Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

I wish to pick up on that point. The most disappointing aspect of this legislation is that it does not provide for the long-promised statutory right to home care. I was just reading the history of that promise yesterday and I saw that in 2017, the current Taoiseach, as Minister for Health, committed to the introduction of a statutory right to home care. That was 2017. In 2020, when questioned about it, he said the scheme was almost ready. It was almost ready in 2020. We were certainly given to believe that this legislation would provide for that. Last week at this meeting, we were told by the Minister of State, Deputy Butler, that she and the Department had not managed to crack the nut of the charging regime for home care. I cannot understand why that is the case. The Department of Health has had seven years now, and there were clear commitments and promises given at political level. From a health as well as an older person’s well-being perspective, it makes no sense whatsoever on any level to direct older people into nursing homes instead of supporting them in doing what is in their best interest and what they want to do, which is stay in their own home with home care. There are umpteen examples of where a person is entitled to the fair deal scheme, and it will cost the State more to provide the fair deal and support somebody in a nursing home than it does to support them in their own home, and they do not want to be in a nursing home in the main. It makes no sense on any level for the Department and the various Ministers involved to have welched on the commitment they gave. I cannot understand it. Why are we doing something that is not in the interest of older people and is not in the interest of value for money either?

Having said that, I also express disappointment at the actions taken last year. It was good to have the expert group’s report on putting home care staff on a proper footing in relation to pay, conditions and so on. However, when those changes to the pay and conditions were introduced, no additional money was provided for that. What then happened is that, in a sleight of hand by the Government, the number of hours provided to older people were reduced to pay improved rates and conditions to staff. It was older people who paid the price for that rather than the Government following through on its commitment to make it a decent role.

All of these issues, in the main, are arising because of decisions taken over recent years to outsource a key area of social care whereas social care should be provided within the public sector. However, a decision was taken by consecutive Ministers to outsource that, and we find ourselves now in this situation.

Will the witnesses give an overview of the rough kind of percentages of care provided, in the context of all HSE-funded services, between HSE directly provided, privately provided and voluntary sector provided? What is the breakdown?