Mattie McGrath (Tipperary, Independent) | Oireachtas source

I want to raise with the Taoiseach this afternoon the approach of the Government to the provision of home care packages. In particular, why are the two lowest levels of provision registered in community health care organisation, CHO, areas 3 and 5, which encompass north Tipperary and south Tipperary, respectively? All the other seven CHOs have a significantly higher number of persons in receipt of the packages. This cannot be explained simply by reference to population levels.

The information provided to me by the HSE shows that, at the end of December 2017, just 1,149 persons were in receipt of a package in CHO area 3, which covers Clare, Limerick, north Tipperary and east Limerick. The second lowest figure is in CHO area 5, where just 1,242 persons were in receipt of home care packages. This area covers Carlow, Kilkenny, south Tipperary, Waterford and Wexford.

It is deeply frustrating to me that the very low levels of home care package provision are evident in counties that consistently record the highest number of patients on trolleys. Everybody, including a second class student in national school, will know that there must be an impact on the trolley count. South Tipperary General Hospital and University Hospital Limerick consistently record the highest numbers of patients awaiting beds in accident and emergency departments. This is from Irish Nurses and Midwives Organisation, INMO, figures. This echoes what my colleague, Deputy Harty, raised with the Taoiseach yesterday, that is, the need to keep care for people as local as possible and away from our acute hospitals. This is the very purpose of the home care package model.

The circumstances reflect an absence of any co-ordination within the HSE. Surely it would make more sense to prioritise home care packages that keep people out of hospitals in those areas where the hospitals are mostly in difficulty. It is not rocket science but the HSE seems to be totally unable to grapple with this and adapt to any kind of change. It is just trundling along from day to day and from year to year, with endless money being pumped in and fewer outcomes. Since we do not have the approach I advocate, we are creating problems at both ends of the spectrum. That is obvious.

Our CHO now has the lowest level of community care and the highest number of patients in accident and emergency departments, clogging up the corridors. This is completely unsustainable. Added to this is the fact that South Tipperary General Hospital has been unable to de-escalate from the full capacity protocol, making the problem even greater. The hospital has been subject to the full capacity protocol for 18 months now. It is farcical. Why is it subject to the protocol day in, day out?

As requested in the Private Members' motion of the Rural Independent Group last December, will the Taoiseach commit to establishing the home care package scheme in law, thereby giving people an automatic right to participate in it? We called for a re-evaluation of the scheme so it would be targeted at those areas, such as Tipperary, that are simultaneously trying to cope with a chronic lack of capacity at hospital level.

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