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

I thank the Deputies for raising this issue. Home supports enable older people to remain in their own homes and communities, as well as facilitating timely discharge from hospital. As outlined in the HSE’s national service plan for 2019, the HSE maximises the utilisation of current resources prioritising those requiring discharge from acute hospitals. Significant resources and services in 2019 have been targeted to facilitate timely egress. Last winter the focus was on reducing delayed patient discharges through mobilising the additional resources made available, as well as ensuring social care measures were effectively deployed to enable older people to move to a more appropriate care setting, including to step-down or transitional care or their own home with the supports they need.

The national service plan for 2019 sets a target to deliver 18.26 million hours to over 53,000 people, including 360,000 hours as part of an intensive home care package. By the end of July, more than 10 million hours of home support had been delivered nationally with almost 52,000 people in receipt of the service. The most recent preliminary data available indicates this has increased to over 11.8 million hours by the end of August. Despite this significant level of provision, demand for home support continues to grow and nationally over 7,000 people have been assessed and are waiting for either new or additional services. Arrangements for home supports have developed over the years with a significant local focus. It is acknowledged by the HSE that there may be a considerable variation in access to services in different parts of the country. The recent report from the ESRI, published in July of this year, Geographic Profile of Healthcare Needs and Non-Acute Healthcare Supply in Ireland, highlighted this variation across counties and regions.

I acknowledge that in some cases access to the service may take longer than we would like. However, the HSE has assured the Department that people on the waiting list are reviewed, as funding becomes available, to ensure individual cases continue to be dealt with on a priority basis within available resources. They are also 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 the services being provided remain appropriate.

In line with commitments in the programme for Government, we have made improved access to home support services a priority in budget 2020. An additional investment of €52 million is being made in 2020 which will provide over 19.2 million hours of home support. This is 1 million hours more than the 2019 target, representing a substantial increase in service provision. This investment is focused on enabling older people to remain at home. As appropriate, provision of hours will also be targeted at times of peak demand, at the beginning and end of the year, to ensure more timely egress from hospital for older people.

While the existing home support service is delivering crucial support to many people, it needs to be improved to better meet the changing needs of our citizens. The Department of Health is developing plans for a new statutory scheme and system of regulation for home support services for older people and adults with a disability. Included in this investment is dedicated funding for the testing of the new statutory home support scheme in 2020. The design of the new scheme will involve the establishment of a model of service with a streamlined central system of administration to improve and simplify how people access home-support services. While the administration of the scheme will be centralised, the delivery of services will be co-ordinated at local level in line with a person's assessed need. This scale of investment clearly demonstrates the Government's commitment to addressing the issue through the introduction of standardised assessments, as well as additional resourcing which will go a long way towards the elimination of waiting lists and piloting of the new statutory scheme.

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