Helen McEntee (Meath East, Fine Gael) | Oireachtas source

It is Government policy that long-term nursing home care should be a last resort and we want to develop home care services to provide a more viable alternative to nursing home care for a greater number of people. Traditionally, home care was viewed as providing a lower level of support than residential care and not as an alternative to it. Increasingly, however, it is considered possible to support many people to continue to live at home who would previously have gone into residential care. That is clear when we consider the length of stay of people in nursing homes, which has changed from around six or seven to two years. People are entering nursing homes much later in life, possibly with more complex needs. This requires an increase in the amount and intensity of home care, and more effective integration with other supports including nursing, therapies and other primary care services.

Arrangements for home care have developed over the years with a significant local focus and, unfortunately, there is considerable variation in access to services in different parts of the country. The services people in Meath receive may be different to those living in Donegal. The HSE is incrementally developing a more consistent and coherent system of service provision. The service plan for this year sets a target of 10.57 million home help hours to support 49,000 people, including 16,750 home care packages and 190 intensive home care packages.

It is my view and that of the Government that we need a stand-alone funding scheme designed for home care that recognises its particular characteristics together with regulation of home care services.

A significant amount of detailed preparation needs to be done, and is currently under way, before final decisions are taken on the form of a home care scheme and the regulation of these services.

Last year, the Department commissioned the Health Research Board to carry out an evidence review of international approaches to the regulation and financing of home care services. The four countries examined were The Netherlands, Scotland, Germany and Sweden. The reason they were chosen was because of the type of framework they have and what it is that we are looking to apply here. The report is going through its final stages of being peer reviewed and will be published shortly. The Department is also undertaking a mapping exercise of current service provision nationally. This will take into account the scale and diversity of services funded by the HSE. This work will be used to identify major policy options for a new statutory home care scheme around the areas of regulation, financing, assessment and eligibility.

Once this is completed, a public consultation will be launched to allow stakeholders, including older people themselves, their families and healthcare workers, to express their views regarding a new home care scheme. It is my hope and intention that the consultation will be launched in May of this year.

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