Seán Haughey (Dublin North Central, Fianna Fail)

The overarching policy of the Government is to support older people to live in dignity and independence in their own homes and communities for as long as possible. Where this is not possible, the Health Service Executive supports access to quality long-term residential care where this is appropriate. In line with this overall approach, a priority of Government in recent years has been to develop a range of community based supports such as home help, home care packages and day-respite care. Between 2006 and 2010, additional investment of more than €200 million was provided to the HSE to develop community-based services for older people. Without these initiatives, many older people would spend longer than necessary in acute hospitals, or would be admitted to residential care earlier than might be required.

The HSE service plan 2010, approved by the Minister for Health and Children last March, commits the executive to providing agreed levels of service nationally for these key community support areas. The plan includes respite care, often available through day care or home care packages, and is delivered either directly by the HSE, or in partnership with the voluntary or private sectors. Broadly speaking, the level of community supports for older people in 2010 is in line with 2009 provision. There is an increase this year in the number of home care packages available due to an additional €10 million given in the last budget for this purpose.

The key activity targets contained in this year's HSE service plan are almost 12 million home help hours to approximately 54,500 people, increased home care package provision from 8,700 recipients at any one time in 2009 to 9,600 in 2010 and a total of 21,300 day care places, which is estimated to cater for up to 80,000 people. While this target is slightly down from a comparable figure of 21,600 places last year, the respite element of day care would be generally compensated for in the overall 2010 home care service picture.

Any changes to these commitments, as part of the agreed HSE service plan, would need to be notified to the Department. Other important initiatives are also being undertaken at a strategic level to improve community-based services for older people. Arising from an evaluation of home care packages, published by the Department last December, the HSE established a taskforce to progress, this year, various improvements in home care provision. The Department accepts the need for a more standardised approach to home care generally, whether by public or private provision. This year the HSE intends to finalise and circulate standardised access and operational guidelines for delivery of home care packages, adopt and disseminate a voluntary code of quality guidelines for home care support services for older people and develop and publish a procurement framework for home care services.

The various guidelines now being prepared are intended to allow the HSE implement a more standardised approach nationally to the provision of home care services, including respite care, in the context of interlinking with the wider range of services.

The HSE has operational responsibility for the delivery of health and social services. The Deputy will appreciate that all developments in the area of home care need to be addressed in light of the current economic and budgetary pressures. The executive has been asked to make a rigorous examination of how existing funding might be reconfigured or reallocated to ensure maximum service provision is achieved. This requires a stringent ongoing review of the application of the resources available. It is, consequently, a matter for the executive to manage the services I have outlined, including respite care, at national, regional or local level, bearing in mind all relevant factors such as overall resources, local circumstances or evolving service priorities.

I have taken note of what the Deputy said about Limerick city and will convey his views to the Minister for Health and Children.

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