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

I thank the House for raising this business. There has been much speculation and media attention in recent weeks asserting that there might be a cut in the funding available for home care. This is not the case and I am glad to have the opportunity to clarify the position.

Home supports enable older people to remain in their own homes and communities. They also facilitate the timely discharge from hospital. The Government has made improved access to home support services a priority. This is reflected in the ongoing additional investment made in these services in recent years, with the budget growing from €306 million in 2015 to almost €446 million in 2019. That is an increase of approximately 45% in the annual budget for home support. In 2018, the total budget for the service was €416.8 million, providing over 17.5 million hours. This year, the HSE intends to provide approximately 18.2 million home support hours, including intensive home care packages, to more than 53,000 people. In 2019, almost €30 million has been added to the home support budget. When one considers the year-on-year targets, this means that this year's national service plan targets the delivery of 800,000 more hours than the 2018 target.

Throughout the winter period, additional home support was provided, supporting early hospital discharges and preventing hospital admissions. Almost 1,100 clients were approved for new home supports nationally and 857 packages had commenced by the end of March 2019. Preliminary information for the end of April indicates that 52,571 people were in receipt of home support hours, including those in receipt of intensive home care packages. Between January and April, approximately 5.8 million hours were delivered, with 5,761 new clients commencing the service. This is 144,000 more hours than were delivered during the same period last year.

The allocation of funding for home supports, though significant, is finite and services must be delivered within the funding available. The home support service is not demand led and is therefore operated in line with agreed budgetary limits and targets as set out in the HSE's national service plan. Services allocated to new clients and additional hours provided to existing clients are dependent on a number of factors, including the number of additional hours approved and funded each year, the hours that become available through recycling, the value of the service that becomes available for recycling and the value of the service required by the new or existing client.

To achieve compliance with its funding allocation, the HSE must ensure that the value of the total number of hours provided does not exceed the budget. This means that the HSE has to manage its service delivery over the course of the year to align with the total funding available. It also has a responsibility to ensure that activity is planned so as to anticipate critical demand pressures, most particularly in respect of emergency pressures in the initial and latter parts of the year. The significant roll-out of packages in the first quarter of the year reflected these requirements, with the HSE now managing the recycling of hours in line with normal prudent management of its budget, as it does every year.

It is not correct to say that no new clients will be allocated home supports for the next five months. The allocation of new hours will be based on clients' needs and the resources available, and the recycling of hours is ongoing in line with budgetary management. I acknowledge that, in some cases, accessing the service may take longer than we would like. Despite the significant level of provision, demand for home support continues to grow and 6,310 people have been assessed and are waiting for either new or additional services. However, the HSE has assured the Department that people on the waiting list are reviewed as funding becomes available so as to ensure that individual cases continue to be dealt with on a priority basis within the available resources and as determined by the local front-line staff, who know and understand the clients' needs and who undertake regular reviews of those care needs to ensure that the services being provided remain appropriate.

While the home support service is delivering crucial support to many people across the country, the Government fully accepts that it needs to be further improved to meet the changing needs of our citizens better. It is for this reason that my Department is progressing the development of a new statutory scheme and system of regulation for home support services. The Sláintecare implementation strategy commits to the introduction of the new scheme in 2021.

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