Thomas Pringle (Donegal, Independent) | Oireachtas source

Fine Gael must be living in a parallel universe when the Taoiseach says that additional funding has been provided in the budget for home help hours, while cuts have been announced in the form of a suspension of all approvals to home help applications. The HSE has suspended home help hours and new applications, despite there being more than 6,000 people on the waiting list for home care support. What a sorry state of affairs it is that this is happening during carers' week, when we recognise the Trojan contribution carers make to people. The HSE confirmed that it is to block new applications between now and early November to balance the budget for this year and this is, no doubt, directly related to the constant health overspend, since Fine Gael came to power and before that too. However, the irony is that stopping funding home help for six months will only exacerbate the problem at the other end. The Minister knows this but insists on doing it because the Government constantly states that it has a budget figure and that is that.

One has to spend money to save money and this health service will never work if it does not realise this. At the current rate, numbers are set to increase as demand for services increases and the population ages. The crux of the problem remains a lack of HSE funding to meet current and growing demand for home help hours. The Government is just delaying the inevitable and is, in fact, making it worse. The number waiting for home help hours in Donegal has doubled from last year. Figures from the HSE show that there were 215 clients waiting for home help in Donegal as of January 2019, an increase of 116 on last year. Numbers have been steadily increasing year on year. In December 2016 there were 139 people waiting for home help hour approvals while, in October 2017, there were 340. There are patients lying in hospital in Letterkenny, costing about €8,000 per week while they could be in the community, getting home help hours for maybe €100 per week.

The problem is that no money is saved in that situation. More money is actually spent because as soon as the bed in the hospital becomes free somebody else takes it up and money must be spent treating him or her. Money is actually saved by keeping beds in hospitals blocked up. That is how the HSE is saving the money. That is the only way in which it can be saved. If that bed stays occupied nobody can get into it and, therefore, money does not need to be spent on treatment. Money also does not need to be spent on home help for the person who leaves the bed and the hospital. That is how the money is saved. That is sad because it means we can never get past this situation. This kind of debate will happen every year from now into the future if it is all going to be based on money alone. We in this House need to get over that and to accept that it will cost more to deal with the health service and to get it right. Initially it will cost more to get it right. That is the problem. That is where we are going to be stuck. If we get people through the hospitals and provide them with proper home help as they live in their communities, we will start to see things easing off on the hospital side. Funding pressures on hospitals will drop and money will start to be saved.

The real reason that home help causes problems and is a difficulty is because it cannot be privatised. If the Government and the HSE could figure out a way to give the private sector balls of money to look after home help this would be sorted out in the morning. That is the ultimate problem; that is what is wrong. The Government cannot see a way to privatise it and that is why home help is not being provided. That is sad because it is the cheapest and best form of care. It is what the people in the communities and the families want. Everybody wants it but the Government cannot grasp that and will not provide it.

The HSE in Donegal has a crazy system under which it says it cannot get people to work in home help. It offers a ten-hour contract for the week. For half of what one would get on the dole one can get a contract with the HSE. One cannot sign on because the hours are spread out over the course of the week, so it is a waste of time and the HSE cannot get anybody to do it. If the HSE offered a 20-hour contract people could make a living. They could get family income supplement to make up the difference. They could get a wage and come off the dole. It would be to people's advantage to take up such a contract and to provide the home help but the HSE will not offer it because the money would have to be increased. If the money could be given to the private sector it would be done in the morning. That is the sad thing.

See this speech in context