Marc MacSharry (Sligo-Leitrim, Fianna Fail) | Oireachtas source

I welcome the opportunity to make a few points on this issue. In the context of a previous matter, another Deputy appealed to the Minister of State to make work permits available to people who are prepared to join the workforce in Ireland as carers because there is such a shortage of staff in this area. I would support that as something which may help to address the problem. We are reaping the rewards of a very short-sighted approach taken some ten to 12 years ago, when financial challenges were to the forefront and when the HSE, in effect, changed its strategy of recruiting home help workers into its permanent staff and instead farmed the service out to private agencies. This led to a growth in such agencies, which are being paid X and are paying the carers who provide the service Y. We are seeing a mass exodus of staff from the private agencies offering home help care. While the HSE is beginning to try to recruit in order to ensure that we have appropriate staff numbers, there is a crisis in the here and now.

I offer one example of a dependent person needing home help provision who will not recover. In this instance, it is not a rehabilitation situation; it is about the provision of care to end of life. This individual has a very generous package of 42 hours per week, but only 26 of those hours can be delivered because of the shortage of staff prepared to do the work and who are available, either through agencies or from the HSE. This person's situation is indicative of an emergency that will lead to an exponential growth in the numbers attending hospitals unnecessarily, in the delays for discharge and in demands for nursing home beds. All of this, in turn, will put our entire health service into chaos.

While I am conscious that public pay talks will be commencing soon, we cannot wait two years for agreement. We need to be prepared to pay home carers an appropriate level of remuneration and expenses consistent with the astronomical rises in fuel and other expenses relevant to this area. This is not something that can wait for reviews, sub-committees, consultants' reports or anything like that. Somebody has to take the bull by the horns and take action now because, otherwise, it will cost too much in terms of the spin-off problems that will arise in our wider health service. We must increase the pay rates and remuneration for home care staff and ensure that they receive adequate expenses to look after the people who are rehabilitating at home and, in line with our national policy, those who are in the twilight of their lives and require full-time care at home.

In fairness to the Minister of State, Deputy Butler, she is making all the hours available. The problem is we are not paying the correct rates to get the job done. There is a superficial granting of hours, as in the case of the poor patient to whom I referred. That individual has been given 42 hours but, in reality, only 26 can be delivered. This is unsustainable. I would like to see us dealing with this crisis with the same gusto, can-do attitude and speed with which we were prepared to take measures in the management of the Covid crisis and, indeed, in welcoming our Ukrainian friends who have been running for their lives.

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