Enda Kenny (Mayo, Fine Gael) | Oireachtas source

In respect of the services for older people, until 2011 in the republic of which Deputy Adams speaks there was no national approach to the procurement of home care providers to supply indirect services through the home care package scheme. Therefore, different standards and approaches were being taken throughout the country in different locations and this left the HSE vulnerable to challenges of anti-competitive behaviour and inefficient service. Most important, as Deputy Adams is aware, it left people in a vulnerable position because different practices had different standards applied to them throughout the country. In some areas of the country where there was no direct HSE provision for carers or where the HSE direct provision had not been sufficiently used, procuring services from what we call external providers was the only viable option to provide services and supports for older people who chose to remain at or return to their homes.

Some €392 million was allocated in 2013 to provide these services to approximately 100,000 older people. Approximately 20% of the population over 65 years received some element of home care or day support service annually. There is an obvious need to provide high-quality services that are flexible to address the needs of these people such as long-term residential care needs or acute hospitals needs.

The programme for Government commits to developing and implementing national standards for home support services because, as Deputy Adams is aware, people generally want to be able to stay in their own homes for as long as possible before it becomes necessary to have them move to a longer-stay institution. There will be, however, a need for primary legislation here and for the introduction of a statutory regulation system that will apply across the board. In the meantime, the standardisation of services, the promotion of access to services and quality and safety are matters of concern to the Minister. This means the procurement framework for home care services and to national guidelines for the standardised implementation of the home care package system. It also means dealing with the specific issue raised by Deputy Adams about respite care and the extent and range of it. We also need the provision of the new national health guidelines for the home help service which includes elements of respite care such as those Deputy Adams mentioned. These issues are constantly under consideration by the Minister and will be reflected in his budget Estimate for 2014.

For the information of Deputy Adams, there are approximately 10,800 home care packages for 2014, approximately 5,000 new home care packages for clients, more than 10.3 million home help hours and some 50,000 people are in receipt of home help hours, there are 21,500 day care places, some 22,000 people funded under the nursing home support scheme and there are approximately 2,500 new elder abuse referrals, all of which are being considered in the context of these services for this year.

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