Maureen O'Sullivan (Dublin Central, Independent) | Oireachtas source

Everyone agrees that home help is invaluable. It keeps a person at home and in his or her own community. In the majority of cases, that is much better, in particular psychologically, for the person as well as economically given the cost of home care versus that of a hospital bed or nursing home care. There are people in hospitals and nursing homes who should not be there and would not be if home help provision was available. I have had some positive experiences of where this has been extremely helpful. I think in particular of a friend who suffered with motor neuron disease for six years and received great care. It involved care being provided from different sources, however, which is difficult unless the family is able to address the issue.

Many people in my constituency receive home care, in particular where I live in East Wall. Tremendous work is being done, as every Member has said. I refer in particular to the work of the voluntary community organisation whose service I know best. I put down a parliamentary question on it to which a reply eventually came back from the HSE. The HSE is trying to streamline the service in a certain way which is not positive for some of the community home care providers. As the particular service I know is not part of the HSE's 2018 tender, it is being undermined and undervalued, yet it is doing tremendous work. The staff are from the area which means not much travel is involved. They know the area and all the local services. They know the people they are caring for. As they are from the area and provide more hours than they are paid for, they are available beyond the provided-for hours if there is an emergency. As they are not part of the tender, however, they are not being allocated new clients. That means the generic budget will continue to be reduced and the number of home-support clients will decline. Consequently, the community group providing this valuable service will have to close. This is a real community initiative. However, I am finding recently that the HSE is not supportive of community initiatives where the community identifies needs and responds.

It appears that the HSE's agenda is top-down rather than bottom-up. Unfortunately, we are seeing other examples of that in other parts of Dublin. In reply to my parliamentary question, the HSE said formal arrangements were being made with external providers to ensure fairness and transparency in the selection of service provision. We have a group that is providing that service fairly and transparently as it is and yet it could be replaced by an external provider. I note discussion of streamlining the home help and home care services into a single home-support service. While that sounds fine, I find it difficult to accept that a community service may end while an external provider is brought in. I find danger in the words "streamlining" and "streamlining process" because I feel the smaller community provider will not be part of the process and will not be encouraged to be part of it either. The community service to which I refer has been operating for years. I note the Government's amendment and the recent announcement of an increase in the home-support budget. The Government says the HSE's national service plan will deliver further hours. The Minister of State said that individual cases will be looked at on a priority basis and determined by local front-line staff who know and understand clients' needs. Community home care organisations have been providing that service inside and outside the tender process and I hope they can continue to do so. They are providing a very worthwhile service.

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