiative. There are 190 people in receipt of intensive home care packages at any one time. These were introduced in the first quarter of 2014 for people who have more complex needs.

Also, a national tool for assessment of people's needs is now available. This means that instead of varying standards across the country there is now a national assessment available. In 2015, €993 million was allocated for the nursing homes support scheme, which is important for people. I take the Deputy's point but I am sure he will be aware that the national dementia strategy has been welcomed. It is a comprehensive and thorough analysis not only of the scale of the challenge in terms of, as I stated earlier, the increase to 68,000 by 2021 of the number of people here suffering from dementia but how, given our rising economy, we can deal more comprehensively with this matter in the time ahead.

The Deputy's point in regard to the budget will be taken into account.

Current trends and statistics indicate we have a dramatically aging population. The Government needs to take this into account and to plan accordingly for the future.

Options such as supportive housing and extra-care nursing must be available to allow people to live in their communities. By 2026, it is envisaged that 16% of the population will be aged over 65, compared with the current figure of 11%. While nursing home care is the only option for many high-dependency patients, the existing model of prioritising that type of care is not sustainable into the future. Having said that, it is vital to ensure sufficient funds are set aside in the budget for the fair deal scheme. In addition, there must be sufficient funding for the extra respite beds and acute hospital beds that are needed to solve overcrowding problems.

These matters can be addressed in the short term, but the demographic issue requires a long-term approach. As the Taoiseach mentioned, the projected increase in the numbers suffering dementia from 47,000 to 68,000 by 2020 presents a huge challenge for future governments. Indeed, there are predictions that we will see a 240% increase in the incidence of dementia by 2040. We are facing a tsunami in this regard and action must be taken. We need a medium- to long-term strategy, which will require the co-operation of several Ministers and Departments. Will the Taoiseach agree to set out that strategy in the coming budget and for future years?

A great deal of work has been done on the national dementia strategy, and the plan has been published and launched. It represents a comprehensive analysis of the scale of the challenge. We can predict reasonably accurately the figures for the coming years, which spell out the scale of the challenge we will have to meet. I gave the House some of the figures which show how the Government has applied resources to ensuring people can remain at home for as long as possible. We need to ensure the method of assessment is more accurate in analysing the particular needs of people in different parts of the country.

On the broader issue of the challenges of an aging population, there has a big change of culture in this country in respect of healthy living. There is a greater awareness of the dangers of obesity, the issues arising from the thousands of deaths that occur each year because of tobacco use, the questions surrounding alcohol and its abuse, and so on. The Deputy will have noticed increased activity levels among citizens. With modern medicine and healthier lifestyles, people can live for longer. The change of attitude towards achieving a healthier Ireland and a healthier population is important in the longer term if people are indeed to live longer. I note the spectacular achievement by an octogenarian the other day in climbing Mount Kilimanjaro, which was an extraordinary feat. In the Deputy's own county last week we saw the interest people have in achieving personal goals. That cycle event was for charity, which means it had a double impact. These are all aspects of the strategy for ensuring people are involved in and engaged with building a healthier Ireland.

In respect of dementia, the strategy, as I said, is in place. It is a question now of being able to meet the challenges outlined in that strategy.