Finian McGrath (Dublin Bay North, Independent) | Oireachtas source

I thank Deputies Buckley, Ferris and Ó Laoghaire for raising this very important issue. I shall take this matter on behalf of the Minister of State, Deputy Jim Daly.

The overarching policy of the Government is to support older people to move to a more appropriate care setting following treatment in acute hospitals and ultimately either to return to live as independently as possible in their own homes and communities, or for those who need it to move to residential care.

The National Service Plan 2019 provides an overall financial allocation of €1.8 billion of which €862 million is available for older persons' services and more than €985 million is available for the nursing home support scheme. In 2019 some 53,000 people will receive 17.9 million home support hours. This includes supporting 550 patients to leave hospital over the winter period. A further 235 people will receive 360,000 hours through intensive home care packages. More than 10,900 people will be supported to leave hospital through transitional care funding. We take this important issue very seriously.

The provision of transitional care beds assists with patients in acute hospitals who are ready for discharge, but who need nursing home care or a period of convalescence up to a maximum of four weeks. The scheme funds these patients in private nursing home beds, thereby facilitating the discharge of the patients from the acute setting and allowing their beds to be used for other patients. The system of transitional care provision has been in place since 2015 and is available to all public hospitals in the State.

Under the HSE’s National Service Plan 2019, a budget of €28.5 million has been allocated to support discharges from acute hospitals to transitional or step-down care. Despite this significant level of funding and service provision, the demand for services continues to grow. The allocation of funding across the system, though significant, is finite and services must be delivered within the funding available.

Up to May 2019, approvals were being allocated on a demand-led basis, as requests for this type of care normally tend to decrease over the summer months. This, however, has not been the case in 2019 and the number of requests for transitional care has continued to increase. The highest expenditure for the year occurred in the months of April and May 2019. The waiting time for transitional care at present is approximately one week. As of today, there are 23 people on the waiting list for transitional care funding who have applied for the fair deal scheme.

Transitional care funding is a national support service and there is no specific allocation for any region such as the Cork/Kerry Community Health Organisation. It is administered taking account of the available resource envelope, with funding distributed accordingly across the regions over the entire year. By the end of May, funding approval was provided for 378 transitional care beds in CHO 4. Preliminary data from June indicates that about a further 60 approvals were provided for CHO 4 in that month.

The HSE is required to deliver services within its available budget. To ensure there is sufficient funding available for the remainder of the year and to ensure that expenditure is in line with the transitional care funding allocation at the end of the year the HSE is managing its allocation of funding approvals having regard to the significant volume of approvals released in the first five months of the year. This means that since the start of June the rate of approvals has reduced compared to the early part of the year. Approvals will continue to be monitored closely and funding will be adjusted on a monthly basis to ensure a balanced budget for 2019.

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