Rose Conway Walsh (Sinn Fein) | Oireachtas source

I thank the witnesses for their presentations. I commend all of our carers and those who provide home help on the work they do throughout the country, including in my community. This is a battle we have been fighting since 2010 when drastic cuts were made to home help hours. Previous to these cuts, we had a very good system in which people were employed by the HSE, paid a proper wage, and service users knew what they could expect. Why did the HSE break a system that was working?

Allowing people to be cared for in their home is vital. It should be a priority for the HSE. The resources being allocated to this service and the manner in which it is being operated and privatised, however, does not speak to that. There is an imbalance between the words that are being spoken and the manner in which carers and home help providers are being treated. I live in a rural area, where I regularly see carers running from one client to another for half an hour. It is ridiculous. One could not make this up. A junior certificate student would fail if he or she wrote that type of prescription to deliver home care, especially in rural areas. It is bizarre. Has any analysis been done on the cost to the HSE of providing one hour of home help via a private company? What is the saving to the HSE per hour in not employing carers directly?

There are 6,450 people waiting for services, which is crazy. The cost to the HSE of providing each of them with, say, four hours of home care per week, even if provided through the private system at €26 per call, would be €670,000. Has the HSE requested this funding? This is not all about numbers. I know of a 79 year old man who is soon to be discharged from hospital. His wife has dementia, chronic pancreatic cirrhosis of the liver, diabetes and chronic arthritis. They have been told they are not a priority case. This couple is among the 6,450 people on the waiting list. This is so wrong. The funding necessary to provide all of them with services must be made available.

Does the HSE propose to return to the one-hour service? Staff recruitment and retention is a problem because of the if-and-when manner in which services are being provided. The one-hour service is not satisfactory to the person delivering it and it is certainly not satisfactory to the vulnerable person that a carer would not have even have time to speak to him or her. Reference was made to an audit and it being a priority issue. I agree that there need to be standards and proper training, but the HSE is not running an army. My concern is that we will have more layers of management, governance, audits and so on and no carers to provide home help services because people will not be willing to do it. It is not the case that we have full employment because unemployment across Mayo is at 30%. What formal communications has the HSE had with the Department of Employment Affairs and Social Protection around working patterns in this area. Currently, when a person does even one hour per day, his or her social protection entitlements are messed up such that he or she cannot pay the bills and so on. Who in their right mind would be home carer? It does not add up.

There are many other questions I would like to ask but it is difficult to answer questions in batches because one cannot develop the answers.