Barry Andrews (Dún Laoghaire, Fianna Fail)

I thank the Deputy for raising this issue as it provides me with an opportunity to update the House on Government policy on the home help service and community services generally for older people.

The guiding principle of Government policy in this area is to support older people to live in dignity and independence in their own homes and communities for as long as possible. This policy is delivered through a range of community-based supports such as home help-home care packages, meals on wheels and day and respite care services. The importance attached to these services is highlighted by the fact that between 2006 and 2010 more than €200 million in additional funding was provided for the HSE to develop such supports for older people. Without these initiatives, many older people would spend longer than necessary in acute hospitals or be admitted to residential care earlier than might be required. Home care services are provided either directly by the HSE or in partnership with the community and voluntary sector, or by arrangement with private providers.

The home help service is one of our core community services, enabling vulnerable people to remain at home. It is a critical support for older people, in particular, and facilitates prompt discharge from acute hospitals or prevents inappropriate admissions to such hospitals or long-stay residential care. Significant progress has been made in developing the service since 2006, with a noticeable impact both on the number of people benefiting and in relieving pressures on the wider health system.

The provision has increased from 10.8 million hours in 2006 to 11.97 million in 2009. This corresponds to an increase from approximately 49,600 clients at the end of 2006 to 53,800 recipients at the end of 2009. The executive is committed to achieving its target of 11.98 million hours this year in respect of some 54,500 clients, as set out in its current service plan. The national target for 2010 for home help hours is unchanged from the 2009 figure of 11.98 million hours. Any change to this commitment would have to be notified to the Department of Health and Children.

Despite the serious economic constraints experienced in recent times, we have continued to prioritise improving community services for older people. This commitment is demonstrated by the €10 million additional funding provided in the last budget to expand home care packages nationally. These packages often contain a significant home-help component.

In addition to the mainstream home help provision, the current service plan is designed to deliver home care packages to approximately 9,600 people at any one time or some 13,000 clients over the course of the year. This represents an increase for this initiative on that provided for last year. The plan also provides for 21,300 day-care places which should facilitate up to an estimated 80,000 people. Other important initiatives in the area of home care supports are also being undertaken. Arising from an evaluation of home care packages, commissioned by the Department of Health and Children and published last December, the HSE has progressed this year with various improvements in home care provision for roll-out during 2011. These initiatives include revised national guidelines for standardised implementation of home care packages, new national quality guidelines for home care support services, national guidelines for the home help service, and a national procurement framework for home care services. The executive went to tender with the procurement framework on 22 October.

The HSE has operational responsibility for the delivery of health and social services, including the home help service at both regional and local health office levels. Reviews of service delivery are ongoing to ensure those who most need the service receive it, that the changing care needs of clients are taken into account, that people are treated equitably and that services are managed in a way that reflects seasonal changes in demand. The HSE has confirmed that services are being closely monitored to ensure the targets for service delivery in 2010 as set out in the service plan will be achieved. Notwithstanding the difficult financial environment, the Government is determined to do everything possible to protect the services referred to by the Deputy, respond to priority demographic and other needs and support ongoing reform of the public health services within available resources.

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