Mr. Joseph Musgrave:

I thank the committee for inviting Home and Community Care Ireland, HCCI, to appear before it. HCCI is the representative body for the private home care sector in Ireland. Our members, and their 15,000 carers, enable more than 25,000 people of all ages who need care to stay living in their own homes. I am joined today by HCCI’s policy and communications manager, Mr. Jamie Farrelly, and by Ms Paula Maher, who is the operator of Care at Home, an SME provider which employs more than 100 carers and provides care for 250 clients, mainly across south Dublin. We are grateful for this opportunity to discuss a major barrier to employment in home care. I will focus our contribution on the impact means testing is having on the sector, including on recruitment, the existing workforce and on our clients.

In October 2022, the Department of Health published the cross-departmental strategic workforce advisory group, CD-SWAG, report to address recruitment and retention in the home care sector. HCCI both called for CD-SWAG to be formed and was heavily involved in the consultations it undertook. Recommendation 8 in the report recognises that those in receipt of State benefits are an important recruitment pool for the care sector and, as such, State benefits, particularly carer’s allowance and jobseeker’s allowance, should be reviewed to ensure they do not disincentivise employment. Yet, more than 18 months later, the Department of Social Protection has made little progress on this review and has not shown an eagerness to engage with the sector on this issue. Discussions about home care recruitment often centre on pay. This is something the sector has made a lot of progress on. HCCI members pay an average of €14.50 an hour. Home care workers are guaranteed the living wage and travel time, something HCCI advocated be included in the HSE authorisation scheme, which is the new mechanism that governs how home care is procured. Home care is also, by design, a part-time occupation, with visits peaking between 8.30 and 9.30 in the morning, plummeting in the afternoon and then peaking again in the evening between 6.30 and 7.30. There is more to be done in this area. Home care workers should get further wage increases and be paid for mileage. Nevertheless, it is structural problems like social welfare, lack of a career structure and how home care is commissioned that is driving recruitment and retention issues today. Members of the committee should be in no doubt that social welfare rules around means testing, income and working hour limits are inextricably linked to recruitment challenges in home care, workplace stress, staff leaving the sector and the persistently high waiting lists we see for HSE home care.

National and international evidence shows that people on State benefits and people returning to work are potential recruits. Current means testing deters people from ever entering employment, as even a modest income may disqualify them from essential social welfare supports. We should, at the very least, means-test the individual, not the household, to prevent this. Means testing impacts those in work too. For example, home care workers claiming carer’s allowance face a precarious balance trying to work just enough hours to maximise their income but avoid disqualification from their payment. We know this stressful situation can lead to burnout and to home care workers leaving the sector. That is, they fall into a social welfare trap. This carer turnover affects continuity of care, something that is critical for home care clients. Means testing even impacts those who do not claim any social welfare benefits. When Jamie and I travelled recently to meet home care workers in Monaghan, they were aware that some of their colleagues claim social welfare. They were not resentful of that, but they did say they felt pressure to cover shifts when their colleagues could not because of rules like means testing and working hour limits. There is a certain irony in that when wages recently increased due to the guaranteed living wage in the contract I described, some home care workers had to reduce their hours because that extra income would put them over the means test threshold.

We should end these cliff-edge cut-offs in payments and move to a tapered approach. A HCCI survey found that 85% of home care workers who claim a social welfare support would work an additional three hours per week if their social welfare benefits were unaffected. Increasing the hours a home care worker can work is very achievable. To increase the working limit on carer's allowance by three hours would cost between €50 million and €54 million. This should be done in conjunction with changes to means testing. Those three hours could be the difference between a vulnerable older person leaving hospital with a home care package or joining the long waiting list for home care which currently stands at 5,500. We will struggle to properly tackle waiting lists until we reform our social welfare system.

When looking for solutions to tackle chronic problems in the home care sector like recruitment and waiting lists, we must accept they are intrinsically linked to social welfare rules like means testing. We must also accept that many benefits were designed for a very different labour market than we have today and that the social protection system needs to modernise. We have solutions to reform social welfare so that it fulfils its true purpose to encourage, rather than restrict, participation in the workforce. We would like to see the Department of Social Protection address the recommendation of CD-SWAG to review eligibility criteria for State benefits to ensure they do not disincentivise employment. We join our colleagues in Family Carers Ireland to call for the abolition of means testing for the carer’s allowance. The working limit for those in receipt of carer’s allowance should be increased from 18.5 hours to 21.5 hours. The Department of Social Protection should bring forward proposals to develop the working age payment to replace the outdated jobseeker’s allowance.

I thank the members of the committee again for the opportunity to appear before them. We look forward to the members’ questions.