Jim Daly (Cork South West, Fine Gael) | Oireachtas source

I thank the Deputy for raising this issue. The overarching policy of the Government is to support older people to live in dignity and independence in their homes and communities for as long as possible. Home care is an increasingly important part of the supports for enabling older people to remain in their homes and communities for as long as possible and for facilitating their discharge from acute hospitals. The HSE has operational responsibility for planning, managing and delivering home and other community-based services for older people. Services are provided on the basis of assessed health care need and there is no means testing. The HSE, working within its available resources, has sought to maintain and, where possible, expand the range and volume of services available to support people to remain in their own homes, to prevent early admission to long-term residential care and to support people to return home following an acute hospital admission. The demand for the home help service and for additional supports through the home care package scheme continues to grow in parallel with the increasing numbers of older people. Many more of our older people with complex care needs are now being maintained at home, leading to increased demand for additional levels of service and for services outside of core hours of Monday to Friday.

The overall funding for services for older people in 2017 is €765 million. This includes about €373 million for the direct provision of home care. The HSE’s national service plan provides for a target of 10.57 million home help hours, 16,750 home care packages and 190 intensive home care packages for clients with highly complex needs. The HSE has progressed a range of measures to improve home care provision overall, to standardise services nationally and to promote quality and safety. National guidelines setting out standard procedures for providers of home supports were introduced in 2011. A procurement framework for home care services came into effect in 2012. This requires service providers to meet defined minimum standards applied to services procured by the HSE. The tender arrangements are reviewed regularly and the current arrangements which commenced on 1 September 2016 will run for a period of two years. The Deputy will be aware that arrangements for home care have developed over the years with a significant local focus, and there is considerable variation in access to services in different parts of the country. There is a need for a uniform approach to assessment of need, and the HSE is in the process of introducing a single assessment tool across home care. The single assessment tool is a comprehensive IT-based assessment used to ensure that every person being assessed for support services has access to a standard and thorough assessment, regardless of where they live or who is doing the assessment.

Home care is monitored on an ongoing basis, to ensure that activity is maximised relative to individual clients’ assessed care needs and within the overall available resources for home care and having regard to demand throughout the year. Arrangements for home care have developed over the years with a significant local focus, and there is considerable variation in access to services in different parts of the country.

The programme for partnership Government includes commitments to increase funding for home support services, to improve these supports, to introduce a uniform home care service in order that all recipients can receive a quality support, seven days per week where possible, and to review the management, operation and funding of national home help services.

I assure the House that the Government is committed to promoting care in the community for older people in order that they can continue to live in their homes for as long as possible. On 6 July, the Minister for Health, Deputy Harris, and I announced the opening of a public consultation on home care services. The purpose of this is to allow all those who have views on this topic to have their say, including older people themselves, their families, and health care workers. The Department wants to find out what people think about current home care services and would also like to hear the public’s views on what the future scheme should look like. I strongly urge all those with an interest in home care services to make a submission to the consultation.

I would appreciate it if Deputy O'Rourke would clarify one point. When he talks about the services that have been allocated and not delivered, is he talking about private home care services or is it the HSE which is in charge? I am concerned about that.

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