Damien English (Meath West, Fine Gael) | Oireachtas source

I thank the Deputy for raising this very important issue, which affects many people, and their families, who are in need of home care throughout the country. It is an issue that has been discussed a great deal in this House with the Taoiseach, the Tánaiste and the Minister of State, Deputy Butler, who has been addressing it in a number of ways. The Minister of State could not be here tonight and has asked me to take the matter on her behalf. I certainly will convey the Deputy's clear message to her.

The Government is very much committed to the development of improved community-based services, shifting care to the home and offering greater choice for older people to be able to remain at home for as long as possible. We want to ensure the people who need that care can receive it, including the person to whom the Deputy referred, for whom more than 40 hours was approved. In budget 2021, the Minister of State secured additional funding of €150 million for home support to progress the development of a reformed model of service delivery to underpin the statutory scheme for the financing and regulation of home support services and provide 5 million additional hours of home support. The funding secured in budget 2021 to provide those additional 5 million hours has been maintained for 2022. In 2021, some 20.4 million hours were provided to more than 55,000 people. This is approximately 2.9 million more hours, or an increase of 17%, compared with 2020. That increase was needed because, as the Deputy noted, demand is up. Preliminary activity data currently available show that in the period to the end of April 2022, some 6.9 million home support hours were delivered nationally to just under 55,000 people.

Significant inroads have been achieved in reducing waiting lists for funding approval for new or additional service from more than 7,800 in January 2020 to 302 in April 2022. This reduction has been achieved through a combination of validation of the waiting lists and availability of additional funding to address those waiting. However, there can be a lag between funding approval and the delivery of home support hours. Certain geographical areas that are experiencing increased pressures due to staff availability are particularly affected. At the end of April, provisional information shows there were 5,344 people for whom funding for home support had been approved and who were waiting for a carer to be assigned. It is important to note that the total number of people waiting for home support has reduced from more than 9,000 at the start of 2020.

Supporting egress from acute hospitals is a key priority of the Government, and each community healthcare organisation area has dedicated staff working closely with the hospitals. As of 7 June, 531 patients nationally were waiting to be discharged from hospital. A total of 96 patients were waiting to be discharged home with home supports, with 59 waiting on a carer to become available. Transitional care funding continues to be in place on a demand-led basis to support patients discharging from acute hospital to long-stay care and for patients who require convalescence care before returning home.

The HSE continues to advertise on an ongoing basis throughout the country for healthcare support assistants and to recruit as many suitable candidates as possible. Due to the nature of the role, this recruitment is normally conducted at a very local level. In addition, approved private home support providers continue to recruit home support workers. The Minister of State is very much aware of the strategic workforce challenges in the home support and nursing homes sector. In recent weeks, she has had meetings with the HSE to discuss the potential of a renewed focus on advertising these positions locally. There is a renewed effort to recruit the staff to provide the care. She has also established a cross-departmental strategic workforce advisory group to examine issues such as recruitment, retention, training and the career development of front-line carers in home support and nursing homes into the future, with a view to ensuring that solutions can be identified and implemented.

It is also expected that the pay and conditions for these workers will be examined. The Deputy asked that these facets be examined. He also said an urgent decision was needed, but this work now looks like it will be due to complete early in September, with recommendations being provided. The Minister of State, Deputy Butler, wishes to achieve the goal of ensuring there is an adequate supply of appropriately-skilled healthcare support assistants. That is a key aim of this initiative. Hopefully, therefore, the report and this work will bring some success in September.

I also engaged with the Minister of State regarding the permanent option. We made changes in April 2021 to the healthcare assistant role in nursing home settings, but not in home settings. This aspect is one that can be reappraised in the next review, which will commence soon. A major part of the focus, however, must be on the terms and conditions and what contracts are on offer. I refer to them being full time, because the terms are generally concerned with those types of contracts.

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