Peter Fitzpatrick (Louth, Independent) | Oireachtas source

There is an acute labour shortage of home care workers in the State. However, the Department of Enterprise, Trade and Employment refuted those labour market shortages in August, suggesting that the recruitment challenges were because of a failure to guarantee hours of work and the lack of travel and subsistence payments. Although it was aware of this reasoning, the Government did not address those long-term pay and conditions issues, which have subsequently harmed recruitment and retention. Instead, the Government is overreliant on private, non-HSE home care providers to fill the gap in the market. Although the national service plan for 2022 makes significant promises in delivering a national service framework that defines a financially and operationally sustainable model for public long-term residential care and intermediate rehabilitation care, only 38% of home support services are delivered directly by the HSE.

As of July, waiting lists for home care support had escalated sixfold in just a few months to 5,000, leaving those with additional needs struggling and unable to stay in the comfort of their own home. On top of this, almost 10% of all older people approved for home support have no carer. If demographic projections for hospital and home care admissions are correct, the demand for such care will grow significantly over the coming years, putting significant pressure on our health system, which cannot and will not cope safely. These failures to provide improved pathways of home care are pushing older people into overcrowded hospitals and nursing homes. The lack of community care alternatives has left more than 7,000 people delayed in a hospital when they should be cared for in their own home, if they had a carer.

A huge number of people have moved to my constituency of Louth and to east Meath in recent years. There are long hospital waiting lists, GP shortages, long waiting times to access child protection and welfare services and now an acute labour shortage of home care workers. I was contacted today by the family of an 88-year-old woman who is currently in hospital after a stroke. Having been granted discharge following treatment, this woman cannot go home as she is still awaiting a care package from the HSE. An 88-year-old stuck in hospital for that long is ridiculous. The members of her family are exhausted fighting for what should be rightfully available for their mother. They are at their wit's end. They are doing everything they can to ensure she gets the required care.

We learned many lessons during the Covid pandemic. One is that care of our older people is far from ideal. These issues are predominant and are only going to get worse. There are poor standards and a lack of authority for safeguarding. The Government says it is committed to ensuring standards and putting safeguarding on a statutory basis. It must advance vital regulation for the home care sector and should make legislation in this regard a priority. Delivering proper home care would reduce the length of hospital stays, the risk of hospitalisation, pressures on emergency departments and delayed discharges.

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