Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I am glad that workforce is a focus of today's motion. The Government is committed to improving recruitment and retention.

In March 2022, I established the strategic workforce advisory group on home carers and nursing home healthcare assistants. It set out to examine and, most importantly, propose solutions. The group was chaired by the Department of Health and comprised representatives from seven Departments, the HSE, HIQA and SOLAS. The report of the advisory group was published on 15 October. It presented 16 recommendations, which I fully endorse, spanning the areas of recruitment, pay and conditions, barriers to employment, training and professional development, sectoral reform and monitoring and implementation. I am pleased that significant progress has been made in implementing these recommendations. A group has been established to drive their timely implementation. The group’s most recent meeting took place in October. This week, my Department will publish a progress update, following the publication of the group's terms of reference and a schedule of meetings. It will go live on the website in the next 24 hours or so.

Recommendation 9 has been fully implemented. The statutory instrument authorising the issuance of 1,000 employment permits for home care workers was signed in December 2022. These permits will be for full-time positions with a minimum salary of €27,000 per year. Some 330 permits have been availed of to date. The implementation of the 16 recommendations will have a lasting, positive impact on waiting lists.

As Deputies will be aware, 60% of home support is provided by private and voluntary agencies. A new HSE tender with these agencies was agreed in August 2023. The new tender rate was backdated to July as a gesture of goodwill. The new tender provides for a core rate of €31 per hour for providers, which works out at an average rate of €34 per hour when taking into account weekends, evening premiums and so on. The new HSE tender for home support providers also commits private and voluntary providers to paying their staff the living wage, which was €13.10 per hour at the time, travel time between appointments, which is €2.99 per hour, and reform of legacy rates. The new HSE home support tender has an in-built review process relating to the national living wage after 12 months so that will be revisited in July and August of next year. There is no evidence that this rate is not being paid. I have met Home and Community Care Ireland, HCCI, every quarter since I became Minister. I meet it regularly. The Department has not had any correspondence that this rate is not being paid by the private providers. I am not saying that other Deputies may not have received correspondence.

The tender will deliver some significant reforms that will directly improve conditions for home care workers. The terms and conditions of each private and voluntary organisation are a matter for themselves. However, they must abide by the minimum payments agreed in the tender, which includes €2.99 per hour for travel time incurred by the home support worker. This is the first time ever that all home support workers delivering care are entitled to receive payment for their travel time. I have to admit that some companies paid that previously, though not all. As per the request of the sector, more than 110 legacy rates dating back over numerous years were also addressed, resulting in the agreed core rate of €31 per hour. It is expected that the new tender should assist in the sourcing of additional hours.

Two core rates are prescribed in the home support authorisation scheme tender, which are a 60-minute rate and a 30-minute rate. Tender 2023, the authorisation scheme, does not provide for a 45-minute rate. A pro ratahourly rate will apply to 45 minute call-outs for new clients commencing a service after the commencement date of the authorisation scheme. However, the range and volume of hours allocated to home support clients is based on their individual assessed care needs.

The motion refers to the pandemic recognition payment. It is important to recognise the efforts of healthcare workers during Covid-19. The pandemic recognition payment was open to applications from public, private and voluntary home support providers. I am pleased that all 136 home support agencies that submitted a claim for eligible staff have been paid. In the programme for Government, we committed to introducing a statutory scheme for home care. A key step in this process is to regulate home support services so that no matter where or how care is provided, everyone can be assured that their provider meets minimum standards of quality, safeguarding and governance. Progress continues on this front.

My Department is currently preparing primary legislation to accompany the regulations. This has been prioritised for drafting in the autumn programme and I will bring the Bill to the Oireachtas this year. As per the programme for Government, the Government is committed to establishing a commission on care for older persons. The proposal for the commission that the Minister, Deputy Donnelly, and I brought forward was approved by the Government on 3 October and in budget 2024, we secured €1.24 million to support the commission's work. The commission will examine the provision of health and social care services and supports for older people and make recommendations to the Government for their strategic development. A cross-departmental group will be established under the commission to consider whether the supports for positive ageing across the life course are fit for purpose and to develop a costed implementation plan to optimise these supports.

Ireland is deemed by the World Health Organization to have the highest life expectancy in the EU. We were also the first country to be designated age friendly status in 2019. This did not happen by accident. The triangle of supports of home care, day care and meals on wheels, including dementia-specific supports, are a key factor in supporting older people to age well in their own homes. With home care, these wraparound supports are vital to prevent loneliness and social isolation, and to maintain positive overall health and well-being. This is why I have allocated increased funding for this every year since the formation of this Government. Significant reform and investment in home support services is underway and is delivering more hours and more funding than ever before, and better terms and conditions for all who work hard to deliver home supports up and down the country every day. This Government is committed to supporting healthy and positive ageing.

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