Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I will try to get through as many of the Deputy's questions as possible. If I forget any, she should come back to me. On her first question, it is a complicated area but there is huge overlap as well. I was struck by what was said earlier, that just because a person is an older person, that does not mean that his or her disability fades away. What we are doing for home support workers? I refer back to the strategic workforce advisory group and the 16 key recommendations. We took all of them on board. We engaged with the public, private and voluntary sector and cross-departmentally. These recommendations must be enforced across all of the Departments.

The first was that when the HSE is outsourcing hours to the private sector, the living wage should be the minimum wage paid. The current living wage is €12.90 an hour; it is going up next year. That was one of the key recommendations, which everyone bought into. On the second recommendation, there are some people who work for private providers who do not always get mileage passed on to them. They have told me this themselves. The second recommendation was that mileage would have to be paid and passed on to the worker. Another recommendation was that the provision of home care should return to a 50-50 split between public and private. It had always been a 50-50 split, but because of the extra €150 million secured over the past two budgets and the fact we delivered more than two million extra hours last year alone, up to 20.9 million, we had to depend more on private companies.

One of the recommendations from the strategic workforce advisory group was that we move quickly back to a 50-50 split. That is what I want to see. We are also asking all nine CHOs to have a recurrent recruitment campaign. The point I made earlier was that the terms and conditions for home care workers working in the HSE are better than some of the private providers, yet we are still challenged trying to recruit through the HSE. There are challenges there. We want to increase the direct provision of home support provided by the HSE. Nursing home care is an 80-20 split, with 80% private and 20% public. That is what we are doing to try to support workers.

One of the other recommendations was that home care be seen as a viable career pathway. Someone coming in with a level 5 Quality and Qualifications Ireland, QQI, qualification could progress the whole way through if he or she decided to do more in caring for people. That person could take on additional courses and skills and be encouraged and supported to do that. It is important that we do that.

On reform of the regulatory framework, in recognition of the need for reform, in January this year we determined a two-phase approach to examine primary and secondary legislation.

We have put in place a national nursing home experience survey, which is under way at the moment. We felt that there is a link between nursing home care and home care because health care workers and nursing staff provide these. I have also put in place a patient advocacy service. We now have a situation where PAS staff, for example, are going into nursing homes and meeting with the residents and hearing their concerns. These concerns can relate to any type of abuse, be it emotional, physical or financial. We are trying to make sure that those supports are there. That is something that we are rolling out.

In October, the Government approved the drafting of the regulated professions (health and social care) (amendment) Bill 2022 to provide for the initial enhancements across the two schemes. I hope to move that legislation. In simple terms, it will provide for standards and best operating procedures for home care across public, private and voluntary. We do not have that in place yet and it is part of making sure that we have a standardised approach for everyone receiving home care, regardless of where they are in the country.