Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank Deputy Ó Murchú for raising this important issue. It is a timely one, as tomorrow we celebrate the UN International Day for Older People. It is a key priority for the Government and for me to enable more people to engage in services that allow them to remain independent and live in their own homes with dignity for as long as possible. To advance this, the Government is committed to establishing a new statutory scheme on home support. In July, I announced the selection of four sites to test a reformed model of service delivery, through the delivery of 230,000 hours of home support. The four CHOs selected were CHO 2, CHO 4, CHO 7 and CHO 8. This pilot will underpin the development of the statutory scheme for home support services and will be fully operational on 1 November.

A national home support office will also be established before the end of this year to support the testing of the reformed model of service delivery. In addition, approximately 130 posts have been funded for the national roll-out of the interRAI Ireland system, which the home support pilot will test as the standard assessment tool for care needs. Recruitment for these posts will commence shortly. In parallel, work is ongoing by the Department to make progress with other aspects of the scheme, including the development of a regulatory framework and the examination of options for the financing model. The Economic and Social Research Institute, ESRI, is examining that aspect for us.

To answer the Deputy's specific question, while this new home support scheme is under development, the Government is prioritising improving access to home support services for older people. An additional €150 million was allocated in budget 2021 to provide for 24 million hours of home support. This is an increase of 5 million hours, or more than 25% on 2020. Therefore, my budget for home support this year is €666 million, and that is a phenomenal amount of money. Provisional data indicate that at the end of August 2021, approximately 13.2 million home support hours had been provided to 53,905 people. This is about 2 million more hours compared to the same period last year. Approximately 478 people were waiting for funding approval, representing an 88% reduction compared to the same period in 2020. This has resulted in keeping 1,200 people out of nursing homes this year alone.

The difference now is that in other years, we did not have the funding. This year, I have the funding but we have a shortage of staff. That is the whole issue. Due to these issues with capacity and staff availability, there are sometimes delays between the approval of funding and the delivery of home support hours. There are ongoing difficulties with the recruitment and retention of staff, with particular local areas experiencing increased pressures. This is particularly the case at weekends and in rural areas. It is a problem in my constituency. This no doubt affects access to home support for approved clients, even where funding is available. At the end of August, some 4,449 people had been assessed, approved and were waiting for a carer to become available. The funding is there to support the package of exactly what those people need. The problem, though, is that we do not have the carers to deliver the packages. As a result, this week I met Joseph Musgrave, CEO of Home and Community Care Ireland, HCCI. I also met representatives of the HSE. I spoke to them this morning to see what we can do to resolve this issue. It is not an issue with funding. I have the required money. We have established a strategic workforce advisory group with the involvement of key stakeholders, including representatives from the sector, education and the Government. Someone delivering home support now has to have a level 5 qualification before entering the house. The group will provide a forum for practical actions. It will also look, however, at aspects such as recruitment and retention. Terms and conditions are important for private providers as well. There is a financial issue in respect of mileage if, for example, a carer is going out to a rural area three or four times a day.

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