James Reilly (Dublin North, Fine Gael) | Oireachtas source

I thank all Members of the House who contributed to the debate yesterday and today. No one disputes the fact that high quality home care makes a big difference to older people and their families. There is no doubt the work to date of all those involved in the development and implementation of policy and the provision of services has contributed positively to the lives of those who receive these services. It is also a vital element in meeting the preferred wishes of older people and people with disabilities and their families to stay in their homes where at all possible. It also helps in tackling wider health and social system pressures and addressing poverty in many cases.

With the growing demand for such services, there will be challenges ahead as services evolve to meet the needs of older people and, as far as possible, care for them in their own homes and communities. Services will have to adapt and be more flexible in their use of funding while maintaining at their core the person-centred approach. Let me be clear. The Government is committed to a single tier publicly funded health system. This is why the Government is committed to universal health insurance.

It has long been the case that the HSE has worked in partnership with the not-for-profit and private sectors to augment its valuable services to people who need home care at local level where, for whatever reason, the HSE is not in a position to do so itself. This may include where there are resource limitations locally or to ensure care in the evenings and at weekends. Among recent HSE initiatives to improve service nationally has been the introduction of a new procurement framework for approved agencies providing services on its behalf. Each local health office, and the clients it serves, now has a choice of four approved providers for new home care packages to supplement its own provision. While these developments have been designed to standardise and maximise the use of limited resources in the face of increasing demand, they are also intended to enhance quality, safety and other relevant aspects of service for providers and care recipients alike.

I must signal clearly that I make no apologies for seeking to maximise the amount of home care we can afford with what is, after all, a substantial budget. I am seeking new models of working in the public sector to achieve efficiencies and seeking to provide a choice of provider where this is possible. This must include partnership arrangements for the voluntary and private sector. Key services realise this objective while also relieving pressures on acute hospitals and long-term care residential systems. The range of community-based services include home care, meals on wheels, and day and respite care. In 2012 we will spend approximately €320 million on home help and home care packages. Approximately 50,000 people receive mainstream home help and, at any one time, approximately 11,000 people receive home care packages.

I must ask Deputy Adams whether it is true that Sinn Féin in government in Northern Ireland is closing long-stay beds.

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