Colm Burke (Cork North Central, Fine Gael) | Oireachtas source

I move: "That the Bill be now read a Second Time."

In 2011, the Law Reform Commission published a report, entitled Legal Aspects of Professional Home Care. It set out clear recommendations in this area. To implement these recommendations, it is necessary to introduce legislation to amend the Health Act 2007, which is exactly what this Bill does. The new Bill is necessary and is designed to provide regulation in the area of professional home care. It provides an appropriate regulatory framework and legal standards to be put in place for professional carers, as opposed to informal carers, engaged in the provision of care for people who live in their own home.

The number of people aged over 65 has increased in the past four years, from 629,000 to 720,000. This is an increase of 90,000. By 2030, there will be 1 million people over 65 in this country. Over recent years, the number of people over 80 years of age has increased. In fact, their number in 2016 was 149,000. Based on the figures available to the Central Statistics Office, CSO, it is predicted that by 2036, which is only 16 years away, their number will be 338,000. The majority of older people live active lives. A minority require assistance to live independently, and the increase in the older population is likely to result in a greater need for community-based health and social care services. Government strategy signifies a clear preference to maintain elderly people in their own homes, and yet despite this commitment, there is an absence of a regulatory framework. Home care is not confined to older people. It also involves those who develop a chronic illness, those who have a physical or mental disability or those who are recovering at home after a serious car or work accident.

The Bill provides for the extension of the function of HIQA to include the setting of standards in services provided by professional home care providers. It gives power to the Minister for Health to put in place regulations dealing with all aspects of home care, including the requirement to prepare a home care plan. It also allows the Minister to put regulations in place which provide that standards are set for detailed training requirements for those providing these services. The change in legislation provided for in this Bill is necessary if we want to guarantee safe, secure home care for all members of society who need it.

This is the third time I have introduced this Bill. I introduced it in 2014, in 2016 and now in 2020. This is not a criticism of the Minister of State, Deputy Butler, or anyone previously. I fully understand that the Department has a heavy work schedule, but this was first discussed in 2009. Then the Law Reform Commission produced its report in 2011. It is nine years since that report was produced. It is time to move on with this.

I will quickly go through the sections in the Bill. Section 1 is a standard section setting out necessary definitions.

Section 2(1) amends the definition of designated centres in section 2(1) of the Health Act 2007 to include undertakings, both unincorporated and incorporated, and whether established for gain or not established for gain, which are involved in the provision of professional home care services.

Subsection (2) provides that professional home care should be defined as services which are required to ensure that an adult person can continue to live independently in his or her own home. This may include, but is not limited to, the services of nurses, home care attendants, home helps, various therapies and personal care. It provides that palliative care be included in the definition of professional home care. It also provides that the proposed legislative framework should apply to undertakings which provide professional home care to persons aged 18 years and over.

Section 3(1) provides that section 8(1)(b) of the Health Act 2007 be amended to extend the functions of the Health Information and Quality Authority to include the setting of standards in services provided by professional home care providers. Subsection (2)(a) and (b) provide the Health Service Executive's National Quality Guidelines for Home Care Support Services should form the basis for national standards for professional home care to be prepared by HIQA under the Health Act 2007. Subsection (2)(c) deals with the issue concerning risk assessments. Subsection (2)(d) deals with the matter concerning the care plan, including the companionship plan, the home care plan and advance home care plan. Subsection (2)(e) provides that the standards include requirements concerning the handling of money and property by the professional care provider on behalf of the care recipient.

Subsection (2)(f) provides that the standards include specific guidance on safety and health requirements in the delivery of professional care in the home, including suitable guidance on manual handling, which shall be developed in liaison with the Health and Safety Authority. Subsection (2)(g) provides that the standards include relevant and detailed training requirements for those providing professional home care services. Subsection (2)(h) seeks to ensure that the standards provide that a contract for the provision of home care must include specific provisions setting out, in plain and easily understood language, the fee arrangements between the contracting parties for the agreed services. Subsection (3) provides the guiding principles to be applied in the legislative framework.

Section 4 provides that the social services inspectorate establish a registry of all professional home carers.

Section 5 provides that the ministerial regulation making powers conferred on the Minister under section 101 of the Health Act 2007 be extended to and include the authority to make regulations that apply to an undertaking involved in the provision of professional home care services.

Section 6 includes several subsections. It provides that an assessment of needs of care recipients must be carried out prior to the provision of care and that the assessment considers both the needs of and outcomes desired by the care recipient. Section 6(3) provides for an undertaking providing professional home care services shall make available an easily understood, well publicised and accessible complaints procedure. Section 6(4) provides for an undertaking providing professional home care services shall have policies in place to ensure that professional home care recipients are protected from all forms of abuse. Section 6(5) provides an undertaking providing professional home care services shall agree with the care recipient policies and procedures on the administration of medication in the home, which must be included in the care plan; and maintain a log in the home of all medication administered, which shall be accessible to all. Section 6(6) provides for an undertaking providing professional home care services shall include in the contract for care policies and procedures concerning the handling of money and property by the professional care provider on behalf of the care recipient. Section 6(7) provides that only suitably trained personnel may provide professional home care. Section 6(8) provides an undertaking providing professional home care services shall adequately supervise the individual home care providers to ensure the maintenance of care standards.

Section 7 is a standard section setting out the short title and commencement of arrangements.

Especially now, when we see the challenges posed by Covid, where more people want to continue to reside in their homes but also require necessary support from home care services, this Bill is necessary.

See this speech in context