I will now take Leaders' Questions under Standing Order 29. In accordance with the recommendation of the Committee on Dáil Reform and the decision of the Committee on Procedure and Privileges, we will for the first time be making use of the clock. I call Deputy Michael Moynihan.

Across the country, families have applied for the home help service for elderly relatives to keep them in their own homes. However, they are receiving letters stating that while the hours are approved, no funding is available to allocate extra resources. It seems ludicrous that the HSE is sending out letters approving home help hours, yet it does not have resources to back them up.

The home help system is a fantastic service which allows people to stay in their own homes, and it encourages them to do so. However, a cost-benefit analysis of that service does not seem to have been undertaken. Such an analysis would show how much could be saved by allocating a proper care package and home help service for patients. For example, it would save the costs involved in providing long-term care in nursing homes.

Last year, the HSE estimated that 2.2 million extra home help hours would be needed to accommodate the requirements arising from demographic changes in 2016. Unfortunately, there was nothing in either the HSE's plans or the budget to allocate funding for those home help hours. On the one hand, the HSE says it is necessary to have these hours in place to accommodate people in their own homes, while, on the other, the Government has not put funding in place for them. That is ludicrous.

The current programme for Government included increased funding for home help and home care packages. The last programme for Government, from 2011 to 2016, had a similar provision albeit with different wording, yet nothing has been done about it. Does the Minister accept that there is a crisis concerning home help and home care packages? We are getting reports that the HSE is dealing with this matter in different ways in various areas. The HSE says it must wait until somebody ceases looking for home help, or dies, before somebody else can be accommodated through that availability.

Is the Minister aware that it is taking six months to process applications for the carer's allowance? Is he also aware that it can take four or five months to process the simplest medical card application? Reports by advocacy services, including Age Action Ireland and the Alzheimer Society of Ireland, state that there is a crisis out there. Is the Minister aware of this? What is on the Government's agenda to tackle this crisis?

The Deputy finished spot on time. I thank him very much. I call the Minister, Deputy Bruton.

How much time do I have?

Three minutes.

I thank Deputy Michael Moynihan for raising this issue. Members of the House will appreciate the importance of community-based care. Yesterday, an announcement was made concerning additional funding for the health service which, significantly, includes additional provision for home help hours. It is also important to bear in mind, as the Deputy has recognised, that the programme for Government contains a commitment to increase home help hours every year. The Minister for Public Expenditure and Reform, Deputy Donohoe, will shortly publish the demographic impact on spending in each area. No doubt the demographic impact on health will include provision, built into the 2017 no-policy-change budget, to deal with the demographic pressures to which the Deputy has referred.

Yesterday, the Taoiseach adverted to the fact that currently there is a 4% annual increase in the number of people over 85. That clearly creates pressure on areas such as the home help service. As regards having uniformity across the country, home help has always been organised on a decentralised model. Part of its strength is that local home help organisers understand their community. It has, therefore, been organised in a way that seeks to respond flexibly to local needs. That balance between uniform provision, national planning, diversity and division is part of the service's strength. It is not something we would want to let go of lightly.

The Deputy mentioned delays in issuing the carer's allowance, which has been a problem for as long as I have been in politics. It concerns the complexity of the assessment methods which the Oireachtas has put in place.

It requires capital and income assessments as well as a medical assessment. That has been put in place, in the wisdom of the Oireachtas, as a fair way of allocating it, but it does create delays in assessment, which are inevitable with that type of approach. There is also the carer's benefit for people who are at work and decide to take a break to provide care. That can be a bridge because it is based on stamps and does not require the same detailed assessment.

I will alert the Minister for Health to the Deputy's concerns. The Minister for Social Protection has responsibility for carer's allowance, but I will alert the Minister for Health about the continuing problems the Deputy mentioned with medical card delays. I have experienced some improvement in that regard. Members of the last Dáil travelled out there to see that improved processes were put in place.

It is not acceptable to say that there is a system in place for the carer's allowance and we must work through it. As Members of the Oireachtas, we are challenged to change that. If there is a system in place that is bureaucratic and is causing undue hardship for families, we are duty-bound to challenge it and ensure it is changed. Does the Government accept that the home help and home care packages, by any standard of cost-benefit analysis, provide a fantastic service to older people and families and save the State a vast amount of money? I ask the Minister to do whatever is required with the carer's allowance and medical cards. With regard to the carer's allowance, it is unacceptable that when a medical report is sent to the Department it can take six to eight weeks for it to be accepted, when any layperson can see that the person concerned is in need of full-time care and attention. It is not acceptable to say that it is the system. We must change that system, because families are under savage pressure to keep elderly relatives at home for as long as possible.

I do not disagree with the Deputy. Much of the effort of the Oireachtas has gone towards recognising that. As the Minister of State, Deputy Finian McGrath, reminded me, last year we restored the respite care grant to its full value and we have sought to improve home help and home care packages. In each of the winter initiatives, a substantial improvement in spending on home care occurs. I agree with the Deputy that we must try to keep as many people as possible living independently in their homes. I noted from the reports during the week that perhaps we have not emphasised that sufficiently and that there has been too much emphasis on institutional care in cases in which people could have remained independent. The programme for Government reflects that concern and commits to expanding this area. We have made a very solid commitment in this regard, even though we are aware that new drugs coming on the market or new procedures will demand attention and resources. There is a recognition in the programme for Government of the importance of this area of care.